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Medicare beneficiary advocates allege CMS' draft “Medicare & You” handbook for 2019 distorts the facts surrounding traditional Medicare and Medicare Advantage by suggesting MA is the cheaper option, describing MA prior authorization as a “right,” and failing to note traditional Medicare's broader provider network.

DME Stakeholders Upset CMS Rule Didn't Hike Pay For All Non-Bid Areas

Durable medical equipment and oxygen lobbyists say CMS' recent move to raise Medicare reimbursement for DME in the second half of 2018 offers much needed relief for rural areas, but they are upset the interim final rule didn't extend that pay raise to other non-competitive bid areas, aside from Hawaii and Alaska.

House, In Rejecting Farm Bill, Sinks Measure To Set Up Agricultural Association Health Plans

The House, in rejecting the farm bill Friday (May 18), sank a provision that would have created agricultural Association Health Plans. The provision would have authorized $65 million for the secretary of Agriculture to create up to 10 loans and grants to help support the creation of the plans.

CMS Writing Part D Rule That Could Be Vehicle For Many Of Trump’s Drug Price Proposals

CMS is writing another Part D rule, according to the unified agenda that outlines agency rulemaking plans, and Ross Margulies, an associate at Foley Hoag, expects that many of the president’s proposals to curb drug prices will be included in that rule.

Energy & Commerce Committee Approves 32 More Bills On Opioid Abuse

The House Energy & Commerce Committee approved 32 opioid-related bills on Thursday (May 17), including a bill that would weaken privacy protections for medical records containing information about substance use disorders and a watered-down version of a bill that would allow Medicaid to cover treatment for opioid use disorder in large inpatient treatment centers.

CMS Officially Puts Plans On Notice To Stop Using Pharmacy Gag Orders

CMS officially put drug plans on notice to stop using so-called gag orders that prohibit pharmacists from telling customers when it is more expensive to use insurance to buy drugs.

House To Vote On Senate-Passed Right To Try Bill Next Week, Gottlieb Onboard

The House will vote next week on the Right to Try bill passed out of the Senate last August, House leadership said Thursday.

Brands Use Voluntary Restricted Distribution As Much As REMS To Slow Generics

FDA's long-awaited list of brand drugs for which generics have sought the agency's help in obtaining the samples necessary for testing and approval confirms that Risk Evaluation and Mitigation Strategies are not the only tool used by brands to withhold samples.

CMS Opens National Coverage Analysis For CAR-T Cell Therapies

CMS' Medicare Evidence Development & Coverage Advisory Committee will meet in August to consider a National Coverage Determination for chimeric antigen receptor (CAR)-T cell therapies after UnitedHealthcare requested such a determination to make sure there is a level playing field across Medicare for coverage of the expensive therapies.