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Daily News

January 10, 2020

The Supreme Court agreed Friday (Jan. 10) to hear a case that could revive an Arkansas law regulating pharmacy benefit managers, a move with widespread implications for state efforts to lower drug prices through limits on PBMs’ activities and profits.

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A Texas surprise billing law went into effect on Jan. 1 without an exception for most non-emergency cases that was sought by a group of hospitals and providers.

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Stakeholders are calling on House Energy & Commerce Committee leaders to hold a hearing on a bill that would authorize grants to states and local entities to tackle social determinants of health for Medicaid beneficiaries.

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FDA on Thursday (Jan. 9) launched a biotechnology regulation website in collaboration with U.S. Department of Agriculture and the Environmental Protection Agency that is intended to streamline information from the three agencies charged with overseeing agriculture biotechnology products.

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California Gov. Gavin Newsom is taking a page from President Donald Trump’s playbook by insisting Californians pay no more for drugs than paid by other countries, and if Californians were to get that so-called most-favored-nation status, all state Medicaid programs would get the same deal due to the Medicaid Best Price rule.

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CMS suggested as part of new guidance laying out ways to avoid duplicate discounts between 340B and Medicaid that states could use state plan amendments to keep some -- or all -- providers and contract pharmacies from using 340B drugs for Medicaid beneficiaries, and 340B hospitals quickly pushed back.

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January 09, 2020

Judges on a federal appeals court expressed concern Thursday (Jan. 9) that health insurers could receive an unjustified financial windfall if the insurers prevail in a series of lawsuits over the government’s failure to make payments under the Affordable Care Act’s cost-sharing reduction program.

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Kansas is a step closer to expanding Medicaid after Democratic Gov. Laura Kelly and Republican Senate Majority Leader Jim Denning on Thursday (Jan. 9) announced a bipartisan proposal to expand Medicaid that also includes Republican-pushed provisions, including premium assistance to help newly-eligible beneficiaries pay for commercial insurance if available to them.

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CMS hasn’t been able to pay more than 2,800 providers in alternative payment models their 5% bonus for 2017 performance because it doesn’t have their banking information, the agency says, and it has given those clinicians until Feb. 28 to clear that up so the bonuses can be paid.

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FDA must soon update Congress on its plan for regulating cannabidiol (CBD) products, but there are myriad issues the agency still needs to grapple with as that deadline looms.

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The regenerative medicine industry wants federal agencies and Congress to increase coverage and reimbursement for innovative gene therapies and to give FDA extra funding to expedite reviews of new gene therapy applications.

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New Jersey has contracted with exchange vendor GetInsured to operate its state-based exchange platform and MAXIMUS to run its consumer call center, the state’s Department of Banking and Insurance announced this week.

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The House Energy & Commerce health subcommittee will hold a legislative hearing on Jan. 15 to discuss federal cannabis policies, E&C Chair Frank Pallone (D-NJ) and subcommittee Chair Anna Eshoo (D-CA) announced Wednesday (Jan. 8).

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New York Gov. Andrew Cuomo (D) announced his intent to import Canadian drugs, cap insulin costs and rein in drug companies that overcharge patients.

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January 08, 2020

A nationwide injunction blocking the Trump administration from implementing its so-called public charge rule will remain in effect while litigation over the rule continues, a federal appeals court ruled Wednesday (Jan. 8).

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The two House committees considering surprise billing legislation did not make progress over the holiday break and are stuck on opposite ends of the issue.

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A federal appeals court on Wednesday (Jan. 8) dismissed a lawsuit over Medicaid work requirements in Kentucky now that the state’s new governor has abandoned the policy, but similar lawsuits challenging work requirements in other states are ongoing.

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The House Energy & Commerce health subcommittee considered three bills Wednesday (Jan. 8) that would strengthen patient protections for Medicare and Medicaid, and the hearing has given beneficiary advocates hope that these protections will be included in legislative packages passed this year.

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CMS on Wednesday (Jan. 8) released the final enrollment snapshot for the 2020 plan year, showing a total of about 8.3 million enrollments through healthcare.gov even as the raw numbers dipped just slightly, or by 17,000 compared to the week 8 snapshot released Dec. 18.

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FDA has proposed withdrawing more than 200 generic drug applications because the application holders repeatedly failed to file annual reports.

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