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.

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.

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.

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.

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 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.

CMS plans to create a national Recovery Audit Contractor program focusing specifically on durable medical equipment and home health, according to contractors and an undated statement of work obtained by Inside Health Policy.

FDA this month signed a nearly $80,000 contract with Eastern Research Group to do an industry profile of pharmacy compounding operations, according to government spending records.

Colorado state officials touted the robust insurance interest in participating in the state's individual and small group exchanges Wednesday, with 10 carriers -- including Cigna, WellPoint, Humana and Kaiser Health -- proposing to offer about 150 plans through the individual exchange and six carriers proposing about 100 products in the small group (SHOP) exchange.

Senators and stakeholders are considering potential changes to the upper chamber's drug compounding bill -- particularly the bill's current pooling and repackaging definitions that stakeholders worry could bring home infusion providers under the new regulatory category for compounding manufacturers and increase the cost of certain eye treatments.

FDA's update of Current Good Manufacturing Practices in the proposed hazard analysis and preventive controls rule raises questions about whether the agency will use the Food Safety Modernization Act to expand its authorities over seafood, juice and low-acid canned food suppliers, according to two industry attorneys.

Virginia received CMS' nod Tuesday (May 21) to move forward with a proposed demonstration to coordinate care for beneficiaries dually eligible for Medicare and Medicaid that beneficiary advocates hope will lead the way for other states when it comes to monitoring patients' movement from plan to plan.

CMS' way of calculating the geographic pricing cost index for physicians is faulty, a bipartisan group of 21 House lawmakers recently told the agency, while urging CMS to consider using real market data for physicians' wages when calculating the work GPCI and to reduce the impact of the practice expense GPCI since no accurate measurements of such expenses exist.

A bipartisan group of 17 senators on Tuesday (May 21) urged CMS to avoid deep payment cuts to dialysis facilities, even though the fiscal-cliff deal directs CMS to scale back dialysis pay.

Charging seniors a home health copay made the list of three Medicare reforms that House Ways and Means health subcommittee Republicans chose to discuss at a hearing on Tuesday (May 21), as the home health industry engages in an aggressive campaign against such copays with the help of former Louisiana Republican House Energy and Commerce Chair Billy Tauzin as their lobbyist.

The head of CMS’ insurance oversight office says the administration is looking at whether it can fund additional consumer assistance activities for the federal exchanges apart from ACA navigators, a key program designed to boost enrollment in the exchanges but for which HHS has only made $54 million available.

House appropriators on Tuesday (May 21) approved top-line spending amounts for each of 12 appropriations bills for fiscal 2014 -- including a 22 percent cut to HHS, Labor and Education funding -- while also rejecting a Democratic proposal to replace the across-the-board sequestration cuts.

The American Orthotic and Prosthetic Association is suing HHS over alleged illegal changes to the prosthetics approval process applied by Recovery Audit Contractors and Medicare Administrative Contractors.

The Senate health committee stripped animal drug provisions from the compounding bill slated to be marked up Wednesday (May 22), replacing the provisions with language calling for a Government Accountability Office report, according to a manager's amendment obtained by Inside Health Policy.

The Congressional Budget Office expects a lot more seniors to enroll in Medicare Advantage plans than it did just a year ago, and health care consultancy firm Marwood Group said CBO's projections are conservative.