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Daily News

November 28, 2018

HHS on Wednesday (Nov. 28) unveiled numerous draft recommendations aimed at reducing provider burden related to health IT and electronic health records, including standardization in many areas and leveraging of health IT to ease prior authorization.

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House Speaker-nominee Nancy Pelosi (D-CA) welcomed a Democratic-led caucus with a health care mandate, proclaiming the party’s campaign focus on protecting the Affordable Care Act helped Democrats secure the chamber. Pelosi, who faces a formal vote to be speaker in January, vowed the House would spend the next two years continuing that focus while combatting the Trump administration’s past two years of action to unravel parts of the ACA.

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Senate health committee ranking Democrat Patty Murray (WA) called for the Senate to return to legislation that would shore up the Affordable Care Act marketplaces, and committee Chairman Lamar Alexander (R-TN), Murray’s co-author of the failed ACA stabilization bill, said he would be open to revisiting the measure.

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Maine Gov. Paul LePage (R) is using his final weeks in office to continue something he has been doing for nearly his entire time as governor: fighting Medicaid expansion.

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CMS has approved HealthSherpa as its first partner to use the new enhanced direct enrollment pathway that will allow consumers, including those eligible for subsidies, to purchase exchange plans from web entities, including web-brokers, private exchanges and insurers, without having to visit healthcare.gov, sources tell Inside Health Policy.

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The White House Office of Management and Budget on Tuesday (Nov. 27) began reviewing a final regulation that, as proposed, would move up implementation of the 340B ceiling price and penalties rule to Jan. 1.

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A day after releasing a plan to overhaul FDA’s clearance process for certain low- and moderate-risk medical devices, FDA Commissioner Scott Gottlieb defended his agency’s proposals amidst a wave of industry opposition to them and used cybsecurity concerns to make his point.

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November 27, 2018

CMS Administrator Seema Verma signaled Tuesday (Nov. 27) that the agency intends to proceed full steam ahead in approving Medicaid work requirements, despite growing calls from patient advocates and federal Medicaid advisers for the agency to slow down.

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CMS Administrator Seema Verma signaled the agency is still weighing whether to continue letting insurance plans mitigate the loss of cost-sharing reduction (CSR) reimbursements by increasing premiums on silver-level benchmark products, also known as "silver loading."

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CMS is expected to release on Thursday (Nov. 29) some specific examples of potential Section 1332 waivers that could be approved under the administration’s revised guidance, according to CMS Administrator Seema Verma and another knowledgeable source.

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Medicare beneficiary advocates are again raising concerns that the administration appears to be promoting Medicare Advantage over traditional Medicare in its education and outreach materials for open enrollment, this time pointing to CMS’ eMedicare initiative and the email campaign the agency is conducting as beneficiaries choose their coverage option for 2019.

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Drug pricing is one of the only areas where the two parties and the president might find common ground to make laws, and President Donald Trump, Democrats and incoming Senate Finance chair have been harping on drug prices so long that it will be difficult for them to do nothing, according to two former White House health aides for Republican and Democratic administrations.

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The International Consortium of Harmonisation agreed with FDA Commissioner Scott Gottlieb this month that its members should develop standard international approval requirements for generic drugs, which would facilitate simultaneous approvals in multiple markets.

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Continuing drug shortage issues are a result of economic and policy failures that span many years, FDA Commissioner Scott Gottlieb told a crowd of researchers, health care providers, industry representatives and other experts during the agency’s Tuesday (Nov. 27) drug shortages public meeting, held in coordination with the Duke Margolis Center for Health Policy.

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Virginia submitted a waiver application to add work requirements to its Medicaid program — a key provision of the compromise that allowed the Virginia legislature to pass Medicaid expansion earlier this year.

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The insurance industry is floating a dozen policy recommendations designed to improve affordability in the individual market, and among the suggestions is that Congress equalize the tax treatment of premiums by allowing unsubsidized consumers to deduct their costs from income.

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November 26, 2018

MS proposed Monday (Nov. 26) letting Part D plans exclude drugs in protected classes from Part D formularies when their makers raise prices faster than inflation or when drug companies make new formulations of drugs already on the market.

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Device industry leaders were taken aback that FDA is considering publishing online the names of devices cleared using predicate devices that are 10 years old or older -- a move the agency announced Monday (Nov. 26) as part of a broader effort to modernize and tighten its medical device clearance process amid recent reports of safety issues.

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A conservative group in Idaho is asking the state’s highest court to block the implementation of a Nov. 6 ballot initiative in which 61 percent of Idahoans chose to expand Medicaid.

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SAN FRANCISCO -- Consumer advocates are urging state insurance regulators to use their positions to help get the word out about open enrollment since the federal government has slashed funding for marketing and outreach.

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