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Daily News

April 02, 2019

Rep. Michael Burgess said maybe Medicare and Medicaid should cover insulin without cost-sharing because the cost to the health care system of diabetics rationing the drug is likely greater than the additional cost of covering it outright.

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FDA will host a public hearing May 13 to gather input from stakeholders on what the agency could do to spur the first-ever availability of interchangeable prescription insulin products, coming as lawmakers criticize insulin makers for increasing prices to the point that some patients haven’t been able to afford the life-saving products.

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Sen. Rick Scott said Tuesday (April 2) that he told President Donald Trump he is focused on lowering prescription drug prices, despite the president's request last week that he help lead an effort to replace the Affordable Care Act.

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April 01, 2019

Medicare Advantage plans will see a higher overall pay bump in 2020 than projected under the draft call letter, CMS announced on Monday (April 1) when the final rate notice and call letter for next year was released.

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Hospitals are pleased that the Health Resources and Services Administration made the 340B ceiling price website available to 340B providers on Monday (April 1), and Maureen Testoni, president and CEO of 340B Health, said the group expects to get feedback from members over the next few months about the website and possible discrepancies between what hospitals pay for 340B drugs and the cap on what they should be charged.

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CMS on Monday (April 1) finalized a policy to let Medicare Advantage (MA) plans offer supplemental benefits for the chronically ill in 2020 -- including those that may increase a beneficiary’s property value -- as part of the MA and Part D call letter for next year.

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Health care stakeholders remain fixated on the lawsuit over the Affordable Care Act’s constitutionality as key Republican and Democratic senators urge Attorney General William Barr to explain the Department of Justice’s surprise move to call for the entire health law to be scrapped and as stakeholders file “friend of the court” briefs in the controversial case, Texas v. Azar, which is now on appeal at the Firth Circuit Court.

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CMS did not eliminate nonpreferred drug tiers or stop insurers from placing generics on brand drugs tiers.

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CMS on Monday (April 1) finalized its call for Medicare Advantage and Part D plans to do more to reduce opioid dependence among beneficiaries and expand access to naloxone, the opioid overdose reversal drug, by reducing beneficiaries’ costs through new tiering policies, among other possible actions.

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The Campaign for Tobacco-Free Kids welcomed an announcement by outgoing FDA Commissioner Scott Gottlieb that the agency will expand its youth e-cigarette prevention campaign beyond social media and high school bathrooms and onto television screens.

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A Gilead subsidiary asked to negotiate an agreement with Louisiana to protect the company from potential losses under the Medicaid best price rule that could stem from participating in the state’s innovative subscription model to provide hepatitis C drugs to its Medicaid and corrections populations, according to documents obtained by Inside Health Policy.

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Sen. Susan Collins (R-ME) told Attorney General WIlliam Barr that she profoundly disagrees with his department’s decision not to defend the Affordable Care Act in an ongoing legal battle and said that if the administration wants to repeal Obamacare, it should turn to Congress and not to the courts.

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A health consulting firm is asking CMS to test a nationwide demonstration allowing multi-year Medicare Advantage (MA) plans, which the firm says would allow more plans to tackle social determinants of health through benefit design as well as reduce costs for those with chronic conditions with better care management.

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Kite Pharma representatives pressed White House budget officials at a March 22 meeting to increase Medicare pay to hospitals for administering CAR-T, according to a White House log of the meeting, and they suggested pilot designs to test new pay arrangements for the expensive cancer treatments.

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Senate Finance Chair Chuck Grassley (R-IA) on Wednesday (March 27) signaled he would back a bill extending the Trump administration’s proposal to shift rebates to the point of sale to the commercial market.

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March 29, 2019

CMS on Friday (March 29) approved Utah’s proposal to implement a more limited version of the state’s voter-approved Medicaid expansion along with work requirements and a first-of-its-kind enrollment cap for people in the expansion group.

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House Speaker Nancy Pelosi (D-CA) announced Friday that the House will vote next week on a resolution (H. Res. 41) condemning the Trump administration’s effort to dismantle the Affordable Care Act through the courts.

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Progressive Democrats’ plans to shine a spotlight on Medicare for All have been put on the backburner due to the renewed focus on the Affordable Care Act and the Trump administration’s call for the law to be scrapped in court and replaced by Republicans.

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Outgoing FDA Commissioner Scott Gottlieb suggested Congress consider establishing incentives, including market exclusivity, to help drive development of safer pain medications.

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President Trump told reporters Thursday night that he has tapped GOP senators John Barrasso (WY), Rick Scott (FL) and Bill Cassidy (LA) to craft a health care plan that could replace the Affordable Care Act should the Supreme Court strike it down as he expects, counter to the view of most legal experts.

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