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Daily News

January 08, 2020

More than half of voters consider out-of-pocket costs for prescription drugs and other aspects of health care as top concerns ahead of the first primaries, according to a recent poll from Morning Consult and Bipartisan Policy Center.

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In 2020, the people who play the largest role in shaping health care policy may not be members of Congress, officials at CMS, or even presidential candidates -- they may be federal judges.

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CMS on Monday (Jan. 6) touted that about 98% of providers in the Merit-based Incentive Payment System received a bonus or avoided a pay cut for the program’s second performance year, 2018, but some stakeholders say that a budget-neutral system where everyone does well doesn’t provide the necessary incentives to move providers to value-based pay and the program is becoming more of a compliance exercise than motivation for providers to move away from fee-for-service.

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New York Gov. Andrew Cuomo (D) will advance legislation this year to place fentanyl analogues on the state’s controlled substances list, according to the governor’s 2020 State of the State agenda unveiled Wednesday (Jan. 8).

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Medicare and Medicaid advocates, attorneys and researchers say HHS lacks authority to approve Tennessee’s Medicaid block grant proposal, and the state’s request to deregulate managed care plans, lock-out beneficiaries guilty of fraud and modify enrollment would harm beneficiaries.

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The Medicaid And CHIP Payment and Access Commission released a report Monday (Jan. 6) finding that Institutions for Mental Diseases, or IMDs, lack clear federal oversight and face a patchwork of state regulation as many states sidestep the restriction that prevents Medicaid from paying for inpatient services in these large facilities.  

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The Medicaid And CHIP Payment and Access Commission released a report Monday (Jan. 6) finding that Institutions for Mental Diseases, or IMDs, lack clear federal oversight and face a patchwork of state regulation as many states sidestep the restriction that prevents Medicaid from paying for inpatient services in these large facilities.  

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January 07, 2020

In light of President Donald Trump’s Medicare executive order, CMS is seeking advice on how to eliminate Medicare regulations that are more stringent than state laws and limit what services certain non-physician practitioners can offer.

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Cyber policy pros are urging operators of industrial control systems and other critical infrastructure to be particularly alert to cyber threats following the U.S. attack that killed Iran's top general, amid intense discussions on whether the right cyber policy tools are in place for a potentially unprecedented confrontation in cyberspace.

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Beneficiary advocates say a Wednesday House Energy & Commerce health subcommittee hearing may signal that beneficiary protection bills could be included in legislative packages passed this year.

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FDA has extended the comment period for its homeopathic draft guidance to March 23, 2020, the agency announced Tuesday (Jan. 7).

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FDA will hold a public meeting March 27 to gather input on efforts to reform its data strategy, which the agency laid out in its Technology Modernization Action Plan (T-MAP) in September.

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The 10th Circuit Court of Appeals recently reversed a district court ruling that shot down CMS’ risk adjustment methodology for the 2014-2018 plan years.

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Many stakeholders are looking more to the Trump administration than to Capitol Hill for new Medicare policies in the lead up to the 2020 election, particularly as they wait for final Stark, anti-kickback, and interoperability rules as well as any rules that come out of the Medicare executive order signed by President Donald Trump last year.

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January 06, 2020

The Supreme Court is already moving quickly on Democrats’ request that it promptly review the constitutionality of the Affordable Care Act: Parties in the case have until Friday (Jan. 10) to respond to calls by the House of Representatives and state Democratic attorneys general for the high court to expeditiously review Texas v. USA.

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CMS on Monday (Jan. 6) proposed for 2021 to speed up the transition to a new Medicare Advantage risk-adjustment model and to increase its reliance on encounter data in the first part of the so-called advance notice and call letter for MA and Part D.

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The former CEO of Anthem’s Diversified Business Group will lead the Center of Medicare and Medicaid Innovation, CMS announced Monday (Jan. 6), replacing former Adam Boehler who stepped down as director last year.

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Sens. Susan Collins (R-ME), Doug Jones (D-AL), Martha McSally (R-AZ) and Bob Menendez (D-NJ) Monday (Jan. 6) introduced a bill that would fund a three-year pilot program to increase federal Medicaid funding for whole genome sequencing (WGS) services for children with a suspected genetic disease.

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The generic drug lobby is appealing a California district court’s decision not to block the state’s pay-for-delay law, which went into effect Jan. 1.

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Whether more states expand Medicaid or move towards block grants, and the fate of the Trump administration’s controversial work requirements policy, hinge largely on the November presidential election and several governors’ races, stakeholders say.

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