This week, action on Capitol Hill remained slow as the fall recess continued. .Every other developed country has evolved schemes to set or negotiate prices, while balancing cost, efficacy and social good. The United States instead has let business calculations drive drug price tags, forcing us to accept and absorb ever higher costs. That feels particularly galling for treatments and vaccines against COVID-19, whose development and production is being subsidized and incentivized with billions in federal investment. .The fate of President Obama's controversial executive action on immigration remains tied up in court. The potential long-term financial impact of the actions on Social Security and Medicare remains unknown, and elected lawmakers have been unable to agree to immigration policy changes legislatively. .TSCL Calls On Congress To Close The Loop Hole .The fact is no one can know ahead of time what healthcare will be needed in the future, let alone the actual costs of the services that providers charge. Doctors frequently refer patients to expensive specialists, and order endless expensive tests without spending adequate time to explain why the tests are necessary, how much they cost, or the chances of improving treatments through their use. .Under a rule change that will take effect in July the Center for Medicare and Medicaid Services (CMS) will allow insurers and employers to exclude certain copay assistance programs from counting toward deductibles and out-of-pocket maximums. The rule applies even for expensive brand-name drugs with no generic alternatives. .This week, key legislators revealed that they will not pass a permanent repeal of Medicare's sustainable growth rate (SGR) formula before the March 31st deadline. .A new audit performed this year by the SSA's Office of Inspector General found that the same problem persists. The Inspector General identified 26,033 spouses – who were eligible for about 5.3 million in higher retirement benefits (about ,502 a piece on average). .Medicare Advantage plans contract with Medicare to provide all basic Medicare services, and plans receive monthly lump sum payments that cover expected costs for an average Medicare beneficiary. But officials have known for years that some Medicare Advantage plans overbill the government by exaggerating how sick their patients are, or by charging Medicare for treating serious medical conditions that they cannot prove that patients have. Audits of 37 health plans revealed that, on average, auditors could confirm only 60% of the more than 20,000 medical conditions that CMS paid plans to treat.