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Daily News

November 22, 2019

Advocates for Medicaid beneficiaries on Friday (Nov. 22) filed the fifth in a series of lawsuits contesting the legality of Medicaid work requirements and related policies.

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A federal appeals panel is set to hear oral arguments Jan. 9 in the high-profile lawsuits over the White House’s decision to stop reimbursing issuers for the Affordable Care Act’s cost-sharing reductions, and the government could be out billions, potentially in perpetuity, if the judges uphold the decision by the U.S. Federal Court of Claims.

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CMS is planning an overhaul of Medicaid eligibility regulations after the national improper pay estimates for the program hit 14.9% for fiscal 2019, and the agency is developing a proposed rule focused on insufficient recordkeeping, eligibility verification, redeterminations and compliance with eligibility requirements when beneficiaries’ circumstances change.

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The Medicare fee-for-service improper pay rate dropped again, according to the HHS fiscal 2019 financial report, dipping below the Medicare Advantage improper pay rate -- though that program’s improper pay rate dropped too, as did the Medicare Part D improper pay rate.

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Advocates for non-emergency transportation benefits in Medicaid are pressing Congress to protect those benefits after CMS signaled this week that it is still considering whether the benefits should remain mandatory for states.

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Sen. Kirsten Gillibrand (D-NY) introduced a bill on Thursday (Nov. 21) that would boost the government’s ability to find the origin of foodborne illnesses by giving FDA authority to oversee concentrated animal feeding operations, coming amid another E. coli outbreak linked to romaine Lettuce.

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A bipartisan group of lawmakers, led by Reps. Cindy Axne (D-IA) and Anthony Gonzalez (R-OH), are pressing HHS Secretary Alex Azar for answers about the ongoing shortage of pediatric cancer drug vincristine.

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November 21, 2019

Congressional Democratic health leaders on Thursday demanded HHS ensure that healthcare.gov functions properly throughout the entire open enrollment season, pointing to reports that as many as 100,000 people may have failed to enroll in coverage on Day 1 of the season due to technical errors.

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Congressional Democratic health leaders on Thursday demanded HHS ensure that healthcare.gov functions properly throughout the entire open enrollment season, pointing to reports that as many as 100,000 people may have failed to enroll in coverage on Day 1 of the season due to technical errors.

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Lawmakers on both sides of the aisle lobbed questions and expressed concerns about issues related to drug pricing, such as drug importation, biologic patent gaming, generic drug exclusivity and insulin access, to FDA commissioner-nominee Stephen Hahn during his Senate confirmation hearing Wednesday (Nov. 20).

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The Trump administration’s highly anticipated regulatory proposal to allow drug importation from Canada will be published in January, according to FDA’s fall 2019 regulatory agenda, which was published Wednesday (Nov. 20).

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House Democrats, AARP, patient advocates and physician groups recently filed amicus briefs supporting the seven stakeholders appealing a district court ruling that upheld the Trump administration’s short-term health rule. 

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Lawmakers are calling on CMS and the HHS Office of the National Coordinator for Health IT to prioritize patient privacy in the agencies’ proposed interoperability rules, highlighting growing tensions between HHS and Capitol Hill as the administration pushes to improve interoperability and lawmakers worry about privacy.

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FDA approved a drug for sickle cell anemia that could pose a significant cost to state Medicaid budgets because a little more than half of the approximate 100,000 Americans living with sickle cell disease are in Medicaid and the annual cost of the drug is $84,852 to $113,136, based on list price.

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Democratic presidential primary candidate Elizabeth Warren says that during the first 100 days of her presidency she would lower brand drug prices and tackle drug shortages with strict antitrust enforcement, and compulsory licensing and march-in authorities.

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Massachusetts Sen. Elizabeth Warren reiterated her commitment to covering all Americans under Medicare in her first term, but also embraced her new strategy of first building off the Affordable Care Act and lowering the existing Medicare program to adults age 50 and above, while Sen. Bernie Sanders (VT) said he’d push for Medicare for All his first week in office, in a Democratic presidential debate that featured only a few minutes on the topic, far less than in earlier events.

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November 20, 2019

During the Senate health committee’s confirmation hearing for FDA commissioner-nominee Stephen Hahn on Wednesday (Nov. 20), lawmakers grilled the nominee on myriad issues, including drug pricing, generic drug approvals, drug shortages and e-cigarette regulations.

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CMS says another 737,000 consumers selected plans from healthcare.gov in the third week of open enrollment, which is similar to the number last year during the same frame time, but Get America Covered notes the cumulative 1.67 million sign-ups lag by around 250,000 compared to previous years despite more options and lower prices.

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Tensions between a congressionally mandated panel charged with recommending alternative physician pay models and CMS’ innovation center culminated in two members of the panel resigning this week over what they view as the agency’s refusal to take the panel’s recommendations seriously.

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Senators on both sides of the aisle on Wednesday (Nov. 20) pressed FDA commissioner-nominee Stephen Hahn to take a stance on whether he thinks there should be a flavor ban on electronic nicotine delivery system (ENDS) products, including e-cigarettes.

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