Billy Wynne J.D.

Chairman

A.B., Dartmouth College; J.D., University of Virginia

(202) 309-0796
billy@wynnehealth.com

Billy Wynne is a nationally respected strategic advisor to elite health care organizations, including Fortune 500 companies, marquee health systems, and prominent foundations. After building one of Washington’s largest health policy practice, he and his team established the Wynne Health Group in January 2018.

Prior to his private sector career, Mr. Wynne served as Health Policy Counsel to the Senate Finance Committee where he was a key drafter and negotiator of several health care laws and assisted in the development of the health care reform “White Papers” that served as the basis for the Affordable Care Act. He has published several dozen articles in Health Affairs and other platforms, often appears on cable news, and is frequently cited by the New York Times, Washington Post, Politico, and other publications.

Mr. Wynne is also an entrepreneur, having founded Policy Hub, the only comprehensive aggregator of federal health policy analysis, and the Public Option Institute, which is dedicated to providing clear analysis of public option programs and developing recommended best practices for states to consider.

Mr. Wynne received a bachelor’s degree in Government from Dartmouth College and a law degree from the University of Virginia. He is a member of the District of Columbia and Virginia bar associations and serves on the boards of Operation Smile, Chinese Children Adoption International, and the Zen Center of Denver.

When he’s not working in Washington, Mr. Wynne lives in Denver, CO with his wife, Christy, and their children, Eleanor and Lei.

Five Reasons Medicare For All (Or Anything Like It) Won’t Pass In 2021

While conventional wisdom, and some presidential candidates, have already begun to temper these expectations, my goal here is to document five reasons why Medicare for All (M4All), Medicare buy-in, or federal public option legislation cannot pass in the near future. My hope, in doing so, is that we Democrats spare ourselves the precious time, internal acrimony, and political fallout that Republicans faced when their lofty ACA repeal promises went unfulfilled....
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CMS Releases Advance Notice For Medicare Advantage And Part D Plans

Last week, the Centers for Medicare & Medicaid Services (CMS) released Part II of its Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part D Payment Policies for Calendar Year (CY) 2021 (fact sheet). The agency also released its proposed rule on policy and technical changes to MA and Part D for CYs 2021 and 2022 (fact sheet). A press release for both developments is available here. This post focuses on summarizing the Advance Notice component of this package of policies....
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The Forecast for Legislative and Regulatory Activity on Health Care in 2020

As the impeachment trial has concluded with the acquittal of President Trump, Congress is now returning to some sense of normalcy. On the health care front, policymakers will need to secure a deal relatively quickly on top-priority issues like prescription drug pricing and surprise medical billing. The apparent deadline for final legislation in both regards is the May 22 expiration date of funding for several public health programs (e.g., community health centers), which many are eyeing as the last real opportunity for meaningful reform this year. Many doubt whether Congress will produce much after that date because of compressed schedules to accommodate party conventions and an extended recess in October. However, health care is in the forefront of voters’ minds. ...
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New Legislation to Control Drug Prices: How Do House and Senate Bills Compare? An Update

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As Congress grapples with an evolving impeachment inquiry, lawmakers have remained focused on lowering prescription drug costs. In December, the House passed the Elijah E. Cummings Lower Drug Costs Now Act (H.R. 3) by a 230–192 vote, largely along party lines with no Democratic defections. House Democratic leaders successfully assuaged grumblings from the Congressional Progressive Caucus that H.R. 3 did not go far enough by doubling the minimum number of drugs subject to price negotiation, among other policy changes....
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Surprise Medical Billing Might Get a Hybrid Solution

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Reaching a consensus on how to protect patients from surprise medical bills has eluded Congress for most of the year even though members in both parties and chambers are highly motivated to find a fix. With an agreement reached over the December 7–8, 2019, weekend, a solution seems closer than it has in a long time....
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A Look Inside The Hospital Transparency Final Rule

On November 15, 2019, The Centers for Medicare & Medicaid Services (CMS) finalized a controversial set of requirements for the disclosure of hospital pricing data to degrees heretofore not seen. Stemming from the recent transparency Executive Order (EO), the final rule reflects the current administration’s overall push to increase pricing and cost transparency throughout the health care system. While the original proposal faced substantial backlash from stakeholders, CMS’ final decision is nearly identical to what the agency originally proposed....
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New Legislation to Control Drug Prices: How Do House and Senate Bills Compare?

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The following tables compare H.R. 3 based on the legislative text advanced by key committees of jurisdiction and key provisions of related proposals: the Prescription Drug Pricing Reduction Act of 2019 (S. 2543), advanced by the Senate Finance Committee in July; and the Advanced Notice of Proposed Rulemaking (ANPRM): Medicare Program, IPI Model for Medicare Part B Drugs, issued by the Centers for Medicare and Medicaid Services last October....
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Proposed Stark Law, Anti-Kickback Reforms Aim To Facilitate Value-Based Care

On Wednesday, October 9, the Department of Health and Human Services (HHS) announced highly anticipated proposed reforms to current regulations implementing the Physician Self-Referral Law (the Stark Law) and the Federal Anti-Kickback Statute (AKS). Also addressed were related civil monetary penalties (CMPs) for inducements to beneficiaries to utilize services. HHS identified the regulations as they stand now as potential impediments to value-based purchasing arrangements for providers and suppliers participating in federal health care programs, as well as in the commercial sector....
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White House Requires Immigrants to Purchase Health Insurance

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On Friday, October 4, 2019, President Trump issued a proclamation to suspend entry of immigrants into the United States if they cannot prove that they will obtain unsubsidized health insurance coverage within 30 days of entering, or that they have the financial means to pay for any foreseeable health care costs (fact sheet). The proclamation is not yet in effect, and we anticipate legal challenges....
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A Single Public Plan Option Versus A Multiplan Approach: A Colorado Case Study

Colorado and Washington State are in the process of implementing public option programs. Other states continue to explore similar actions as well as a variety of Medicaid buy-in proposals. A core consideration states implementing these programs face is whether to allow multiple public option plans (potentially offered by multiple carriers) to any given consumer or just a single public option plan. In both forerunner states and presumably those to follow, policy makers are charged with striking a delicate balance between maximizing affordability and maintaining market stability, including in their exchanges, where such plans are likely to be offered. ...
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