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Inside CMS - 05/17/2018

  • Budget Gap Puts 37,000 People In Louisiana At Risk Of Losing Medicaid

    Louisiana is warning 37,000 Medicaid beneficiaries -- most of them in nursing homes or group homes -- that they may lose their benefits on July 1 if state lawmakers cannot resolve a budget shortfall.

    445 words

  • Azar Hits Back At Pharma Criticism Of Drug-Price Containment Proposal

    HHS Secretary Alex Azar on Wednesday (May 16) hit back at the drug industry for criticizing the administration’s proposal to move Medicare Part B drugs into Part D, and he said the announcement on how HHS will execute that policy is coming soon.

    372 words

  • Trump Ties 340B To High Prices, Asks For Feedback On Changing Program

    President Donald Trump's drug price containment plan blames the 340B drug discount program in part for high drug prices, and asks for feedback in a number of areas including how the program's growth affects list prices and insurers, whether the definition of a 340B patient should be changed and how to better prohibit duplicate discounts.

    933 words

  • Kentucky Wants Quick Ruling On Work Requirements From Kentucky Judge

    Kentucky Gov. Matt Bevin (R) is urging a federal judge in Kentucky to issue an expedited ruling in the lawsuit Bevin brought against 16 Medicaid beneficiaries on the validity of the state's planned work requirements and other coverage restrictions.

    518 words

  • Azar To Ask IG To Probe Price Concessions PBMs Charge Pharmacies

    HHS Secretary Alex Azar said Thursday (May 10) that he plans to ask the department's Inspector General to investigate price concessions that pharmacy benefit managers retroactively charge pharmacies. PBMs already fear Trump might target rebates in his plan to contain drug costs, and an HHS Office of Inspector General probe could separately lead to restrictions on so-called direct and indirect remuneration, or DIR fees.

    374 words

  • Much Of Trump's Plan Puts Onus On Patients To Get Cheaper Drugs

    Many of the policies in the president's drug price plan put the onus on patients to get cheaper drugs: such as including prices in drug ads, giving patients information on competing drug prices during office visits, posting drug prices on Medicare's "dashboard" website and banning gag orders that stop pharmacists from telling customers when it is cheaper to buy drugs without insurance. Other immediate actions weaken patient protections in Part D by letting plans limit coverage to one drug in each class and allowing for medication management in the six protected classes.

    749 words

  • Wyden Seeks Seeks Documents On Novartis Payments To Cohen

    Senate Finance Committee ranking Democrat Ron Wyden (OR) is demanding documents about the $1.2 million that pharmaceutical company Novartis paid to Michael Cohen, President Trump's personal lawyer, at the same time that the company was negotiating with federal officials over an expensive cancer therapy it developed.

    213 words

  • Consumer, Patient Advocates Tell Congress Not To Shrink 340B Program

    About 60 patient and consumer advocates told House and Senate leadership to reject proposals to cut back the number of patients and safety net providers that are eligible for the 340B drug discount program, though the groups say they support transparency in the program.

    644 words

  • Ohio Is Latest State To Apply For Medicaid Work Requirements

    CMS has received Ohio's request to add work requirements to its Medicaid program, the agency said Tuesday (May 15).

    183 words

  • Consumer, Patient Advocates Tell Congress Not To Shrink 340B Program

    About 60 patient and consumer advocates told House and Senate leadership to reject proposals to cut back the number of patients and safety net providers that are eligible for the 340B drug discount program, though the groups say they support transparency in the program.

    644 words

  • Cummings Report Slams Trump For Not Embracing Drug Negotiation, Highlights Price Hikes

    Rep. Elijah Cummings (D-MD), who met with President Donald Trump earlier in his presidency to push for Medicare price negotiation, appears to have given up on working with Trump -- releasing a report Friday (May 11) outlining what he sees as the president’s failure to constrain drug prices.

    455 words

  • Azar: Short-Term Plans Are A Temporary Fix For ACA Costs In Absence Of Legislation

    HHS Secretary Alex Azar told senators that the administration’s proposed short-term, limited duration plans are meant to serve as a Band-Aid for consumers facing skyrocketing costs in the absence of congressional action to shore up the ACA markets.

    816 words

  • Protect Our Care Launches Campaign Blaming GOP For ACA Rate Hikes

    A pro-ACA group Wednesday launched a campaign that casts blame on the Trump administration and the GOP-led Congress for premium increases, holding up the GOP's repeal of the individual mandate penalty, cutback of ACA advertising and outreach, and proposed non-ACA compliant plan options that could undermine the risk pools.

    993 words

  • Alexander, Collins Talking With CMS About 1332 Waiver Process

    In the wake of their failed congressional pitch for Affordable Care Act market stabilization legislation, Senators Lamar Alexander (R-TN) and Susan Collins (R-ME) are now talking with CMS Administrator Seema Verma about administrative solutions to mitigate Obamacare premium increases -- including possible agency action to let states easily replicate already-approved 1332 waivers, speed up the waiver approval processes, and facilitate the creation of invisible high-risk pools.

    589 words

  • Urban Institute Builds Off ACA, Medicare For Universal Health Care Proposal

    Health policy experts at the Urban Institute are advancing a new universal health care proposal that would build off existing health care programs.

    1272 words

  • Actuaries: Association Health Plans Could Decrease ACA Enrollment By Up To 10 Percent

    Affordable Care Act enrollment could decline by 3-10 percent due to consumer exodus to Association Health Plans if the administration moves forward with its AHP proposal, according to a Friday (May 11) study published by the Society of Actuaries.

    396 words