CMS proposed Friday (Jan. 18) to share with insurers savings from lower Part D catastrophic spending in return for plans agreeing to penalties when they exceed spending targets.

Arizona is the eighth state to receive permission from the Trump administration to add work requirements to its Medicaid program, and after months of behind-the-scenes negotiations between state officials and CMS lawyers, CMS allowed the state to exempt some Native Americans from the requirements.

CMS on Friday (Jan. 18) announced a nation-wide expansion and several new features of its Value-Based Insurance Design model, which provides flexibility to Medicare Advantage plans with the goal of encouraging beneficiaries to consume high-value clinical services.

House Energy & Commerce Chair Frank Pallone (D-NJ) says his committee will be looking into the Medicaid work requirement waivers, which the Trump administration has approved for eight states, but E&C oversight subcommittee Chair Diana DeGette (D-CO) says they aren’t at the top of her agenda.

In an effort to encourage drug companies to develop over-the-counter (OTC) versions of overdose-reversal drug naloxone, FDA has developed a model drug facts label with pictograms that show how to use the drug, which can help consumers better understand how to use naloxone without the supervision of a health care professional, agency chief Scott Gottlieb announced on Thursday (Jan. 17).

FDA released final guidance on Thursday (Jan. 17) that the agency says will encourage the development of antimicrobial susceptibility tests (ASTs) to help determine whether a pathogen will likely respond to, or has developed resistance to, certain antimicrobial drugs.

CMS on Thursday (Jan. 17) released its long-awaited exchange policy regulation, and while it avoided making changes to the silver-loading process, the agency did propose several other policies including allowing mid-year drug formulary changes, creating a new special enrollment period for people newly eligible for subsidies, increasing maximum out-of-pocket spending limits, and reducing the user fee by half of a percentage point.

CMS is calling for a legislative solution to reinstate cost sharing reduction payments to insurers and to end the silver-loading workaround by plan year 2021 as a part of the proposed 2020 Notice of Benefit and Payment Parameters.