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Daily News

July 31, 2019

CMS on Wednesday (July 31) gave Colorado and North Dakota approval to move forward with their planned reinsurance programs via 1332 waivers. Both states had submitted waiver applications in May as part of an effort to drive down premiums for the 2020 plan year.

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A federal appeals court has scheduled an oral argument for Oct. 11 on the legality of Medicaid work requirements.

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Senate Democrats are using the Congressional Review Act in a bid to block the Trump administration’s policy changing the purpose of the Affordable Care Act’s 1332 waivers.

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A new report from the Government Accountability Office highlights wide disparities in how Medicaid payments are distributed to disproportionate share hospitals as Congress grapples with whether to again postpone cuts to Medicaid DSH payments that are scheduled to take effect Oct. 1.

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In light of a deadly pig disease sweeping across China, bipartisan leaders of the House Energy & Commerce Committee want FDA to brief lawmakers on the potential threat to the U.S. supply of heparin, the only anticoagulant drug used in the United States for open-heart surgeries and kidney dialysis.

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The Trump administration’s newly unveiled two-track plan to allow drug importation was touted as a precedent-setting move by HHS officials, but some health policy experts said it could slow up state importation efforts through unnecessary rulemaking and do little to lower drug costs under the voluntary, industry-driven track.

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CMS Administrator Seema Verma warned a receptive audience at the Heritage Foundation about what she called the dangers of Medicare for All or a public health insurance option the morning after Democratic primary candidates touted these types of plans on the debate stage in Detroit.

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July 30, 2019

Democrats vying for the 2020 nomination spent the first 45 minutes of the second debate hashing out policy disagreements on Medicare for All versus a public option, with progressives arguing that a single-payer system would provide the most benefit to the most people and more moderate candidates saying it would eliminate choice and raise taxes on the middle class.

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Texas District Judge Reed O’Connor on Tuesday (July 30) rejected Nevada’s motion to intervene is a class action case over the Affordable Care Act’s contraceptive mandate and entered a final judgment blocking enforcement of the Affordable Care Act’s requirement that plans cover all FDA-approved birth control methods without cost-sharing for any individual or employer that objects to the mandate due to religious reasons.

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CMS finalized a 2.4% pay bump for nursing homes in fiscal 2020 on Tuesday (July 30) as part of the industry’s annual pay rule, as well as changes to how many patients can be involved in group therapy under the new Medicare pay model that will go into effect Oct. 1.

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Inpatient psychiatric facilities will see a 1.5% pay bump in fiscal 2020 and will be subject to a new quality measure intended to assess whether patients fill their prescriptions soon after being discharged.

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Support for Medicare for All and public option proposals is losing favor as voters from both parties learn more about the policies, a new report from the nonpartisan Kaiser Family Foundation found.

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The US Court of Appeals for the District of Columbia on Tuesday (July 30) told a lower court to take another look at the American Clinical Laboratory Association’s lawsuit over lab reporting policies the group says have driven down CMS’ pay for clinical lab services.

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House Ways & Means Committee leaders asked CMS to detail how it plans to improve its oversight of hospices, including by collecting better quality information, as recommended by the HHS Office of Inspector General.

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Public Citizen wants the Federal Trade Commission (FTC) to block the merger between Mylan and Pfizer’s Upjohn, which the companies announced Monday (July 29).

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The leaders of the Senate Finance and health committees met Tuesday (July 30) to begin cross-committee talks on drug pricing, the chairmen said.

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CMS announced a voluntary pilot on Tuesday (July 30) as part of the MyHealthEData initiative out of the White House that will let providers access Medicare claims data starting in January 2020.

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July 29, 2019

Hospitals would have to publicly post pay-specific negotiated prices of their “shoppable services,” including x-rays or caesarean deliveries, under CMS’ proposed 2020 outpatient rule, as the agency also doubles down on its site-neutral and 340B pay cut policies that hospitals have slammed.

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CMS on Monday (July 29) proposed to increase Medicare payments for doctor’s office visits and abandoned its plan to pay a blended rate for certain levels of office visits starting next year.

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CMS proposed a payment rule Monday (July 29) meant to encourage dialysis facilities to adopt new equipment and supplies while also increasing pay for those facilities and updating the pricing system for medical devices.

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