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Daily News

June 19, 2020

Tobacco control groups on Wednesday (June 17) sued FDA for not banning menthol-flavored cigarettes and providing no justification for its inaction, which they say violates the Administrative Procedure Act.

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The Medicare Payment Advisory Commission is calling on CMS to continue its work on changing Medicare Advantage risk adjustment, though the commission says five different models it looked at all resulted in underpayments for sick Medicare beneficiaries and overpayments for low-cost individuals.

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June 18, 2020

Kentucky Gov. Andy Beshear (D) has informed CMS that the state will revert to a fully state-based exchange -- dubbed Kynect-- for the 2022 plan year, reversing former GOP Gov. Matt Bevin’s 2017 decision to disconnect the state-based marketplace and rely on the federal platform.

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Stakeholders are concerned that China’s list of COVID-19 tests that are authorized for export is preventing myriad coronavirus diagnostic and serology tests from being sent to the United States, even though those tests are authorized for distribution in America.

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CMS says insurers can pay out 2019 medical loss ratio (MLR) rebates in the form of premium relief -- or lump-sum payments -- prior to the September due date or even the newly extended deadline for filing MLR data, now set for Aug. 17.

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A group of tech industry CEOs, including the leaders of Door Dash, Instacart and Postmates, joined key health policy experts in urging White House and Congressional leaders to open an emergency special enrollment period (SEP) ahead of potential second wave of the COVID-19 pandemic, adding their voices to the myriad stakeholders who have called on policymakers and officials to allow any American to sign up for coverage through healthcare.gov for a limited time.

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The U.K. government stockpiled enough cheap generic steroid dexamethasone to treat 200,000 COVID-19 patients and banned companies from reselling it abroad at a higher price.

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Trump administration officials said COVID-19 vaccines will be free to anyone who cannot afford it, and the administration is urging commercial insurers to waive co-pays.

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Two major pharmaceutical companies racing to make a vaccine to combat COVID-19 do not want to be the ones to decide who receives their products first and are depending on public health entities, such as government health departments and NGOs, to make the call.

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Attorneys general from 46 states, the District of Columbia and four U.S. territories sued major drug makers for colluding on generic dermatologic drug prices.

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The administration should begin thinking about how it will respond to vaccine skeptics before a coronavirus vaccine is available, according to an advocate for supplying poor countries with vaccines.

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CMS proposed a rule Wednesday (June 17) to make it easier for insurers to negotiate deals in which drug prices fluctuate based on how well they work, without forcing drug companies sell drugs to Medicaid at very low prices.

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A group of plans, providers and consumer advocates on Thursday (June 18) announced the formation of a telehealth taskforce, with plans to issue recommendations on advancing the use of telehealth while maintaining patient safety by September.

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June 17, 2020

Parties are slated to hold a meeting Thursday (June 18) to discuss next steps in a lawsuit D.C.-based Democracy Forward filed on behalf of Chicago that challenges the administration’s refusal to open a special enrollment period (SEP) through healthcare.gov, a lawyer for the advocacy group tells Inside Health Policy.

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Senate health committee Chair Lamar Alexander (R-TN) recommended that Congress permanently eliminate the Medicare telehealth originating site requirement and allow Medicare and Medicaid to expand upon the types of providers that can be reimbursed for telehealth as the Senate health committee considered which relaxed requirements should be continued after the pandemic on Wednesday (June 17).

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The White House Office of Management and Budget on Tuesday (June 16) cleared a final Substance Use and Mental Health Services Administration rule that would loosen privacy restrictions on substance use records.

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In their June report to Congress, Medicare advisers began reworking the process for choosing drugs that are paid for separately from bundled outpatient services.

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More than 100 House Democrats are asking FDA to lift restrictions on abortion drug mifepristone so that, at a minimum, doctors can mail the medication to patients’ homes during the COVID-19 pandemic.

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Congressional Medicare advisers are recommending lawmakers replace the Medicare Advantage quality bonus program with one that saves money by pooling funds for rewards and penalties and would also focus more on beneficiaries’ quality of care by eliminating the star rating system.

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June 16, 2020

In a win for pharma, a federal appeals court on Tuesday (June 16) backed a lower court decision to throw out CMS’ rule requiring that drug makers disclose list prices in television ads.

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