Mass. lawmakers hit stalemate over hospital oversight and prescription drug reform bills
Photo I Courtesy of State House News Service
House Speaker Ronald Mariano talks to reporters after participating in a Diwali celebration in the Great Hall on Tuesday.
While the Steward Health Care saga has subsided in Massachusetts, lawmakers charged with finding consensus on bills intended to prevent a similar meltdown, as well as prescription drug reforms, appear to be hitting roadblocks.
Sen. Cindy Friedman and Rep. John Lawn, the co-chairs of the Joint Committee on Health Care Financing, are helming both private conference committees which have been in place for about three months without any indication of how talks are going.
House Speaker Ron Mariano, who pulled House bills from conference negotiations during the early morning hours of Aug. 1 at the end of formal lawmaking, confirmed Tuesday that the competing bills are "still being discussed." But Mariano also referenced complications.
"Part of the problem is they don't line up the way we would like them to line up. So the trades aren't -- in the hospital part of it and the pharma part of it -- so we're having a tough time trying to match it up," Mariano told reporters Tuesday, without detailing disagreements.
The House passed a hospital oversight bill (H 4653) on a 152-1 vote May 16; the Senate voted 38-2 to pass its bill (S 2881) on July 18.
Both bills largely look to boost facility oversight and reporting requirements, with an eye toward better monitoring the role of private equity in health care, in response to Steward's business dealings that ultimately led to the company filing for bankruptcy.
The bills also increase penalties for failing to report financial data, overhaul how regulators manage health care costs, and require lessors to notify the state before repossessing any medical equipment.
The House bill prohibits hospitals from leasing their property to real estate investment trusts. The Senate bill did not directly ban sale-leaseback agreements with REITs, but it would require a formal material change notice with state health regulators.
The Health Policy Commission, which recently vetted another private equity firm to take over Steward's physician network, has repeatedly urged the Legislature to pass the hospital oversight bill. HPC regulators cannot block or impose conditions on transactions, but the Senate bill would empower HPC to modify proposed deals.
Senate President Karen Spilka indicated that health care is not currently at the forefront of her agenda with more immediate legislation in play, including a compromise energy bill that she said the branch plans to tackle on Wednesday.
"I know discussions are ongoing. Right now, we're focused on the climate -- as I think you know, this is a landmark climate bill," Spilka separately told reporters Tuesday. "I want to get that done, and then we'll turn to others."
With lawmakers still wrestling with unfinished priorities, the Ashland Democrat touted an "incredibly successful session," as she rattled off accomplishments like tax relief, pay equity, housing, gun reform, free universal community college, and early education and care.
"We have done so much, and now on top of it will be a landmark climate bill, as well as hopefully soon at least economic development. And the health care, we'll continue the discussion," Spilka said, without differentiating between the hospital oversight and prescription drug pricing bills.
The Senate unanimously passed the prescription drug reform bill (S 2520) on Nov. 15, followed by a unanimous vote in the House on its bill (H 4910) on July 24 as lawmakers seek to ease cost burdens for Bay Staters. The bills add scrutiny to pharmaceutical manufacturers and pharmacy benefit managers, and they eliminate or cap out-of-pocket costs for drugs to treat certain chronic conditions.
PBMs broker drug transactions between insurers, manufacturers and pharmacies, and they argue their work drives down costs for consumers. Critics say PBMs function with little oversight and are also responsible for rising costs.
At around 6:40 a.m. on Aug. 1, Mariano had confirmed to reporters he spiked both health care bills. The speaker said he would "rather have a good bill than a bill with errors and mistakes and mismatched sections."
"We were frustrated by the progress we were making trying to do the two bills at once. It was very difficult and there were other health care items scattered in other conference committees. So it was very difficult to compare trades and to effectively match up the bills. And we were getting frustrated, they were getting frustrated," Mariano explained at the time. "And those two bills that we sent over -- I think one was unanimous and one I forget, two negative votes -- are too important to get lost in the shuffle and get watered down. So I wanted to get away from the frustration that my staff was going through, and the Senate staff was going through. And we did that."
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