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January 19, 2017

What Trump's HHS nominee just told the Senate on value-based care, the ACA, and more

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The Senate Health, Education, Labor, and Pensions (HELP) Committee on Wednesday held the chamber's first hearing on Rep. Tom Price's (R-Ga.) nomination for HHS secretary.

The Senate HELP committee will not vote on Price's confirmation. The Senate Finance Committee, which will vote on the confirmation, has scheduled a hearing on his nomination for Tuesday.

Price, a House lawmaker and former orthopedic surgeon, has long opposed the Affordable Care Act (ACA).

Hearing details

Price fielded questions from committee members about CMS' Center for Medicare and Medicaid Innovation (CMMI), the GOP's plans to repeal the ACA, and other health care issues.

Comments on the ACA

According to the Wall Street Journal, much of the hearing focused on Republicans' plans to repeal the ACA.

In response to a question from Sen. Patty Murray (D-Wash.) on whether the Trump administration would increase the number of uninsured Americans, Price told committee members that it's "not our goal or our desire, nor is it our plan" to have people lose their health coverage. Price added, "We all want a health care system that's affordable, that's accessible to all, of the highest quality, with the greatest number of choices, driven by world-leading innovations, and responsive to the needs of the individual patient."

Both Democrats and Republicans asked Price for details on the GOP's plans to replace the health reform law. Price did not provide specific details, and instead offered only "vague reassurance," according to the New York Times.

Price said his ideas for replacing the ACA include giving U.S. residents more options and eliminating certain mandates. He also said health savings accounts and high-deductible catastrophic coverage "make a whole lot of sense for many individuals."

Comments on CMMI, other models

Committee members also asked Price about whether Republicans would seek to eliminate CMMI.

According to Modern Healthcare, Price, who has criticized CMMI in the past, did not commit to keeping or eliminating the center, but said that it "has great possibility and great promise."

Price said he is opposed to CMMI making certain payment models mandatory. Price added, "I am a strong proponent and advocate for innovation, but I have seen in certain instances what is coming out of CMMI is a desire to require certain kind of treatment for certain diseases that may or may not be in the best interest of the patient."

He continued, "Because it carries the full force of the federal government and the payment for those services, it means we are answering the question of who decides about what kind of care patients receive, by saying the answer on that ought to be Washington, D.C. I simply reject that that is where those decisions ought to be made."

Comments on Price's stocks

Price also fielded ethics questions related to his stock trades during his time in the House. According to the Journal, Price traded stock in dozens of companies while supporting legislation that could affect those companies.

CNN: Trump HHS pick invested in device company, then intro'd bill that could have benefited it

Sen. Elizabeth Warren (D-Mass.) asked Price whether he had tried to "help the compan[ies] that you now own stock in" through his work in the House.

Price rejected that notion, saying, "I'm offended by the insinuation, senator."

Price also denied that he used non-public information to profit from the stock market and said that, for the most part, a broker independently directed his investment decisions.

However, Price acknowledged that he did personally direct an investment in Innate Immunotherapeutics, an Australia-based biomedical firm, after discussing the company with Rep. Chris Collins (R-N.Y.), who sits on the company's board and is its largest shareholder. Price said Collins "talked about the company and the work they were doing ... on progressive secondary multiple sclerosis." Price added, "I studied the company for a period of time and felt like it had significant merit and promise" and "directed the broker to purchase the stock."

Sen. Al Franken (D-Minn.) said Price was given a "sweetheart deal" for his stock in Innate Immunotherapeutics. Franken added, "I think our job is to avoid the appearance of conflict. And [Price has] not done that."

Comments on Medicare, Medicaid

During the hearing, Sen. Bernie Sanders (I-Vt.) said President-elect Donald Trump during his campaign repeatedly vowed not to cut Social Security, Medicare, or Medicaid. Sanders asked Price whether Trump planned to keep that promise.

Price responded, "I have no reason to believe that position has changed."

Report: 18M could lose coverage in first year after ACA repeal with no replacement

Still, Price—who in the past has supported proposals to transition Medicare to a "premium support" model—declined to make a similar pledge. Price said he has not yet discussed Medicare with Trump and added that the GOP's ACA replacement bill would not serve as a vehicle for Medicare reform.

Price said he would work to give states more flexibility under Medicaid if he is confirmed as HHS secretary. He also said he supports tying Medicaid eligibility to certain work requirements.

Comments on Rx drug prices

Committee members also asked Price questions about rising prescription drug prices.

Price in response said he would address the "root causes" of the issue in "a bipartisan way."

Price did not directly answer a question from Sanders about whether Price would work with Trump and Congress to develop legislation that would allow Medicare to negotiate prices with drugmakers. "You have my commitment to work with you and others to make sure that drug pricing is reasonable," Price responded.

Other comments

Committee members also raised questions about the value of EHRs.

Sen. Bill Cassidy (R-La.) said EHRs have hurt providers' productivity, and Price agreed. He said, "We've turned many physicians and other providers into data entry clerks and it detracts … from their productivity" and "ability to provide quality care."

However, Price said EHRs still yield benefits. EHRs, he said, "are so important from an innovative standpoint; [they] allow the patient the opportunity to have their health history with them at all times and be able to allow whatever physician or other provider access to that."

 (Sullivan/Hellmann, The Hill, 1/18; Pear/Kaplan, New York Times, 1/18; Armour/Radnofsky, Wall Street Journal, 1/18; Alonso-Zaldivar/Fram, AP/Sacramento Bee, 1/18; Grimaldi/Hackman, Wall Street Journal, 1/18; Muchmore, Modern Healthcare, 1/18; Cancryn, Politico, 1/18; Diamond, Politico, 1/18; Frieden/Firth, MedPage Today, 1/18; Young, Roll Call, 1/18; MacDonald, FierceHealthcare, 1/18; Shaw, FierceHealthcare, 1/18; Hensch, The Hill, 1/18; Rappleye, Becker's Hospital Review, 11/19).

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