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Daily News

December 24, 2019

Drug makers and distributors say FDA’s proposal to let states import drugs would jeopardize the security of distribution channels, but importation boosters say states would follow existing importation rules and former FDA Commissioner Scott Gottlieb says the regulatory proposal places stringent conditions on the importation of drugs.

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December 23, 2019

Health insurers, beneficiary advocates and Democratic lawmakers pilloried the Trump administration for finalizing with some changes a rule requiring separate payments for abortion services, which they argue will result in consumer confusion, higher costs and ultimately diminish coverage.

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Medicare Advantage plans pushed back against a new HHS Office of Inspector General report that concluded the plans might be receiving inappropriate risk-adjusted payments, saying the report relies on old data and overstates the improper pay rate.

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The House Democrats’ bill that would direct Medicare to negotiate drug prices would increase wages $116 billion over a decade for those with employer-sponsored health insurance, according to the Joint Committee on Taxation.

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December 20, 2019

The federal health insurance marketplace remained steady for the seventh open enrollment season, with 8.30 million Americans selecting a plan through healthcare.gov or an approved direct enrollment partner from Nov. 1 through Dec. 17, just shy of the 8.45 million enrolled last year, CMS said Friday (Dec. 20).

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Senate Finance Committee Chair Chuck Grassley (R-IA) was caught by surprise when six of his fellow Republican committee members introduced an alternative to his drug pricing bill on Friday (Dec. 20), a Grassley spokesperson said.

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Key House and Senate committees are expanding their investigation of private equity’s role in surprise billing practices to physician staffing companies and insurers.

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CMS awarded grants to 10 states to implement a model to improve health care for pregnant and postpartum Medicaid beneficiaries with substance-use disorders on Thursday (Dec. 19).

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FDA advisers on Tuesday (Dec. 17) narrowly backed the risk-benefit profile for AstraZeneca’s Lynparza (olaparib) to treat pancreatic cancer, even though they questioned the company’s use of progression-free survival as a primary endpoint, as they said it may not reflect a clinical benefit.

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December 19, 2019

The Senate on Thursday (Dec. 19) passed its year-end spending deal 71-23 despite Sen. Bill Cassidy’s (R-LA) last-ditch plea for fiscal conservatives to reject the bill over the high costs of repealing three major Affordable Care Act taxes.

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CMS is reviewing Nebraska’s proposal to adopt a two-tiered version of Medicaid expansion in which beneficiaries would have to satisfy a work requirement and other criteria in order to qualify for full Medicaid benefits.

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Leading lawmakers on the House Energy & Commerce Committee pegged the United States’ reliance on foreign manufacturing of generic drugs as a top-line issue they will tackle in 2020.

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The year-end spending package passed by the Senate Thursday (Dec. 19) includes provisions pushed by laboratories that would delay commercial pay data reporting until 2021 and require Congress’ Medicare payment advisers to study how CMS has implemented an earlier law aimed at basing Medicare pay rates for lab tests on commercial rates.

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The nation’s largest seniors’ lobby applauded Congress for including in its year-end spending package a measure that maintains the 7.5% income threshold for the medical expense deduction for the 2019 and 2020 tax years.

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December 18, 2019

A federal appeals court created even more uncertainty over the future of the Affordable Care Act when it agreed Wednesday that the law’s individual mandate is unconstitutional but punted back to a lower court to decide which other pieces of the law remain valid -- a highly anticipated ruling that led to more sparring between Democrats and Republicans who view the case through an election lens, opposition from health care stakeholders that benefit from the ACA, and predictions among legal experts on whether the Supreme Court might hijack the case during the election season.

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Senate Finance Committee Chair Chuck Grassley said Senate Majority Leader Mitch McConnell (R-KY) told fellow Republicans to withhold support for the Finance drug pricing bill, but the Iowa Republican hopes to build support by negotiating with the House and urging the president to add his personal touch to the White House’s backing of S. 2543.

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California is touting its new, more generous subsidies for middle-income residents as a reason for increased enrollment in its state exchange and encourages other states to enhance assistance in similar programs.

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If Congress ended surprise medical billing, insurance premiums for people with employer-sponsored plans would drop by as much as 3.4%, or approximately $40 billion annually, a new study from Health Affairs found just days after lawmakers announced they would not vote to end surprise billing until 2020.

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House Ways & Means Chair Richard Neal (D-MA) on Tuesday (Dec. 17) asked HHS’ Office of Inspector General (OIG) to look into CMS contracts on Medicare Plan Finder and healthcare.gov following recent problems with both sites.

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The Trump administration on Wednesday moved forward on its plan to let states and drug makers import lower-cost prescription drugs from other countries.

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