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Daily News

June 07, 2019

New Hampshire told a federal judge Thursday (June 6) that imposing Medicaid work requirements and rolling back retroactive eligibility are “common-sense measures designed to provide medical assistance to eligible populations in a fiscally responsible and sustainable manner.”

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Connecticut lawmakers’ effort to pass a sweeping health reform bill collapsed in the state’s senate late Wednesday (June 5), the final day of the session.

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Opioid maker Insys Therapeutics, which manufacturers fentanyl product Subsys, will plead guilty to five counts of mail fraud, pay millions in fines and pay to settle allegations that it violated the False Claims Act, the Department of Justice (DOJ) announced Wednesday (June 5).

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FDA for the first time has granted marketing authorization to a device intended to help relieve pain in adolescents with irritable bowel syndrome (IBS) through the use of electrical nerve stimulation, the agency announced Friday (June 7).

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Lawyers in the gene therapy field said FDA’s approval of AveXis’ Zolgensma, a new drug for treating spinal muscular atrophy (SMA), lays the groundwork for an expected wave of future gene therapy drug applications.

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The Biosimilars Forum is scheduled to meet with White House budget officials June 10 to discuss policies that the trade group says would reduce Medicare spending by boosting the use of biosimilars, according to the Office of Management and Budget website.

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Washington is the fourth state to seek approval from CMS to enter performance-based contracts with drug makers, according to documents obtained by Inside Drug Pricing.

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CMS Administrator Seema Verma on Thursday (June 6) called out large hospital systems for anti-competitive behavior, and said CMS policies like pay cuts for 340B drugs and site-neutral pay policies -- both of which led to lawsuits over CMS’ authority to enact them -- were put in place to help combat consolidation and physician movement from independent work to hospital employment.

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June 06, 2019

As support builds among insurers, think tanks and some lawmakers for including network matching, also known as an in-network guarantee, in surprise billing legislation, physician groups and hospitals warn the proposal could hurt physicians and benefit insurers with no benefit to patients.

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The White House Office of Management and Budget has begun its review of a planned CMS guidance letter that stakeholders expect will allow states to convert their federal Medicaid funding into some form of a block grant.

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A proposed ballot measure to expand Medicaid in Florida has cleared an early hurdle on the path to be added to next year’s ballot.

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The White House Office of Management and Budget on Wednesday (June 5) began its review of HHS’ proposal to revise anti-kickback statute safe harbors and beneficiary inducement penalties.

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Lobbyists for brand drug makers have told Senate Finance Committee staff they’re open to paying a share of seniors’ catastrophic Medicare Part D drug costs in exchange for capping seniors’ out-of-pocket costs and relieving drug makers of the 70% discounts they currently must pay for drugs that beneficiaries take while in the donut hole, according to sources close to the negotiations.

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A Senate Finance Committee task force has added the Affordable Care Act’s health insurance tax to the list of health fees for which it is seeking a permanent fix, a Senate staffer confirmed.

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Senate Finance Committee Chair Chuck Grassley (R-IA) plans to work on a rural health package and changes to the Medicaid Disproportionate Share Hospital payments formula separately, according to the lawmaker’s office, though earlier this year he had discussed the possibility of putting the two together.

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CMS is asking for another round of feedback on ways to cut administrative and regulatory burden through its ongoing Patients Over Paperwork campaign and is specifically looking for ways to cut down on the burden posed by prior authorization procedures, beneficiary enrollment and beneficiary eligibility determinations, as well burdens on rural providers and duals.

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As all eyes are on Oklahoma’s trial against drug maker Johnson & Johnson over its role in the opioid epidemic, the number of states filing charges against opioid makers is stacking up.

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FDA on Monday (June 3) announced a pilot program call center at its oncology office that is meant to serve as an information hub for physicians treating patients with cancer who seek access to unapproved therapies.

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Rep. Joe Courtney (D-CT), a longtime champion of repealing the Affordable Care Act’s 40 percent tax on high-cost health plans, dubbed the “Cadillac tax,” filed a motion to schedule a House vote now that the bipartisan repeal bill has gathered 345 co-sponsors.

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Members of the House Energy & Commerce health subcommittee agreed that extending funding for community health centers, the National Health Services Corps, and the Teaching Health Center Graduate Medical Education program for more than two years is a priority, but some House Republicans at a hearing on Tuesday (June 4) expressed concern about paying for the programs.

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