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Daily News

June 01, 2021

Michigan’s decision to have Medicaid enrollees with incomes above 100% of the federal poverty level pay premiums for their coverage has led healthier beneficiaries to disenroll from Medicaid at higher rates than they otherwise would, according to a study published in May.

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Overall health care costs for a family of four decreased by about 4.2% due to the pandemic but are expected to increase by about 8.4% for the same family in 2021, according to the Milliman Medical Index (MMI), which measures costs for families enrolled in an employer-sponsored preferred provider plan (PPO).

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May 28, 2021

The Biden administration’s fiscal 2022 budget released Friday (May 28) proposes giving FDA $3.6 billion in budget authority, which FDA says would provide an 8% increase over fiscal 2021 enacted levels, though FDA watchers assert it would actually add up to an 11% increase.

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Under President Joe Biden’s fiscal 2022 budget, Medicaid would see an additional $49.6 billion compared to fiscal 2021, though the only Medicaid proposal with a new funding request is for home- and community-based services.

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In its fiscal 2022 budget justification released Friday (May 28), FDA identifies several legislative proposals it says could help with the agency’s COVID-19 pandemic response, including by giving FDA authority to require specific medical device supply chain information, request facility records in advance or in lieu of inspections, and share medical product information with state and local governments.

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CMS wants to create a dedicated $25 million health equity pot so it can implement two of the Biden administration’s executive orders that direct agencies to identify systemic barriers to their programs and address the pandemic’s disproportionate impact on communities of color.

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CMS requests $16.3 million for opioid and substance use disorder support services in its fiscal 2022 budget -- a nearly $13 million increase from the 2021 enacted level -- indicating CMS wants to prioritize tackling the substance abuse crisis this year.

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The President’s budget includes $163 billion over the next 10 years to make permanent the enhanced Affordable Care Act tax credits that were enacted as part of the American Rescue Plan, but the budget punts other health care priorities, including a public option, to Congress. 

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The eight states where CMS launched its Medicare prior authorization innovation model for repetitive non-emergency ambulance transport saved $746 million and reduced transport by 70%, an independent review of the pilot found, but the researchers warned that the prior authorization policy likely wouldn’t wring similar savings from states outside the demonstration, and it could hurt patient care.

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May 27, 2021

A few state-based exchanges recently released enrollment updates from the special enrollment period (SEP), Nevada and Colorado are working on public option bills and Virginia delayed the launch of its state-run exchange until 2024.

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Georgia’s two newly-elected Democratic senators sent a letter to Senate leadership Wednesday (May 26), followed by a similar letter from civil rights groups on Thursday (May 27), asking that federal action to close the coverage gap in non-Medicaid expansion states be included in an upcoming legislative package.

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More than 155 House Democrats are pressuring the president to add Medicare benefits, paid for with government drug price negotiation, to his American Families Plan as Democrats try to regain a grip on drug pricing on the eve of President Joe Biden proposing his budget.

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Senate Republicans unveiled a $928 billion infrastructure counteroffer Thursday (May 27) that does not include caregiving infrastructure investments, saying they want a bill to stick to so-called physical infrastructure.

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Congressional appropriators recently expressed bipartisan, bicameral support for the Biden administration’s proposed new biomedical research agency, the Advanced Research Projects Agency for Health (ARPA-H).

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The White House is reviewing an FDA draft guidance that device makers hope will lay out strict requirements for third-party device servicers.

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The Senate health committee on Tuesday (May 25) passed bipartisan legislation that will increase the amount of funding FDA and the National Institutes of Health can transfer to their respective nonprofit foundations, both of which are supporting activities to research and develop COVID-19 tests, treatments and vaccines.

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Fifty-eight doctor and patient groups are urging the Biden administration to reinstate a ban on Medicare Advantage plans from using step therapy for Part B drugs.

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The U.S. government should build production facilities for Moderna’s messenger RNA coronavirus vaccine because the government funded nearly the entire development cost of that vaccine, it works better than many of the other vaccines being provided to other countries, and production of mRNA vaccines can be scaled up faster than cell-based vaccines, according to PrEP4All.

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May 26, 2021

FDA on Wednesday (May 26) granted emergency use authorization to GlaxoSmithKline’s investigational monoclonal antibody, sotrovimab, for treatment of patients with mild-to-moderate COVID-19.

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CMS on Wednesday (May 26) proposed a six-month delay of a measure that lets drug companies report multiple best prices for each drug when those prices are tied to so-called value-based payment arrangements.

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