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Daily News

November 08, 2019

A second federal appeals court has sided with CMS and upheld a 2017 rule that prevents hospitals from receiving Medicaid DSH payments to cover costs for which they have already been compensated by Medicare or private insurers.

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Congressional Medicare advisors weighed proposals to reform Medicare Advantage’s quality bonus program and the benchmarks in the MA pay system, but the advisors asked staff to complete analyses on the impacts of the proposed reforms before developing policy recommendations.

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A bipartisan, bicameral bill introduced Thursday (Nov. 7) would increase oversight of hospices after reports released by the HHS Office of Inspector General (OIG) in July identified abuse and neglect of Medicare beneficiaries in hospice.

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November 07, 2019

A second federal judge on Thursday (Nov. 7) struck down an HHS rule that would allow health care workers to refuse to provide care based on their moral or religious beliefs.

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The House Ways & Means Committee will hold a hearing Thursday (Nov. 14) on caring for aging Americans, and a spokesperson told Inside Health Policy the hearing will likely cover a wide range of issues including care in the home, hospice, nursing homes, antipsychotic use in nursing homes and other long-term care issues.

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A bipartisan group of House lawmakers recently introduced legislation to keep CMS from adding noninvasive ventilators to the durable medical equipment competitive bidding program for five years after the agency defended its decision to add the ventilators despite lawmakers’ concerns.

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Dozens of hospital and pharmacy groups have thrown their support behind a bipartisan Senate bill to avert drug shortages, with sources telling Inside Health Policy some of the groups worked with the cosponsors to develop the bill.

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The charity that says it will be forced to stop operations in California due to a state law enacted earlier this month continues to be on the defense over its industry-backed premium assistance program that has been at the heart of a longstanding battle among issuers, unions and dialysis firms.

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Humira revenues fell 33.5% internationally in the third quarter of this year due to biosimilar competition, according to AbbVie, while revenues increased 9.6% in the United States, where there is no biosimilar competition until 2023.

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Sen. Dick Durbin (D-IL) said Wednesday (Nov. 6) he will soon request a floor vote on legislation to require that television drug advertisements disclose list prices.

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HHS has sued Gilead for patent infringement after the drug manufacturer repeatedly refused to obtain licenses for HHS patents on an HIV medication. The suit, filed in federal court in Delaware, alleges Gilead willfully infringed on patents given to HHS meant to protect the government’s work in developing pre-exposure prophylaxis (PrEP), and has profited from research funded by taxpayers through the sale of the brand-name drugs Truvada and Descovy, according to HHS.

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Senate Finance Committee ranking Democrat Ron Wyden (OR) warned that a provision in a bipartisan budget reform measure sponsored by Budget Chair Mike Enzi (R-WY) and Sen. Sheldon Whitehouse (D-RI) could portend the end of traditional Medicare if enacted.  The bill would set up an automatic budget reconciliation process for debt reduction that would kick in should the Congressional Budget Office determine the debt would be higher at the end of a decade than it would be under the budget resolution. The Budget Committee approved the legislation 15-6 on Wednesday.

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November 06, 2019

HHS exceeded its statutory authority and violated the Constitution when it issued a final rule attempting to make it easier for health care providers and insurance plans to refuse care based on religious or moral objections, a federal judge ruled Wednesday (Nov. 6).

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More than 177,000 Americans selected health care plans through healthcare.gov from Friday (Nov. 1) through Sunday (Nov. 3), CMS announced in its first “weekly enrollment snapshot” of the season, and a key former Obama official says the numbers suggest the widespread enrollment problems on day one were more serious than the agency acknowledged.

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The Senate health committee on Nov. 20 will hold a confirmation hearing for FDA commissioner nominee Stephen Hahn, who is currently chief medical executive of MD Anderson Cancer Center.

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Senate Homeland Security and Governmental Affairs Committee ranking Democrat Sen. Gary Peters (MI) on Tuesday (Nov. 5) launched an investigation to identify solutions to high drug prices and drug shortages, which he said raise serious health, economic and national security threats.

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HHS has teamed up with the National Kidney Foundation and the American Society of Nephrology on a public awareness initiative about kidney disease that President Donald Trump called for in an executive order. Both stakeholder groups praised the initiative, but some have criticized the administration for not also reforming kidney treatment payment and coverage policies.

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Kentucky will likely abandon its controversial plan to adopt Medicaid work requirements as Democrat Andy Beshear claimed victory over incumbent Republican Gov. Matt Bevin in a closely fought race for governor Tuesday night (Nov. 5).

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House and Senate appropriations panels are both pushing funding increases for FDA, but whether the agency will get additional money for fiscal 2020 hangs in the balance as lawmakers eye at least one more short-term continuing resolution (CR) and the prospects of individual appropriations bills remains unclear.

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CMS announced Wednesday (Nov. 6) that it approved a waiver to allow District of Columbia to sidestep a restriction on using Medicaid dollars to fund inpatient treatment for substance use and mental illness.

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