EXPRESS SCRIPTS, INC. for EXPRESS SCRIPTS, INC.

Health Issues HCR

Regulatory policies related to the health reform law: structure, drug benefits, disclosure. Regulatory implementation of HITECH/accounting of disclosures. Issues regarding making prescription drugs more affordable. Restrictions on specialty tiering.

Contacted: Health & Human Services, Dept of (HHS); Centers For Medicare and Medicaid Services (CMS); Medicare Payment Advisory Commission (MedPAC); White House Office; Government Accountability Office (GAO); Food & Drug Administration (FDA); Executive Office of the President (EOP); Congressional Budget Office (CBO); SENATE; Federal Trade Commission (FTC); Labor, Dept of (DOL); Health Resources & Services Administration (HRSA); HOUSE OF REPRESENTATIVES; Internal Revenue Service (IRS); Office of Personnel Management (OPM)

Medicare/Medicaid MMM

Health reform proposals that impact Medicare Part D such as formulary requirements, PBM disclosure provisions, closing of the Part D coverage gap. General Legislative and regulatory issues such as direct negotiation. Statutory implementation of changes to the definition of AMP in Medicaid. Exclusion of specialty distributors prompt pay discounts from the definition of average sales prices. Medicare audit and preferred network restrictions. HR 244; HR 793.

Contacted: Health & Human Services, Dept of (HHS); Congressional Budget Office (CBO); Internal Revenue Service (IRS); Labor, Dept of (DOL); Government Accountability Office (GAO); Health Resources & Services Administration (HRSA); SENATE; Food & Drug Administration (FDA); Executive Office of the President (EOP); White House Office; Office of Personnel Management (OPM); Centers For Medicare and Medicaid Services (CMS); Federal Trade Commission (FTC); HOUSE OF REPRESENTATIVES; Medicare Payment Advisory Commission (MedPAC)

Bills named: H.R. 793 (114th), H.R. 244 (114th)

Pharmacy PHA

Regulatory design and coverage of pharmacy benefits in health reform Exchanges and the commercial market, including: EHB, grandfathering, Rx quality, eRx, PBM disclosure, MLR, specialty pharmacy tiering restrictions. Regulatory implementation of a pathway for the approval of biosimilars. REMs. 340b program reform. policies placing restrictions on pharmacy benefit design. Issues regarding making prescription drugs more affordable, including: generic user fees, pedigree, biosimilars, REMs. General issues dealing with prescription drug abuse, including Medicare lock-in programs. General issues dealing with regulating pharmacy drug compounding. HR 1600; S 1190/ HR793.

Contacted: SENATE; Labor, Dept of (DOL); Congressional Budget Office (CBO); Executive Office of the President (EOP); Health & Human Services, Dept of (HHS); White House Office; Medicare Payment Advisory Commission (MedPAC); Federal Trade Commission (FTC); HOUSE OF REPRESENTATIVES; Internal Revenue Service (IRS); Office of Personnel Management (OPM); Health Resources & Services Administration (HRSA); Government Accountability Office (GAO); Centers For Medicare and Medicaid Services (CMS); Food & Drug Administration (FDA)

Bills named: H.R. 793 (114th), H.R. 1600 (114th)

Taxation/Internal Revenue Code TAX

Regulatory implementation of various tax provisions in the health reform law, including the health insurer tax (HR 928/ S 183).

Contacted: Labor, Dept of (DOL); Food & Drug Administration (FDA); Internal Revenue Service (IRS); Office of Personnel Management (OPM); Health Resources & Services Administration (HRSA); Centers For Medicare and Medicaid Services (CMS); SENATE; Medicare Payment Advisory Commission (MedPAC); Federal Trade Commission (FTC); White House Office; Congressional Budget Office (CBO); HOUSE OF REPRESENTATIVES; Executive Office of the President (EOP); Health & Human Services, Dept of (HHS); Government Accountability Office (GAO)

Bills named: H.R. 928 (114th)

Defense DEF

Pharmacy issues related to the annual defense reauthorization (HR 4909).

Contacted: Labor, Dept of (DOL); SENATE; Health & Human Services, Dept of (HHS); Federal Trade Commission (FTC); Internal Revenue Service (IRS); Government Accountability Office (GAO); Medicare Payment Advisory Commission (MedPAC); Executive Office of the President (EOP); Health Resources & Services Administration (HRSA); HOUSE OF REPRESENTATIVES; Centers For Medicare and Medicaid Services (CMS); White House Office; Congressional Budget Office (CBO); Office of Personnel Management (OPM); Food & Drug Administration (FDA)

Bills named: H.R. 4909 (114th)

Postal POS

Postal reform proposals, including rate reform, and their impact on 6 day mail delivery.

Contacted: Government Accountability Office (GAO); Congressional Budget Office (CBO); Health Resources & Services Administration (HRSA); SENATE; Internal Revenue Service (IRS); Food & Drug Administration (FDA); HOUSE OF REPRESENTATIVES; Executive Office of the President (EOP); Health & Human Services, Dept of (HHS); Centers For Medicare and Medicaid Services (CMS); Federal Trade Commission (FTC); Medicare Payment Advisory Commission (MedPAC); Labor, Dept of (DOL); White House Office; Office of Personnel Management (OPM)