Congress' Medicaid and CHIP Payment Advisory Commission (MACPAC) on Tuesday (Jan. 15) reviewed policy recommendations to mitigate the number of people that will “churn” from Medicaid to the private coverage offered by the upcoming health insurance exchanges. Commissioners pondered proposals involving continuous coverage of Medicaid and the future of the Transitional Medical Assistance (TMA) program, which provides Medicaid to families who would otherwise lose coverage due to increased income.

The Supreme Court is set to hear a patent infringement case next month that centers on the use of soybean seeds but could have far-reaching impacts on biotechnology, such as regenerative medicine treatments with multiple generations.

A Virginia bill outlining patient and prescriber notification requirements for interchangeable biosimilars is drawing support from a key biotechnology industry group, which says the legislation follows its suggestions for state substitution policies.

Congress' Medicare advisers will likely review research on how Medicare's drug benefit affects spending in Part A and Part B, according to Mark Miller, executive director of the Medicare Payment Advisory Commission, as commission members become increasingly interested in how drug policies influence medical costs.

Nursing homes are disproportionately hurt by pay cuts to therapy services in the fiscal cliff deal, and the sector will absorb at least one-third of the $1.8 billion in lost revenue over 10 years, according to a study by Avalere Health conducted for the Alliance for Quality Nursing Home Care.

A GOP lawmaker is pressing CMS to be more aggressive in detecting fraud under Medicare Parts C and D in the wake of HHS Office of Inspector General findings that a bipartisan group of senators said show the Medicare Drug Integrity Contractor has had little success in these areas.

CMS wants to increase allowable cost sharing levels in Medicaid for non-preferred drugs and for non-emergency usage of emergency departments, as well as change the amount of “nominal” cost sharing for outpatient services that can be imposed on beneficiaries with incomes up to 100 percent of the federal poverty level, according to a proposed rule released Monday.

A Massachusetts-based health policy institute has a unveiled a series of proposals that the group says could slash $521 billion from the health system by reducing waste and inefficiencies, the majority of savings -- an estimated $290 billion -- coming from improving patient medication adherence.

FDA's new effort to establish a new limited use drug approval pathway -- one mimicking the Limited Population Antibacterial Drug approval mechanism floated during user fee debates last year -- is viewed by many stakeholders as a way to supplement legislative efforts to set up an LPAD scheme.

FDA and lawmakers continue to confront off-label prescribing concerns as they debate creation of a new limited population drug approval framework and a White House advisor recently floated a solution: Slap penalties on physicians who don't adhere to conditions attached to the limited approvals.

Congress' Medicare advisers are looking into rising Medicare reinsurance payments to Part D plans, which could lead to talks of lowering Medicare's share of catastrophic coverage, and they are monitoring the growing number of tiered drug plans that use preferred pharmacies, which some commissioners worry could lead to restricted access.

One of the Medicare physician payment patch's offsets that has received little attention in the weeks following the fiscal cliff deal allows contractors to recover overpayments for up to five years, increasing providers' exposure and liability for recoveries, experts say.

Congress' Medicare payment advisors are urging lawmakers to promptly repeal the Sustainable Growth Rate physician payment formula to keep it from interfering with beneficiaries' access to care, and said the repeal will only become more difficult to pay for if Medicare savings are applied to deficit reduction.

In announcing he will retire from the Senate in 2014, Sen. Jay Rockefeller (D-WV), one of the Chamber's strongest advocates for Medicaid, the Children's Health Insurance Program (CHIP) and other safety-net systems, says defending those programs as well as working on the new Commission on Long Term care he included in the fiscal cliff deal will be among his key priorities as his finishes up his nearly 50-year tenure in public office.

New Mexico and Nevada are the first two Republican states to say they will expand their Medicaid programs, as several states' Medicaid expansion plans begin to take shape with state legislatures convening for their 2013 sessions.

A newly signed law backed by wide-ranging stakeholders -- including the trial lawyers and the Chamber of Commerce -- aims to improve the process of returning funds to the Medicare Trust fund if Medicare covers the care for an injured beneficiary who later receives a paid settlement.

Congressional debate on two high-profile pharmaceutical issues that closed out 2012 -- how to address gaps in compounding oversight and the lack of a federal drug track and trace system -- is expected to re-emerge this year, although it remains unclear how lawmakers will tackle the hot-button issues.

The White House's key health advisor and deputy chief of staff, Nancy Ann DeParle, will be leaving her position and plans to at least temporarily join the Brookings Institution, Inside Health Policy has confirmed.

A duo of Democratic senators and several House Democrats are urging the multi-agency gun violence task force -- whose work is being led by Vice President Joe Biden -- to embrace legislation that would authorize “federally-qualified community behavioral health centers” to serve individuals with mental illnesses and addiction disorders.

Congress' Medicare payment advisors Thursday (Jan. 10) reassured hospitals that they support a 1 percent payment update for the industry in 2014 after lawmakers' cuts to offset the Medicare physician payment patch and potential upcoming payment reductions from sequestration are taken into account.