December 4, 2021

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Secretary Antony J. Blinken with Andrew Ross Sorkin of The New York Times DealBook Summit

28 min read

Antony J. Blinken, Secretary of State

Washington, D.C.

QUESTION: My next guest is U.S. Secretary of State Antony Blinken. For nearly 20 years, he’s been an advisor to President Biden. Blinken has served three Democratic presidential administrations – for Clinton, Obama, now Biden. As the nation’s top diplomat, he is tasked with taking on issues of our time, including relations with China, what that means for addressing climate on a global stage, and protecting vital interests at home. We welcome the Secretary this morning.

Thank you for joining us, Mr. Secretary.

SECRETARY BLINKEN: Andrew, great to be with you. Good to see you.

QUESTION: It’s great to see you. I’m sorry we’re doing it virtually. So much to talk about, and what I’d love to do is start this morning by talking about China. There are reports just this morning that President Biden and President Xi may be meeting virtually for the first time next week. Is this happening?

SECRETARY BLINKEN: There will be a virtual meeting between the presidents coming up soon. They’ve had a couple of very extended conversations since President Biden’s been in office, multiple hours on the phone. But now we have an opportunity for them to get together at least face to face virtually, and hopefully at some point in person.

QUESTION: Can progress be made virtually? I ask because clearly we’re doing this virtually, but at some level you want to get the two presidents standing next to each other.

SECRETARY BLINKEN: Ultimately, yes, of course, that’s always better. But as I said, they’ve already spent I think something like five hours on the phone over the course of several conversations. When they have this virtual meeting, that – that’ll be more time, more focus on a whole host of issues.

Because here’s the thing: This is the most complex and also the most consequential relationship that we have, the relationship with China. And it’s tempting to try to put it on a bumper sticker, but we can’t do that. It has aspects of – that are clearly competitive, some that are cooperative, and some that are adversarial. And the challenge for us is to make sure that we’re managing that relationship across all of these different aspects.

QUESTION: I want to read you a comment by the Joint Chief of Staff, Chairman General Mark Milley. He said last week, quote, “We are witnessing one of the largest shifts in global geo-strategic power the world has witnessed.” “They are clearly challenging us regionally” – this is China – “and their aspiration is to challenge the United States globally.” What do you think of that?

SECRETARY BLINKEN: Well, I think the Chairman is right in the sense that China aspires to have the largest and strongest economy in the world. It aspires to have the largest and strongest military in the world. It aspires to leadership not just in the region but around the world. I think that’s clearly what its aspiration is. The nature of that leadership, the nature of its engagement, is what really matters. And for us, for the United States, we have a stake in a few things. As I said, we have a stake in making sure that we’re managing the relationship in a way that allows us, where possible, to cooperate; where we’re put in a – where we put ourselves in position to compete, and compete effectively; and where we can stand strongly where the relationship is more adversarial.

And Andrew, that requires two things, whether it’s any of these aspects of the relationship. One is we have to be making the right investments in ourselves, and it really does start at home. And we’re seeing that – we’re seeing that right now. Second, we’re so much more effective in dealing with whatever challenge China poses when we’re working closely with allies and partners. Just on the economic front, as you know, when we’re acting alone and trying to stand up to conduct that we object to when it comes to what China is doing commercially, we’re 20, 25 percent of world GDP. We’re acting in concert with allies and partners, it may be 45, 50 percent of world GDP. That’s a lot harder for China to ignore. That’s why we put such an emphasis these first 10 months of the administration in making those investments at home and in revitalizing our relationships and partnerships with allies around the world.

QUESTION: I wanted to talk about some of those investments in a moment. But the word “containment” – is there any effort to contain China, or do you think the view is that China cannot be contained?

SECRETARY BLINKEN: This is not about containing China. It’s not about holding China back. What it is about is upholding something that we talk a lot about, the infamous international rules-based order, but that has real meaning. We took the lead many years ago, many decades ago, in helping to put that order together, that, among other things, encouraged the free flow of ideas, of capital, of people, and based on widely shared rules, and rules that were inspired by liberal values. To the extent that order is being challenged by anyone – whether it’s China or anyone else – we will stand up and defend it. That’s what this is about. It’s about upholding that order, and it’s about making sure that as the world is moving forward, we’re engaged in a race to the top, not a race to the bottom.

QUESTION: Right. So much of the world and so much of the business world is looking at Taiwan as the neck, as the centerpiece, as the chess piece in what happens next. And there seems to be still so much confusion about what the United States will or will not do, and what it’s required to do or not, if in fact China were to quote-unquote “breach” Taiwan.

SECRETARY BLINKEN: Hmm. Look, we stand strongly against anyone taking unilateral action to disrupt the status quo by force. And we have commitments – longstanding commitments under the Taiwan Relations Act – to make sure that Taiwan has the ability to defend itself. We’re committed to the Taiwan Relations Act, and our responsibility is to do just that.

Similarly, we continue to adhere to the “one China” policy, but that is based on the Taiwan Relations Act. It’s based on various assurances —

QUESTION: Right.

SECRETARY BLINKEN: — and commitments that have been made. But we will make sure that Taiwan has the means to defend itself, because the purpose here is never to get to that point, where anyone is actually trying to disrupt the status quo by force, to make sure that deterrence is there, and that no one engages in actions that could be profoundly, profoundly disruptive, dangerous to world peace and security.

QUESTION: Right. Maybe this is a language question. But I went back to look at the law, and effectively it says, quote – that the United States is, quote, “to assist Taiwan in maintaining its defensive capability.” And you talked about them maintaining the defense itself. What does that mean in terms of what our role would be?

SECRETARY BLINKEN: Our role, as I said, is to make sure that Taiwan has the means to defend itself, because ultimately —

QUESTION: But does that mean that we would —

SECRETARY BLINKEN: — that is the —

QUESTION: Does that mean that we would step in and defend it? I think that’s the big question.

SECRETARY BLINKEN: Our role is to make sure that it has the means to defend itself, because if it does, that is the best deterrent against any very, very, very unfortunate action that might be contemplated by China. That’s what we’re focused on.

At the same time, I think it’s fair to say that we’re not alone in this determination to make sure that we preserve peace and stability in that part of the world. There are many countries, both in the region and beyond, that would see any unilateral action to use force to disrupt the status quo as a significant threat to peace and security, and they too would take action in the event that that happen. But again, the purpose here —

QUESTION: Right.

SECRETARY BLINKEN: — is to make sure that no one does that.

QUESTION: Let me ask you a question about the business community for a moment and China. I think there are a lot of business leaders, especially in the United States, that are challenged about thinking about how to do business or not in China right now given all of the issues that are taking place. And I’m curious how you think about that issue.

SECRETARY BLINKEN: So a couple of things here. First, from my perspective this is not about decoupling from China. Trade, investment in both directions and with other countries is important to all of us, and done the right way – with a level playing field, with playing by the rules – it’s a good thing. It’s a good thing for us. It’s a good thing for China. It’s a good thing for many other countries. So that’s not the issue.

It’s not about decoupling. It’s not about stopping trade. It’s not about stopping investment. It is about making sure, as I said, that it’s done in a fair way: that we have a level playing field, that there is genuine reciprocity in the way China engages the world commercially and the way the rest of us engage China. And it is also about making sure that when it comes to particularly sensitive areas —

QUESTION: Right.

SECRETARY BLINKEN: — we’re protecting them and that we recognize that there may be some threats that come along with engaging with China. Because here’s the problem, particularly for sensitive areas of technology and investments, for example, coming from China in those areas: There is no separation between private enterprise and the state. And private enterprise in China is absolutely beholden to the state. And if the state wants information, if it wants intellectual property, if it wants anything that one of these enterprises is having access to as a result of its investment or its engagement, the state will get it. So countries have to be very, very aware of that.

At the same time, I think that what I’m seeing from companies around the world and countries around the world is to the extent that China’s engaged in repressive activities at home, we don’t want to be in the business of providing it the technology to do that.

QUESTION: Right.

SECRETARY BLINKEN: And I think you’re seeing that increasingly around the world. Similarly, if products are made as a result of forced labor, or worse, we shouldn’t be in the business of acquiring that or buying that.

So there are certain guardrails around this that I think the world is establishing —

QUESTION: Right.

SECRETARY BLINKEN: — but not for the purpose of decoupling.

QUESTION: Let me ask you another question because this relates to U.S. business leaders. A number of U.S. business leaders over the past year or two have come out quite publicly making pronouncements about politics or, frankly, moral issues in the United States. And they have often been described by some in political quarters as hypocrites because they will speak in the United States but they won’t speak out when they do business in China. What do you think of that, and do you think that they have an obligation to speak out in a place like China?

SECRETARY BLINKEN: Look, I’ll let businesses decide for themselves how they want to approach these issues. They’re incredibly complicated. There are, I think, good faith arguments in various directions. What I’m hearing again from company after company in the United States and around the world is a clear focus on making sure, for example, that they’re not providing technology to China or to anyone else that could be used to repress people, and similarly, that they’re not engaged in businesses with – in business with entities or countries that are producing things based on forced labor. So that’s one thing I think that’s very, very important.

But look, companies have to make these decisions. They also are hearing from shareholders. They’re hearing from their own employees. All of those things are factored in to the decisions they make.

QUESTION: We just got a question that came in from the audience, so I’ll ask it. And the question is: Can progress with China be made when President Xi is able to play the long game while the U.S. administrations have no guarantee of more than four years in office? And what do we want and expect from China?

SECRETARY BLINKEN: Yeah. That’s really – that’s a great question, and I’d say a couple of things to that. First, and I said this at the outset, as I’m going around the world and trying to help lead our foreign policy at President Biden’s request, what I know is this: for everything I can do, the State Department can do, maybe the most important thing we can do is to actually start by making these investments in ourselves and also demonstrating that our system can actually deliver real results. That’s where it all starts.

Because here’s the story that autocracies are telling around the world. They’re saying that our system —

QUESTION: Right.

SECRETARY BLINKEN: — our democratic system can’t deliver anymore. The world is moving too fast. Our systems are polarized, they’re paralyzed, they’re not producing results. Autocracies are.

So if we can start by showing results in making the right investments in ourselves, in our people, and showing that our system can actually deliver, that in and of itself is the most powerful thing and that helps the long game too.

QUESTION: Okay, I’ve got a complicated one because it has to deal with investing in ourselves, which is around semiconductors. There’s a big move in the United States to invest in semiconductors, in part because of the issues in Taiwan. The question that I was going to ask you, though, is: would you do business effectively and bring in Taiwan Semiconductor, which is based there, to help manufacture here —

SECRETARY BLINKEN: Well —

QUESTION: — given the long-term potential implications of that?

SECRETARY BLINKEN: So I think we have to develop further capacity to actually manufacture the highest-end semiconductors here in the United States and in other countries. We, as you know, do the innovation, but the actual production and manufacturing is in other places. But it’s a complicated piece of business. Our semiconductor companies, for them China is a huge market for the sort of run-of-the-mill, day-in, day-out semiconductors. And that’s a good thing, because here’s what happens: those semiconductors are sold there. It’s a huge source of profits. Those profits are then plowed back to the companies here and put into research and development, among other things, and that allows us to keep our edge. So it’s important to maintain that.

But when it comes to the most leading-edge semiconductors, we have to make sure that we’re protecting that technology, and that includes making sure we have some capacity to manufacture here. There’s – I won’t get into politics or legislation, but suffice to say that there are things happening in Congress that are very important that will allow us to do that.

QUESTION: You said earlier this year that you were consulting with allies about the Olympic Games that are going to be taking place in Beijing in 2022. And I was curious if there’s an update on that and whether you think that U.S. athletes should be participating in the Games given that the United States has, in your words, described China as being involved in genocide.

SECRETARY BLINKEN: We are talking to allies, to partners, to countries around the world about how they’re thinking about the Games, how they’re thinking about participation. It’s an active conversation. We’re coming up on the Games, but let me leave it at that for today.

QUESTION: What do you think the deadline is that you need to land on a decision one way or the other?

SECRETARY BLINKEN: Well, let’s see. The Games are coming up when, in —

QUESTION: February.

SECRETARY BLINKEN: Early in the year. So before then.

QUESTION: This virtual meeting – and I want to pivot to the conversation around COVID in just a second because I know you just came from a meeting around vaccines. But when President Biden meets with President Xi, how much of the conversation do you think is going to be around this ongoing investigation into the origin of COVID?

SECRETARY BLINKEN: Well, look, that’s going to be part of it. And it’s important to be really clear about this because I know that some in China, including the leadership, think that this investigation into the origins is actually a political tool, a cudgel, to try to hammer them. That’s not at all the point. This is not about pointing the finger and placing blame. It is about understanding what happened so that we’re in a better place to prevent it from happening again. That’s what we need to know. That’s why we need to know it. And so I hope that China will step up to its responsibilities to make sure that it is cooperating with the effort to find out the origins of the pandemic, to make sure that information is being shared, experts are being made available, there’s real transparency, and that we can work together – because we have to work together to make sure that we’re putting in place a better, more effective system to prevent this from happening again.

QUESTION: You just came from a meeting where you announced a plan to get more vaccines into some developing – or I should say less-developed – countries and places, frankly, that have had thus far no access. We just had Albert Bourla here from Pfizer.

SECRETARY BLINKEN: Yeah.

QUESTION: I’m curious if you could grade how you think about the pharmaceutical companies and how they have done not in terms of the creation of the vaccine, which of course is a miracle, but in terms of its distribution.

SECRETARY BLINKEN: Look, they have performed miracles. It’s important to say that. And what’s been done with the creation of the vaccine of different kinds, especially the mRNA, is remarkable and they need to be applauded for that. I think as an international community, with all of the different actors involved – governments, companies, international organizations – we have fallen short of the mark when it comes to distribution, and especially when it comes to equitable distribution. How can it be that in the United States and Europe, we have vaccination rates that, on average, are probably somewhere around 60 percent; in Africa it’s under 14 percent? That’s not only wrong, it’s a huge problem because we know this – we keep repeating it, but it’s important to remember this: as long as the virus is replicating somewhere, it’s going to be mutating. And if it’s mutating, at some point we’re going to get a variant that defeats the vaccines.

So we have an imperative to get ahead of this, and that means companies have to step up, countries have to step up, international organizations have to step up. One of the things we did today, Andrew, is that we’ve agreed with all the international organizations and the companies involved to actually have a tracker so that we know who’s producing what, who is distributing what, who needs what, where it’s needed, and to make sure that there’s one place where all of that information is located. We need that kind of transparency, and that’s what gets accountability to make sure that we’re making progress.

QUESTION: Right. Do you think, though, that if there had been a waiver, if the pharmaceutical companies had effectively given over their IP, that there would be greater distribution of these vaccines at this point?

SECRETARY BLINKEN: Look, it’s possible. But to be perfectly honest, even with the waiver, it takes time. It takes time to put production in place. It takes time to develop the capacity to do that. Now, I think it’s critical that we do that for next time. We have to have the ability to produce vaccines in more places around the world. And we have to go from, in effect, “loanership” to ownership so that countries around the world have the capacity to produce what’s needed on a regional basis so that vaccines can get more quickly to people who need them.

QUESTION: I know you’re going to be distributing shots of J&J as part of this announcement.

SECRETARY BLINKEN: That’s right.

QUESTION: Is that going to be one shot or two? Here in the United States, as you know now, the CDC is saying after two months everybody should get a second shot if their first shot was J&J.

SECRETARY BLINKEN: Yeah, well, the main thing is this – and I’ll leave it to the experts to figure out the details – we wanted to make sure that folks particularly in conflict zones, as well as the humanitarian workers who are engaged there and who have difficulty getting vaccines, have a way to get them. And that’s what we put in place. We put in place a program with J&J, with the World Health Organization to do just that. That’s really important. The other thing we set up is something that we’re calling a COVID Corps with the private sector, making sure that the expertise that they can bring to bear is focused on places where it’s not just a question of producing vaccines, it’s actually getting shots in arms. And there’s tremendous expertise in the private sector that they’re now in effect loaning to this COVID Corps to make sure that we can do that. The last mile, where we’re seeing – with cold chain problems, distribution problems – all of that I think we can help solve with this COVID Corps.

QUESTION: As you know, COP26 is just winding up this week. China and Russia were not there. How disappointed were you about that, and what has to happen now?

SECRETARY BLINKEN: Well, first, what did happen and – or I should say what’s happened thus far at COP, because it’s not over, so let’s wait and see what the final communique looks like. Let’s see what countries actually end up end up doing. But we have a global methane pledge whereby now more than a hundred countries have said that by 2030 they’ll reduce methane emissions by 30 percent. Now, if they do that – and by the way, if China joins in that – that’s the equivalent of taking every car off the road, every airplane out of the skies, every ship off the seas. That’s how important that would be. Similarly, very important commitments on deforestation – preventing it – and reforestation – advancing it. We know how important that is. And 65 percent of world GDP thus far has signed up to commitments that, if fulfilled, would help us keep to 1.5 degrees warming Celsius.

Now, we need China in the game; we need Russia in the game. And my hope is that they will stand up, they will step up, they will do the right thing.

QUESTION: Final question for you. You started your career as a journalist, so I’m going to ask you to take your political hat off for a second, but you’ve also been around Washington and the Democratic Party for quite some time. And as you know, President Biden’s approval ratings have slid – in part, by the way, since the exit from Afghanistan. And I’m curious if you could just give us a read on what you think is happening inside the party, where the strength lies and where it does not.

SECRETARY BLINKEN: Andrew, one of the great things about my job is I don’t do politics. So – and unfortunately, or fortunately, depending on your perspective, the hat never comes off. So I don’t want to engage in that. But let me let me just say this – and I want to come back to where we started – from where, from where I sit as Secretary of State, the most important thing that we can do as a country – Republicans, Democrats, independents, everyone in between, and presumably the Democratic Party – is to demonstrate that we can actually produce results for our people, that we can actually deliver, that we can make their lives a little bit better, a little bit safer, a little bit healthier.

Now, we’ve gone from a place where, as a country 30 years ago, we were number one in the world in investments in research and development – we’ve fallen way back on that. We’re 35 out of 37 top countries in the world in terms of the investments we’re making in early education. We’ve fallen way back from that. And when it comes to the work that – the investments we make in infrastructure, we were at the lead of the pack. We’ve fallen back. If we can show that we can do this, we can get our act together, that’s going to be very powerful for people here at home, but also – also for our standing in the world.

Let me leave you with one last thought, if I can. If we were sitting here 50 or 60 years ago, and the conversation we was having – we were having was about how do you define the wealth of a nation, what constitutes the wealth of a nation, we’d probably talk about the expanse of our landmass, the size of our population, the strength of our military, our abundance of natural resources.

Happily, we are still very strong in all of those areas. But what you know, what I know is the real wealth of a nation now is defined by its human resources and our ability to allow them to reach their full potential. That’s what this is about. If we do that, this is going to be a very good century for the United States. But that’s the challenge we face.

QUESTION: Secretary of State Antony Blinken, thank you so very much for joining us this morning.

SECRETARY BLINKEN: Great to be with you. Thanks, Andrew.

QUESTION: Absolutely. Thank you.

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  • Tennessee Doctor Pleads Guilty to Hydrocodone Distribution Resulting in Death
    In Crime News
    A Tennessee physician pleaded guilty today in the Western District of Tennessee to causing the death of one of his patients through his illegal prescribing of hydrocodone.
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  • Crumbling Foundations: Extent of Homes with Defective Concrete Is Not Fully Known and Federal Options to Aid Homeowners Are Limited
    In U.S GAO News
    As of December 2019, at least 1,600 homes in Connecticut had confirmed pyrrhotite but the total number of affected homes is likely higher. According to one estimate, 4,000–6,000 more homes in Connecticut could develop crumbling foundations due to pyrrhotite. Affected homeowners may face total remediation costs of $150,000 or more and drops in property values of 25 percent or more. Connecticut established funding to provide homeowners with up to $175,000 towards the cost of foundation replacement, but affected homeowners are typically responsible for about one-third of total repair costs (which can include costs for replacing driveways and porches damaged during foundation replacement). Current funding is expected to assist 1,034 homeowners. Pyrrhotite Damage to a Basement and a Home Being Repaired Due to Pyrrhotite Damage GAO found that highly affected towns lost more than $1.6 million in tax revenue in 2018 due to lost assessment value of the houses affected by pyrrhotite, but town officials told us the losses have not yet significantly affected their budgets. However, officials were concerned that pyrrhotite could have long-term effects on their towns if the number of affected homes increased or homes were not remediated. GAO also found that homes located in highly affected towns and built when pyrrhotite-containing concrete was used sold for significantly less, on average, than similar homes in less-affected towns. Stakeholders told GAO that defaults and foreclosures related to pyrrhotite have been limited to date. Some federal funds have already been used for pyrrhotite testing and GAO identified eight additional federal programs that could be used to help mitigate financial impacts on homeowners. However, most of these programs have eligibility or funding restrictions that limit their potential for this purpose. Stakeholders with whom GAO spoke suggested other federal responses—in particular, declaring pyrrhotite damage a major disaster or establishing a federally backed insurance product. However, the Federal Emergency Management Agency determined that pyrrhotite damage did not qualify as a natural catastrophe, and a federally backed insurance program may not be feasible since it would serve a small population with high expected costs. Certain homes built in northeastern Connecticut and central Massachusetts between 1983 and 2015 have concrete foundations containing the mineral pyrrhotite. Pyrrhotite expands when it is exposed to water and oxygen and, over time, concrete foundations containing pyrrhotite may crack and crumble. The Explanatory Statement accompanying the Consolidated Appropriations Act, 2019 included a provision for GAO to study the financial impact of pyrrhotite. This report describes (1) what is known about the number of homes affected by pyrrhotite in the region; (2) the financial impact of pyrrhotite on homeowners; (3) the financial effects on towns, local housing markets, and the federal government; and (4) federal options to mitigate pyrrhotite's financial impact on affected homeowners. GAO analyzed data from state, local, and private entities about the extent of pyrrhotite in foundations and associated costs, and federal actions taken in response to pyrrhotite. GAO also interviewed federal, state, and local officials; homeowners; and other stakeholders such as banks and real estate agents. For more information, contact John Pendleton at (202) 512-8678 or pendletonj@gao.gov.
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  • Medicare Part B: Payments and Use for Selected New, High-Cost Drugs
    In U.S GAO News
    Hospital outpatient departments perform a wide range of procedures, including diagnostic and surgical procedures, which may use drugs that Medicare considers to function as supplies. If the drug is new, and its cost is high relative to Medicare's payment for the procedure, then hospitals can receive a separate “pass-through” payment for the drug in addition to Medicare's payment for the procedure. These pass-through payments are in effect for 2 to 3 years. When the pass-through payments expire, Medicare no longer pays separately for the drug, and payment for the drug is “packaged” with the payment for the related procedure. The payment rate for the procedure does not vary by whether or not the drug is used. Medicare intends this payment rate to be an incentive for hospitals to furnish services efficiently, such as using the most cost-efficient items that meet the patient's needs. Examples of Types of Drugs that Medicare Considers to Function as Supplies GAO's analysis of Medicare data showed that higher payments were associated with six of seven selected drugs when they were eligible for pass-through payments versus when their payments were packaged. For example, one drug used in cataract removal procedures was eligible for pass-through payments in 2017. That year, Medicare paid $1,824 for the procedure and $463 for the drug pass-through payment—a total payment of $2,287. If a hospital performed the same cataract removal procedure when the drug was packaged the following year, there was no longer a separate payment for the drug. Instead, Medicare paid $1,921 for the procedure whether or not the hospital used the drug. Of the seven selected drugs, GAO also reviewed differences in use for four of them that did not have limitations on Medicare coverage during the time frame of GAO's analysis, such as coverage that was limited to certain clinical trials. GAO found that hospitals' use of three of the four drugs was lower when payments for the drugs were packaged. This was consistent with the financial incentives created by the payment system. In particular, given the lower total payment for the drug and procedure when the drug is packaged, hospitals may have a greater incentive to use a lower-cost alternative for the procedure. Hospitals' use of a fourth drug increased regardless of payment status. The financial incentives for that drug appeared minimal because the total payment for it and its related procedure was about the same when it was eligible for pass-through payments and when packaged. Other factors that can affect use of the drugs include the use of the drugs for certain populations and whether hospitals put the drugs on their formularies, which guide, in part, whether the drug is used at that hospital. The Department of Health and Human Services reviewed a draft of this report and provided technical comments, which GAO incorporated as appropriate. Medicare makes “pass-through” payments under Medicare Part B when hospital outpatient departments use certain new, high-cost drugs. These temporary payments are in addition to Medicare's payments for the procedures using the drugs. They may help make the new drugs accessible for beneficiaries and also allow Medicare to collect information on the drugs' use and costs. The Consolidated Appropriations Act, 2018 included a provision for GAO to review the effect of Medicare's policy for packaging high-cost drugs after their pass-through payments have expired. This report describes (1) the payments associated with selected high-cost drugs when eligible for pass-through payments versus when packaged, and (2) hospitals' use of those drugs when eligible for pass-through payments versus when packaged. GAO reviewed federal regulations on pass-through payments and Medicare payment files for all seven drugs whose pass-through payments expired in 2017 or 2018 and that were subsequently packaged. All of these drugs met Medicare's definition for having a high cost relative to Medicare's payment rate for the procedure using the drug. GAO also reviewed Medicare claims data on the use of the drugs for 2017 through 2019 (the most recent available). To supplement this information, GAO also interviewed Medicare officials, as well officials from 11 organizations representing hospitals, physicians, and drug manufacturers, about payment rates, use, reporting, and clinical context for the drugs. For more information, contact James Cosgrove at (202) 512-7114 or cosgrovej@gao.gov.
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  • Department of State Named 2020 Government Employer of the Year by CAREERS& the disABLED Magazine
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