HHS Chief Urges States to Ease Scope-of-Practice Rules
Written by Dr. Chris Dalrymple   
Friday, August 10, 2018 12:41 PM

The Secretary of the US Department of Health and Human Services has noted that excessive scope-of-practice limitations do not broaden the free market in health care, but rather serve to raise costs for patients and deprive them of choices.  

States should consider relaxing restrictions on scope of practice in order to broaden the free market for healthcare.

Health and Human Services (HHS) Secretary Alex Azar told state lawmakers.  "I would urge all of you to take a look at how state and local regulations can be impeding healthcare competition, raising costs for American patients, and depriving them of choices," Azar said at a meeting of the American Legislative Exchange Council, a group of conservative state legislators. “Regulations like … scope of practice can have a legitimate purpose. But too often, these rules can be a significant barrier to new competition and lower-cost market disruptors.”

"Fundamentally, when we wonder why American healthcare costs so much, why patients feel so disempowered, so often the answer is that government rules are standing in the way of necessary innovation," Azar said. “As we undertake our efforts to free up competition from the federal level, we hope all of you will examine what can be done in the states."

He also received a warm response when he mentioned the department's new rules allowing for short-term insurance plans. "We look forward to offering states all the flexibility possible under the law to craft solutions that promote affordability, fiscal sustainability, private coverage, and consumer choice. As one example, we recently finalized new regulations for short-term, limited-duration insurance plans that are free from most Obamacare regulations and, therefore, as much as 50% to 80% cheaper than Obamacare plans.”

Azar also used the speech as an opportunity to announce a new HHS policy regarding the rebates that drugmakers pay to the Medicaid program. "I am pleased to announce ... that HHS is issuing a guidance today to drug manufacturers that will ensure they are paying the full Medicaid rebates they owe on certain prescription drugs," he said.  "When drug manufacturers roll out what's called a 'line extension' for a drug, ... some of them have used it in the past to reset the price that's used to calculate the inflation rebates they have to pay," Azar explained. "This meant they could pay less than they would otherwise owe, just by introducing a new drug formulation."  "This is the kind of abusive behavior from drug companies that this administration will not tolerate. Starting today, we've made clear that manufacturers must pay the full amount of rebates that they owe under the law."

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