Post by BrucePost by ItsJoanNotJoAnnPost by BrucePost by ItsJoanNotJoAnnThe experience I've had with Ring Doorbell cameras was when
it proved a woman rolled through a 4-way stop sign and hit
me while riding my bike. Instead of my insurance company
paying the $69,000 emergency room/ambulance charges, her
company paid.
69,000 American sounds like you must be a bionic woman now. What a
rip-off.
I thought it was a rip-off as well, but I never paid a dime
of the charges. Her insurance company picked that up expense.
Bionic woman?? Hahahaaaaa, I didn't even receive an aspirin
nor a Tylenol. I did get a pair of grippy hospital socks,
though.
Some people must get terribly rich from all these companies charging
each other behind the scenes. Anyway, as long as you don't get the
bill.
Something Trump comprehensively addressed in 2020:
https://trumpwhitehouse.archives.gov/presidential-actions/executive-order-lowering-prices-patients-eliminating-kickbacks-middlemen/
By the authority vested in me as President by the Constitution and the
laws of the United States of America, it is hereby ordered as follows:
Section 1. Purpose. One of the reasons pharmaceutical drug prices in
the United States are so high is because of the complex mix of payers
and negotiators that often separates the consumer from the manufacturer
in the drug-purchasing process. The result is that the prices patients
see at the point-of-sale do not reflect the prices that the patient’s
insurance companies, and middlemen hired by the insurance companies,
actually pay for drugs. Instead, these middlemen — health plan sponsors
and pharmacy benefit managers (PBMs) — negotiate significant discounts
off of the list prices, sometimes up to 50 percent of the cost of the
drug. Medicare patients, whose cost sharing is typically based on list
prices, pay more than they should for drugs while the middlemen collect
large “rebate” checks. These rebates are the functional equivalent of
kickbacks, and erode savings that could otherwise go to the Medicare
patients taking those drugs. Yet currently, Federal regulations create
a safe harbor for such discounts and preclude treating them as kickbacks
under the law.
Fixing this problem could save Medicare patients billions of dollars.
The Office of the Inspector General at the Department of Health and
Human Services has found that patients in the catastrophic phase of the
Medicare Part D program saw their out-of-pocket costs for high-price
drugs increase by 47 percent from 2010 to 2015, from $175 per month to
$257 per month. Narrowing the safe harbor for these discounts under the
anti-kickback statute will allow tens of billions in dollars of rebates
on prescription drugs in the Medicare Part D program to go directly to
patients, saving many patients hundreds or thousands of dollars per year
at the pharmacy counter.
Sec. 2. Policy. It is the policy of the United States that discounts
offered on prescription drugs should be passed on to patients.
Sec. 3. Directing Drug Rebates to Patients Instead of Middlemen. The
Secretary of Health and Human Services shall complete the rulemaking
process he commenced seeking to:
(a) exclude from safe harbor protections under the anti-kickback
statute, section 1128B(b) of the Social Security Act, 42 U.S.C.
1320a–7b, certain retrospective reductions in price that are not applied
at the point-of-sale or other remuneration that drug manufacturers
provide to health plan sponsors, pharmacies, or PBMs in operating the
Medicare Part D program; and
(b) establish new safe harbors that would permit health plan sponsors,
pharmacies, and PBMs to apply discounts at the patient’s point-of-sale
in order to lower the patient’s out-of-pocket costs, and that would
permit the use of certain bona fide PBM service fees.
Sec. 4. Protecting Low Premiums. Prior to taking action under section
3 of this order, the Secretary of Health and Human Services shall
confirm — and make public such confirmation — that the action is not
projected to increase Federal spending, Medicare beneficiary premiums,
or patients’ total out-of-pocket costs.
Sec. 5. General Provisions. (a) Nothing in this order shall be
construed to impair or otherwise affect:
(i) the authority granted by law to an executive department or agency,
or the head thereof; or
(ii) the functions of the Director of the Office of Management and
Budget relating to budgetary, administrative, or legislative proposals.
(b) This order shall be implemented consistent with applicable law and
subject to the availability of appropriations.
(c) This order is not intended to, and does not, create any right or
benefit, substantive or procedural, enforceable at law or in equity by
any party against the United States, its departments, agencies, or
entities, its officers, employees, or agents, or any other person.
DONALD J. TRUMP
THE WHITE HOUSE,
July 24, 2020.
