How Fast Pass became law, and how it could shape future legislative efforts.
The celebration was well-earned. In December 2024, a major piece of legislation crossed the finish line when Congress approved FAST PASS legislation in the National Defense Authorization Act (NDAA) for Fiscal Year 2025. The legislation passed by a vote of 281-140 in the House of Representatives and 85-14 in the Senate.
“This is a bipartisan victory for the medical supply chain,” HIDA President and CEO Matthew J. Rowan said at the time. “During the pandemic and the subsequent supply chain delays, healthcare distributors worked closely with ports and shippers to get critical medical products to patients and providers. We are eager to share best practices with the government that can be applied to supply chain bottlenecks in the future.”
The passage marked the culmination of three years of HIDA legislative advocacy to address shipping delays for medical products.
Repertoire Magazine reached out to several stakeholders who contributed to the legislation’s creation to better understand the conversations, obstacles, and framework, and what future med/surg related legislative efforts could look like in the future.
Identifying the problem
Transportation is ultimately a healthcare issue, said Kathryn DiBitetto, vice president of government affairs, HIDA. “During the pandemic and the subsequent supply chain delays, healthcare distributors worked closely with ports and shippers to get critical medical products to patients and providers,” she said. “But patients and providers still suffered from delays.”
A HIDA study of the medical supply chain found that during the West Coast port backlog of 2021-22, approximately 31,000-46,000 containers of critical medical supplies were delayed an average of 29 days throughout the transportation system.
Something needed to be done at the national level, yet after the pandemic, there was a lot of skepticism in Congress about revisiting COVID-era supply chain policies. “Our best argument for FAST PASS was ‘We’ve done it before,’” said DiBitetto. HIDA has worked with the Ports of Los Angeles and Long Beach to identify cargoes of medical products and expedite them through the port to the patients and providers that needed them. “What we were asking Congress to do is study whether this effort could be scaled up into a national program during a future public health emergency.”
A winding path
For three years, HIDA advocated for legislation that would help to expedite the flow of critical medical cargo through American ports. FAST PASS was initially introduced by Representatives Mike Ezell (R-MS) and John Garamendi (D-CA) as H.R. 6140, the Facilitate Access to Swiftly Transport Goods during a Publicly Announced State of Emergency Situation (FAST PASS) Act.
“During the COVID-19 pandemic, we saw firsthand how fragile our supply chains can be. Port congestion can be a matter of life-and-death, especially when it comes to emergency medical supplies,” Rep. Garamendi said. “As a major proponent of the U.S. maritime industry, I decided it was worth investigating how to avoid this problem in the future.”
The bill was introduced in November 2023. In March 2024, it was passed unanimously by the House Transportation & Infrastructure Committee, but it was not considered on the House floor. In an effort to expedite passage of the bill, the House Armed Services Committee included FAST PASS as a provision in the National Defense Authorization Act (NDAA). This passed the House in June 2024. FAST PASS was included in the final text of the NDAA that became law in December 2024.
“As you know, the process of passing a bill is rarely simple. It requires working with interested parties, like the Health Industry Distributors Association, and working across the aisle when possible,” Rep. Garamendi said. “Congressman Ezell was a great partner in this. And it involves working in creative ways. For instance, FAST PASS passed out of the House Transportation and Infrastructure Committee, which I am a senior member of, by a bipartisan vote. But the bill never made it to a full floor vote in the House.
But since FAST Pass is about being able to access critical supplies in an emergency, which is vital for our national security,” Rep. Garamendi continued, “I pushed for its inclusion in the annual defense spending bill, the National Defense Authorization Act, which is ultimately how the bill became law. All this to say, the process of legislating rarely follows a straight line.”
From the med/surg community, DiBitetto said HIDA members were the industry’s strongest and best advocates for FAST PASS. “Members of our Shipping & Logistics Working Group provided persuasive evidence of cargo delays and the impact they had on patients and providers. Key members of the HIDA Board of Directors met at critical moments with key staff on committees of jurisdiction. And dozens of HIDA members have had hundreds of meetings with Congressional staffers at HIDA Washington fly-ins for three consecutive years.”
HIDA especially wanted to commend:
- Shipping Work Group Co-Chairs, Patrick Halloran of Cardinal Health and Jon Archer of McKesson. FAST PASS was a member-led initiative of the Shipping Work Group created to manage transportation bottlenecks during COVID. “Patrick and Jon were key subject matter experts on healthcare logistics. Patrick personally lobbied Congressman Garamendi at HIDA’s 2023 Fly-In and convinced him to introduce the bill.”
- Lisa Hohman of Concordance Healthcare Solutions. “We needed the Chairman of the House Transportation Committee – Congressman Sam Graves of Missouri – to approve of FAST PASS so that his committee would consider it,” said DiBitetto. “Thanks to Concordance’s facilities and customers in Missouri, Lisa was able to get us a key meeting with legislative staff for Chairman Graves.”
- Dennis Clock of Clock Medical. “Dennis met with Congressman Ezell during the 2023 HIDA fly-in, because of Clock Medical’s distribution facility in Mississippi,” said DiBitetto. “We met with a very informed and engaged staffer – Allie Cameron – who led the charge for FAST PASS on Capitol Hill.”
FAST PASS has had the encouragement and support of trade associations such as AdvaMed, and healthcare distributors such as Cardinal Health. “This is a bipartisan victory for the medical supply chain, and a recognition of the hard work healthcare distributors accomplished during both the COVID pandemic of 2020 and the West Coast port delays of 2021,” DiBitetto said.
Only the beginning
Rep. Garamendi said FAST PASS is a first step in a longer process. “We have a long way to go towards ensuring every American has access to plentiful, affordable, world class healthcare. And I will continue working to make this a reality. But ensuring that hospitals can access critical supplies during an emergency is basic. FAST PASS will help ensure that our hospital shelves stay stocked in a crisis.”
DiBitetto believes FAST PASS will have a positive impact on the efficiency and reliability of the healthcare supply chain moving forward. FAST PASS directs the Government Accountability Office (GAO) to conduct a study on the transportation of PPE through vessels and ports onto trucks or rail, and the role played by the Department of Transportation and other relevant federal agencies to expedite the transportation of PPE. The study will look at ways to improve the coordination among relevant federal agencies to expedite the transportation of PPE, and the impact (if any) that this might have on the transportation of other goods. The GAO study must be conducted within one year of enactment, and report back to Congress by the end of 2026.
“It is now the job of everyone in the medical supply chain to help the GAO research their report, by telling the story of how we overcame multiple transportation obstacles in order to better serve our customers,” DiBitetto said. “We are eager to share best practices with the government that can be applied to supply chain bottlenecks in the future.”
FAST PASS proves the necessity of good public-private partnerships in healthcare distribution. “The work we did with West Coast ports to expedite medical cargo was a useful case study and proof of concept for FAST PASS,” DiBitetto said.
It is also important to emphasize persistence and creativity when it comes to lawmaking. FAST PASS legislation took a number of twists and turns on its way to becoming law. “The medical supply chain is linked across the continuum of care,” DiBitetto said, “and it needs to work together to make sure our interests are properly represented in Congress.”
Prioritizing medical supplies
“The healthcare supply chain relies on reliable and consistent global transportation systems. In 2021, significant port delays directly contributed to longer lead times, affecting patient care nationwide. Commercial organizations across the supply chain collaborated with public agencies at the state and federal levels to prioritize medical supplies. This solution, implemented on the West Coast, became the foundation for a future nationwide response. In September 2023, I was honored to meet with Chairman Sam Graves (R-MO) and Transportation & Infrastructure Committee staff to advocate for his support for this critical legislation on behalf of the distribution industry. His approval was crucial to advancing the FAST PASS legislation. By working with federal agencies and legislators, such as Chairman Graves, FAST PASS ensures that medical supplies will be prioritized in times of need.” — Lisa Hohman, CEO, Concordance Healthcare Solutio