Congressional Hearing Goof Pulls Back The Curtain On How Washington Really Works

Here's a hint: It was lobbyists.

WASHINGTON -- Everyone knows Washington can be a virtual echo chamber, but a pair of witnesses at a congressional hearing this week took things a little too far.

Two experts called to speak about a controversial Medicare regulation submitted written testimony to a House subcommittee Tuesday that included identical and near-identical passages outlining their opposition to a plan that would cut how much physicians get paid to administer medicines to patients in their offices.

It's usual for witnesses on the same side of an issue to share a point of view. It's not normal for them to use the exact same words to articulate it.

So how did this happen? Not surprisingly, lobbyists were involved.

In theory, congressional hearings are an opportunity for experts to provide perspectives on important issues facing the Republic, and for lawmakers and citizens to learn more about complex subjects and to enable them to make informed decisions on policy matters.

As Tuesday's goof reveals, these hearings mostly turn out to be yet another venue for partisan posturing and big-money lobbying fights to play out.

A lobbying firm called Hart Health Strategies does business with the organizations both witnesses represented.

"Both of our clients were asked to testify at yesterday's hearing. We inadvertently merged the process parts of both testimonies. It was merely a clerical error," Vicki Hart, the lobbying firm's president, wrote in an email to The Huffington Post.

The witnesses in this case were Marcia Boyle, president of the Immune Deficiency Foundation, and Michael Schweitz, a Florida-based rheumatologist who spoke on behalf of the Alliance of Specialty Medicine and the Coalition of State Rheumatology Organizations.

Marcia Boyle, president of the Immune Deficiency Foundation, speaks at a House subcommittee hearing on May 17.
Marcia Boyle, president of the Immune Deficiency Foundation, speaks at a House subcommittee hearing on May 17.

The rheumatology group is part of the Alliance for Specialty Medicine, which is a Hart Health Strategies client along with the Immune Deficiency Foundation. The matching passages appeared in the written testimony each presented.

The Immune Deficiency Foundation, Coalition of State Rheumatology Organizations and Schweitz didn't respond to requests for comment. Vicki Hart is listed as the contact for the Alliance for Specialty Medicine on that organization's website.

Hart Health Strategies also represents the Pharmaceutical Research and Manufacturers of America, the drug industry's main trade group, which is spending millions to lobby against the Medicare policy President Barack Obama's administration has proposed.

The pharmaceutical industry and allied medical and patient organizations have been fighting the proposed changes in how Medicare pays for drugs delivered by physicians in their offices tooth and nail, and have gotten large numbers of lawmakers in both parties to go along with it.

Rep. Larry Bucshon (R-Ind.) authored a bill to kill the proposal, and some Democrats have asked the administration to delay or scale it back.

Other Democrats, backed by consumer groups like the AARP and the Medicare Rights Center, Aetna and other health insurers, and big labor unions including AFL-CIO, have sided with the administration.

Michael Schweitz, a rheumatologist from Florida, testifies on behalf of the Alliance for Specialty Medicine at a House subcommittee hearing on May 17.
Michael Schweitz, a rheumatologist from Florida, testifies on behalf of the Alliance for Specialty Medicine at a House subcommittee hearing on May 17.

Rep. Jan Schakowsky (D-Ill.), who backs the Medicare plan, remarked on the oddity during the hearing.

So did Charles Ornstein, a reporter at ProPublica. Two sections of each witness's testimony are nearly the same, and Ornstein helpfully highlighted one relevant portion on Twitter.

Houston Chronicle reporter Markian Hawryluk and the New York Times' Margot Sanger-Katz soon figured out this wasn't the first time some of the language in question appeared. The Immune Deficiency Foundation used it in a May 5 letter to the Centers for Medicare and Medicaid Services, and it also showed up in an undated post on the Alliance for Specialty Medicine website.

The Republican majority of the House Energy and Commerce Committee's Health Subcommittee invited the individuals to appear at the hearing.

The event largely proved to be a time for the GOP -- and some Democrats -- to criticize the Medicare policy, which Republicans ominously dubbed "The Obama Administration’s Medicare Drug Experiment." Schakowsky and other Democrats spoke out in favor of the plan.

The rationale behind the proposed Medicare policy -- which probably will take effect in some form no matter what happens in Congress -- is that the current system for paying doctors like cancer and rheumatology specialists for giving drugs to patients encourages them to choose more expensive medicines when cheaper ones would be as effective.

The regulation is consistent with recommendations from the independent Medicare Payment Advisory Commission, which counsels Congress on policy.

The new policy wouldn't affect prescription drugs purchased at pharmacies and covered by the Medicare Part D drug benefit. Instead, it targets the $20 billion a year Medicare spends on medicines doctors must administer themselves, which are paid for by Medicare Part B, which covers physician visits and similar services.

Under the current system, doctors get paid the “average sales price” of the medicines plus 6 percent. The new formula would be the price of the drug plus a 2.5 percent markup and a $16.80 per day fee. The plan also would test new models for these payments, such as tying the dollar amounts to how effective the drugs are for patients.

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