3 possible changes to Pelosi's drug plan to watch as a House panel takes up bill

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A House committee is going to take up House Speaker Nancy Pelosi's major drug prices bill to give the Department of Health and Human Services the power to negotiate for lower drug prices. (Getty Images/Bill Chizek)

A House committee is expected to take up House Speaker Nancy Pelosi’s drug prices plan during a legislative session Thursday, but not before considering some changes including a massive $75,000-a-day fine for drug companies that don’t divulge revenues and expenditures.

The House Energy and Commerce Committee Wednesday released a series of amendments the committee will consider during the legislative markup Thursday of the plan, which would give Medicare the power to negotiate for lower drug prices.

The changes would drive the bill further to the left, which could imperil its chances in the Senate.

RELATED: Top Pelosi aide urges insurance industry to fight for drug prices plan, blunt opposition

The markup is the first step to getting the bill to the House floor. If the bill gets out of the House, it will head to a very skeptical GOP-controlled Senate, where Republican leaders have already called it “socialist.”

Some of the amendments the committee will consider are:

  • Requiring drug companies whose products are selected for negotiation by the Department of Health and Human Services (HHS) to submit a report to the agency 30 days before increasing the wholesale cost by 10% or more over a year or by 25% or more over a 36-month period. The manufacturer must report on the total expenditures for research and development and manufacturing for the product. The information would be published unless it is considered a trade secret or confidential. If a drug company doesn’t supply this information, they could face a fine of $75,000 a day.
  • Allowing prescription drug plans to give beneficiaries that have high drug costs the ability to pay for such costs in installments throughout the year, a process called “smoothing.” Beneficiaries that are eligible for the installment plan would already meet the $2,000 annual out-of-pocket deductible for a single prescription fill, according to the amendment. The requirement would go into effect in 2021.
  • Increasing the number of drugs for which HHS must negotiate with manufacturers for lower prices from 25 to 35. HHS can start out negotiating for 25 drugs a year, but that must increase to at least 30 by 2028 and 35 by 2033. Pelosi’s original bill requires HHS to select at least 25 brand-name drugs to negotiate for a lower price for Medicare that must be 120 times the median amount paid by other countries. Drug companies must also offer the negotiated price to commercial health plans. Several advocacy groups have called for the bill to boost the number of drugs eligible for negotiation. 

The committee will also consider several bills to add hearing, vision and dental benefits to Medicare Part B. Medicare currently covers hearing exams but not other hearing services or hearing aids. There also is no vision benefit.

RELATED: CBO: Pelosi drug plan saves $345B but could reduce flow of new drugs

The agency only covers some services for eye diseases such as glaucoma. The bill would add a vision benefit to cover contacts, routine eye exams and eyeglasses. Medicare also does not cover most dental health services.

Another bill would boost income eligibility levels for partial dual-eligible Medicare and Medicaid beneficiaries to get financial assistance.