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Daily News

October 18, 2017

The individual market stabilization deal struck by Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA) may face challenges and more tweaks, but health policy analysts say the measure's changes to 1332 waiver statute are a key step to the future of U.S. health care even if the cost-sharing reduction payment authorizations are just a short-term fix.

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A source tells Inside Health Policy that rumored potential HHS secretary nominee, former Lilly president and HHS official Alex Azar, has been interviewed for the job and wants it with conditions -- but those conditions remain unknown as of press time.

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The IRS will reject 2017 electronic tax returns filed without confirmation of whether the filers had health insurance, the agency said Wednesday (Oct. 18).

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FDA approved Wednesday (Oct. 18) Kite Pharma's Yescarta (axicabtagene ciloleucel), marking the second gene therapy approved in the United States and the first for certain types of non-Hodgkin lymphoma.

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A coalition of Democratic attorneys general are seeking a temporary restraining order that would force the administration to continue paying out the cost-sharing reduction payments, arguing the coalition is likely to succeed on the merits of their case and failure to take action would cause irreparable harm to residents.

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Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA), in their just-released market stabilization bill that funds the cost-sharing reduction payments for two years, agreed to amend 1332 statute to fast-track the waiver process, broaden the budget neutrality requirements, and set up the pass-through funding structure Alaska recently used for its reinsurance waiver.

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Basic Health Program (BHP) funding would be held harmless from any reductions in projected funding under the state innovation waivers as part of the bipartisan market stabilization legislation unveiled Tuesday, a reaction to the administration's decision that is slated to cost Minnesota about $369 million if not reversed.

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The ranking Democrat on the Senate health committee Monday (Oct. 16) slammed FDA Commissioner Scott Gottlieb's proposal to delay implementation of the agency's updated nutrition facts rule, saying the move is detrimental to public health and creates uncertainty for industry and consumers.

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October 17, 2017

Senate health committee Chair Lamar Alexander (R-TN) and ranking Democrat Patty Murray (WA) reached a deal to fund the cost-sharing reduction payments for two years, allow all Americans to purchase catastrophic plans, restore ACA marketing funding via state outreach grant and provide “significant” changes to the Section 1332 waivers that would expand choices and speed up the approval process, according to Alexander's office.

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The Trump administration's decision to stop cost-sharing reduction payments will result in a significant fourth-quarter financial blow to health insurance plans, with issuers in Florida, California, Texas, North Carolina and Virginia facing the largest hit, a new Avalere study finds.

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The executive order that the president signed last week could drive healthy people to buy short-term and association health plans that are not required to cover drugs, but Pharmaceutical Research and Manufacturers of America Executive Vice President Lori Reilly declined Tuesday (Oct. 17) to take a position on the policy.

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The American Civil Liberties Union (ACLU) Foundation and ACLU of Hawaii Foundation, representing a medical professional and other health organizations, have sued HHS and FDA for what the plaintiffs say are inappropriate and unnecessary Risk Evaluation and Mitigation Strategies (REMS) restrictions on Danco Laboratories' Mifeprex -- also known as the “abortion pill” -- that limit patient access.

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As the FDA continues to delay several food-related regulations, it appears that the agency is still committed to taking steps to evaluate how the agency regulates 'healthy' and other food claims.

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Senate health committee Chair Lamar Alexander (R-TN) questioned the merit of drug rebates at a hearing Tuesday (Oct. 17) on drug prices.

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Lawmakers and states have turned their attention to overturning a statutory hurdle that keeps Medicaid funds from going to institutions of mental disease (IMD), and behavioral health experts and patient advocates believe that Congress and CMS may soon take actions to eliminate the Nixon-era rule.

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West Virginia's substance use disorder 1115 waiver removes a statutory hurdle that keeps Medicaid funds from going to institutions of mental disease (IMD) for substance abuse treatments, and advocates are hopeful that the administration’s approval of the waiver could lead to similar waivers in other states.

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October 16, 2017

Throughout the day Monday, the president declared the Affordable Care Act “dead” and claimed his move to abruptly end the law's reimbursements to insurers for reducing out-of-pocket costs sparked bipartisan work on a short-term market fix that he now supports.

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Pennsylvania's insurance commissioner on Monday (Oct. 16) announced it has approved rate increases that average 30.6 percent, or 23 percent more than the 7.6 increase issuers sought under the assumption the cost-sharing reductions would be paid.

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Sen. Ron Johnson (R-WI) is working on an alternative fix to the Affordable Care Act that follows five principals, including improved transparency, expanded insurance choices, strengthened consumer-directed plans, and lower premiums in exchange for cost-sharing reduction funding.

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Watchdog group Democracy Forward sued the White House Office of Management and Budget for information on the role OMB Associate Director of Health Programs Joseph Grogan played in the delays of the Obama administration's 340B drug ceiling price and manufacturer penalty rule.

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