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Daily News

October 16, 2020

The vast majority of Medicare beneficiaries surveyed by CMS say they did not forego medical care for non-COVID-19 concerns during the pandemic, according to a survey released Friday (Oct. 16), but 21% said they did skip needed medical care and dental care was the most likely to be skipped.

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Medicare next year will cut pay for labs that take more than two days to turn around COVID-19 test results, CMS announced Thursday (Oct. 15).

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Pfizer will apply for emergency use authorization for its COVID-19 vaccine around the third week of November, assuming it gets a positive data readout on efficacy and safety by then, company CEO Albert Bourla says in a Friday (Oct. 16) open letter.

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GOP Gov. Brian Kemp and CMS Administrator Seema Verma talked up Georgia’s 1332 waiver during a Thursday event to announce the agency will be approving the state’s controversial request to exit healthcare.gov and rely on its own agents, brokers and insurers -- although they have yet to agree on the final terms.

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October 15, 2020

Federal judges seemed unconvinced on Thursday (Oct. 15) that the Trump administration’s hospital price transparency rule violates the First Amendment and exceeds HHS’ statutory authority, as the American Hospital Association argued in an appeal to stop the rule.

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CMS on Thursday (Oct. 15) approved an 1115 waiver to allow Georgia to partially expand Medicaid and impose work requirements.

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Eli Lilly is still pursuing emergency use authorization for its COVID-19 antibody therapy, LY-CoV555 (bamlanivimab), for use in mild-to-moderate COVID-19 patients, even as its National Institutes of Health-sponsored trial of hospitalized patients remains on hold while an independent group of experts reviews the trial data, a company spokesperson confirmed to Inside Health Policy.

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As the fate of the innovation center -- and the rest of the Affordable Care Act -- faces uncertainty in the courts, CMS Administrator Seema Verma said the innovation demonstrations are losing money and the center needs a course correction, including less-generous model benchmarks.

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Despite the president’s boasts, a top Trump campaign policy adviser said legal and regulatory challenges might thwart the administration’s drug import rule.

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Joe Biden said he would like to adopt a variation of the German drug pricing model, which makes drug companies justify prices to an independent panel, according to a press pool account of comments the Democratic presidential candidate made Thursday (Oct 14).

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An official with the Biotechnology Innovation Organization said he’s disappointed that the federal government failed to discuss pull incentives for antimicrobial medicines in its recently released national plan to reduce antibiotic resistance.

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October 14, 2020

CMS on Wednesday (Oct. 14) expanded the list of telehealth services Medicare will reimburse, two months after unveiling a proposed rule to make some of the telehealth flexibilities allowed during the pandemic permanent for rural Medicare beneficiaries.

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Private-equity owned companies account for the majority of Medicare spending on air ambulance services and charge an average of more than seven times the Medicare reimbursement rate, which leads to expensive surprise medical bills, according to an analysis by the USC-Brookings Schaffer Initiative.

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Health care navigators tasked with helping consumers purchase coverage through healthcare.gov have been preparing to tackle one the most challenging open enrollment periods to date by moving to virtual enrollment method signups to keep consumers and workers safe during the pandemic, while also facing a dearth of guidance from an administration that is trying to scrap the very law that navigators are trying to get consumers to embrace.

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Lobbies representing community health plans are asking CMS to extend the 2021 open enrollment period through January, or create a special enrollment period to let consumers affected by COVID-19 enroll in early 2021.

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Nevada health officials rescinded their order for nursing homes to stop using point-of-care COVID-19 testing machines supplied by CMS due to alleged 60% false positive rates shortly after HHS called the directive unlawful and demanded the state retract it.

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Pediatricians and family health care advocates were not surprised by CMS’ findings in September that fewer children are receiving vaccinations or health screenings, but they say the agency’s urgent call to action does not substantively deal with increasing rates of uninsured families and underfunded children’s programs.

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October 13, 2020

Supreme Court nominee Amy Coney Barrett on Tuesday (Oct. 13) continued to suggest her 2017 paper that criticized Chief Justice John Roberts’ decision that uphold the Affordable Care Act due to Congress’ power of taxation has no bearing on the lawsuit the high court is set to hear Nov. 10, saying severability, an issue on which she has yet to reveal her position, is what the current case centers on.

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Maryland Governor Larry Hogan (R) on Tuesday (Oct. 13) urged Medicaid plans to press lawmakers to again increase the federal Medicaid match during the COVID-19 pandemic but acknowledged that a new stimulus bill likely won’t come until after the November election.

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The pandemic has highlighted and exacerbated long-standing vulnerabilities of employer-sponsored insurance (ESI), marking a good time to evaluate what role employers should be playing -- or want to play -- in the future of health care, the non-partisan think tank United States of Care says in a recent report that looks at how some states and employers have tried to tackle costs via direct negotiations and price transparency.

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