LET’S TALK ABOUT IT — The top Democrat and Republican senators on the Finance Committee released a discussion draft aimed at reining in pharmacy benefit managers and boosting mental health access. The discussion draft from chair Ron Wyden (D-Ore.) and Mike Crapo (R-Idaho) includes provisions that would boost the mental health workforce and reduce drug prices. It comes after Wyden and Crapo put forward several PBM proposals, and the panel nearly unanimously advanced legislation in July aimed at boosting transparency for PBMs. The discussion draft adds to that legislation. The House has also advanced a measure that would strengthen transparency in the PBM sector. The mental health provisions include: — Expanding eligibility for workforce shortage area incentives to clinicians providing mental health and substance use treatment — Allowing licensed clinical social workers to do more work under Medicare — Mandating that Medicare Advantage plans have accurate provider directories The PBM provisions include: — Requiring that sponsors of prescription drug plans with preferred pharmacy networks have a minimum share of in-network pharmacies in underserved areas not tied to a PBM or sponsor — Mandating that HHS collect monthly data on drug-acquisition costs to boost PBM transparency — Requiring plans to include certain discount-eligible drugs in formularies and tie cost-sharing to the net price for them The pay for: The measure intends to use the Medicare and Medicaid improvement funds. A Senate aide said the PBM plans will “pay for themselves,” and the non-PBM parts are “fully offset.” The path forward: The committee will host a markup on the discussion draft Wednesday morning. JOHNSON FLOATS NEW FUNDING PLAN — New House Speaker Mike Johnson (R-La.) has a fresh concept for avoiding a government shutdown — seemingly creating a series of rolling funding threats, a move that could draw opposition from across the political spectrum, POLITICO’s Katherine Tully-McManus and Caitlin Emma report. During a press conference Thursday, Johnson suggested a “laddered CR” for funding the government ahead of the Nov. 17 deadline, describing a continuing resolution that “extends individual pieces of the appropriations process, individual bills.” While it’s unclear how that would work, Johnson seemed to be referring to different lengths of stopgap funding for each of the 12 appropriations bills, triggering ongoing shutdown threats for different parts of the government. Democrats and the White House wouldn’t back such an approach. Johnson has also suggested a stopgap measure to keep the government open until Jan. 15.
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