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Daily News

January 21, 2020

CMS on Tuesday (Jan. 21) called for public comments on coordinating care from out-of-state providers for Medicaid-eligible children with medically complex conditions.

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The Supreme Court said Friday (Jan. 17) that it will once again wade into the contentious fight over the Affordable Care Act’s requirement that employers provide coverage for birth control in employee health plans.

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Leaders on the House Energy & Commerce Committee are probing why there has been a lag in the development and approval of complex generic drugs, which tend to be high-cost medications, and whether FDA needs new authority from Congress.

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January 17, 2020

Congress’ Medicare advisers approved 2021 payment recommendations for a variety of health sectors Thursday, including suggestions that Congress eliminate a number of scheduled pay raises for various sectors, despite stakeholder pushback on some of the proposals.

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Illinois has submitted a waiver to CMS asking to extend Medicaid coverage up to one year after a Medicaid beneficiary has had a baby, as opposed to the current 60-day limit.

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FDA plans to study how proprietary drug names affect public perception and how they can sometimes be misleadingly overstate the safety or efficacy of the drug, expand drug indications or suggest superiority, the agency told the White House budget office on Friday (Jan. 17).

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A panel of FDA advisors were split on whether FDA should approve Durect Corporation’s Posimir (SABER-bupivacaine extended-release solution) for post-surgical pain relief, touted by the company as a drug that would reduce use of opioids for at least 24 hours after surgery.

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January 16, 2020

The administration has released the proposed rate review calendar and other technical guidance insurers need to prepare for the 2021 plan year, but midway through January stakeholders are becoming increasingly anxious because HHS is yet to release the draft exchange rule that sets policy on networks, open enrollment, drugs and other key issues.

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The Federal Trade Commission is moving forward on its efforts to crack down on anti-competitive behavior by hospitals and hospital systems, according to FTC Commissioner Christine Wilson, as called for by some Democrats.

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Eli Lilly is halving the list price on two more of its insulin products for consumers who either are uninsured or choose to buy the products without insurance, the company announced Tuesday (Jan. 14).

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Eli Lilly is halving the list price on two more of its insulin products for consumers who either are uninsured or choose to buy the products without insurance, the company announced Tuesday (Jan. 14).

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CMS rejected Wyoming’s proposal to eliminate air ambulance surprise medical bills by making all residents Medicaid-eligible for ambulance services on the grounds that the proposal is at odds with the purposes of the Medicaid program.

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The White House Office of Management and Budget has been meeting with industry stakeholders the past several weeks as it reviews the final interoperability rules drafted by the National Coordinator for Health IT and CMS last February.

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A group of laboratories and clinicians filed a citizen petition challenging FDA’s attempts to stop labs from providing physicians with genetic test data that assess a patient's risk of an adverse response or likelihood to respond to a given drug.

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Two Sanofi insulin products will lose exclusivity protections as a result of FDA’s updated list of drugs that will be considered biologics in March, a shift that Sanofi previously argued would violate the Fifth Amendment.

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Nearly half of total 2018 spending on brand name medicines went to the supply chain and brand drug makers are retaining an increasingly smaller share of list prices, according to an industry-funded study by the Berkeley Research Group.

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Although it’s an off year for state legislatures, states are expected to make progress on legislation and initiatives to lower drug prices, and state attorneys general are showing more interest in protecting residents from high drug prices, according to National Academy for State Health Policy Executive Director Trish Riley.

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January 15, 2020

The insurance industry, seniors’ organizations, hospitals, small businesses, health advocates and a bipartisan coalition of 56 economists back Democrats’ calls for the Supreme Court to review the Fifth Circuit’s ruling over the Affordable Care Act, arguing it is imperative to resolve the future of the health law as quickly as possible to remove the vast cloud of uncertainty created by the decision.

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The debate over the future of the health care system will continue to be a key issue on the presidential trail in 2020, but as Tuesday’s winnowed-down Democratic debate highlighted, Sen. Bernie Sanders (I-VT) is now the lone top-tier presidential candidate still calling for a quick transition to Medicare for All, while the other Democratic candidates argue that their policy ideas are just as bold.

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States want HHS and Congress to allow them to use grants aimed at curbing the opioid crisis to also tackle other drugs that are prevalent in their regions, including cocaine and methamphetamine, as lawmakers call on HHS to explain how it is responding to a rise in the use of stimulants.

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