Sunday, May 26, 2013

GOP Senators Say Medicare Hospital Rate-Setting Needs To Be Changed

More than 90 percent of hospitals receive supplemental Medicare pay, according to a recent report from the Government Accountability Office that Sens. Tom Coburn (R-OK) and Richard Burr (R-NC) said illustrates the hospital payment system is broken and a new one is needed.

Drug Sector Divisions Persist Over IP, Biosimilar Exclusivity In Trade Talks

Biologics exclusivity, intellectual property protections and patent rights continue to divide U.S. brand and generic pharmaceutical makers monitoring ongoing trade negotiations.

Trans-Pacific Partnership Members Float Pharmaceutical Ideas

LIMA -- Countries participating in the Trans-Pacific Partnership (TPP) negotiations here have informally floated new ideas for how to move forward in the controversial area of pharmaceutical intellectual property (IP) protections, according to a U.S. trade official.

Three House Republicans Push Back Against Medigap Reform Proposals

Three House Republicans are urging lawmakers to put off changes to Medigap plans that could increase beneficiaries' costs until Medicare is substantially reformed, even as Congress' Medicare payment advisers, the president and budget-cutting experts push for increased beneficiary cost sharing to decrease the use of health services by those with Medigap plans, particularly those with first dollar coverage.

Key Democrat Seeks To Offset Cost Of Freeing Sequestered FDA User Fees

The top Democrat on the House FDA funding panel is trying to identify ways to pay for a measure that would allow FDA to access $85 million in sequestered user fees before he introduces language that could be tacked onto an agency funding bill, according to a congressional source.

Unreleased FDA Compounding Guide Becomes Focus Of House Bill

House Energy and Commerce Republicans signaled they may clarify FDA's authority over drug compounding -- particularly the much debated part of the statute that is subject to a circuit court split -- but they held steady on not giving the agency new powers.

Lawmakers Seek To Hike Prices As CMS Hears Concerns On Diagnostic Test Pay

CMS will hold its annual meeting in July to hear concerns over pay rates for tests added to the clinical laboratory fee schedule in 2014, which includes molecular diagnostics, the agency announced the day after a bipartisan group of lawmakers introduced a bill aimed increasing pay by overhaul the rate-setting process.

CA Exchange Head: Provider Pay, Risk Adjustment Helped To Keep Premiums Down

California providers' agreement to accept lower reimbursement rates as well as health plans' willingness to bet on a good risk mix and to limit administrative costs and profit were key factors in ensuring affordable premiums for plans participating in the individual exchanges, Peter Lee, executive director of Covered California, said Thursday (May 23) as he announced 13 health plans are likely to participate in the state's individual exchange.

Illinois Decides To Turn Pre-Existing Condition Plan Over To Feds

Illinois has decided it won't continue administering its Pre-Existing Condition Insurance Plan, Health Exchange Alert has learned, lowering the total number of states that will continue to run their own PCIP programs under CMS' new contract terms to nine. Earlier in the week, CMS said 10 states had agreed to keep running their PCIPs and 17 decided they would not, but subsequently Illinois decided to end its program, an agency official confirms.

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