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GOP Health Reform

November 13, 2018 | Daily News

Maryland Attorney General Brian Frosh on Tuesday (Nov. 13) asked a federal district court to issue an injunction to stop Matthew Whitaker from participating in a case over the Affordable Care Act and to declare Deputy Attorney General Rod Rosenstein as the rightful acting Attorney General of the United States.

November 13, 2018 | Daily News

Express Scripts is introducing an optional formulary for drugs with alternative drug codes, which starts the move from so-called spread pricing based on rebates to a system that shares those rebates at the pharmacy counter, the pharmacy benefit manager announced Tuesday (Nov. 13).

November 12, 2018 | Daily News

A coalition of GOP attorneys general threw their support behind the Trump administration’s controversial association health plans, telling a federal court they back the administration’s call to dismiss a Democratic-led lawsuit challenging a rule that expanded the scope of the plans.

November 12, 2018 | Daily News

Dozens of academics in public health and health law told a federal judge that CMS misrepresented studies on the relationship between work and health when the agency approved Arkansas’ controversial program of Medicaid work requirements.

November 09, 2018 | Daily News

Rep. Anna Eshoo announced Friday (Nov. 9) her bid to chair the House Energy & Commerce health subcommittee, which is expected to be a key position given Democrats’ campaign promises to work on health care policies and control drug prices.

November 09, 2018 | Daily News

While stakeholders expect lawmakers to focus less on Medicare than other health policy in the new Congress, strengthening Medicare is still part of Rep. Frank Pallone's (D-NJ) agenda for the House Energy & Commerce Committee, advocates hope Democrats will look at coverage gaps in the program, and lobbyists say lawmakers could take another look at the site-neutral cuts included in CMS’ recent hospital pay rule.

November 08, 2018 | Daily News

CMS is seeking to give states more freedom to define network adequacy in Medicaid managed care and to set the capitation rates paid to Medicaid plans.

November 08, 2018 | Daily News

A federal judge has temporarily shut down a Florida-based operation that the Federal Trade Commission charged with misleading consumers into thinking they were purchasing comprehensive, ACA-compliant coverage, rather than skimpy products that left them with unpaid medical claims and thousands in bills.

November 08, 2018 | Daily News

CMS proposed a rule that aims to better ensure consumers are not dually enrolled in exchange and other public coverage, including Medicare, Medicaid, CHIP and the Basic Health Plan.

November 08, 2018 | Daily News

HHS Secretary Alex Azar on Thursday (Nov. 8) said CMS plans to both bring back the mandatory bundled-pay models the agency canceled last year and look at new models, including for radiation oncology.

November 08, 2018 | Daily News

CMS says about 93 percent of eligible providers in the Merit-based Incentive Payment System received a bonus for their 2017 performance and the vast majority avoided a pay cut -- though CMS Administrator Seema Verma says in a blog post that she expects performance in the program will change as the thresholds are harder to meet.

November 08, 2018 | Daily News

The Trump administration released two final rules on Wednesday (Nov. 7) that offer exemptions to the Affordable Care Act’s contraceptive mandate for entities that have either religious or moral objections to contraceptive services.

November 07, 2018 | Daily News

Texas District Judge Reed O' Connor is expected to rule any day on the high-profile case over the Affordable Care Act now that the election is over, and some legal experts believe he is likely to overturn as least the law's protections for preexisting conditions but could also move to an injunction that would end implementation of the entire law.

November 07, 2018 | Daily News

In the immediate aftermath of the midterm elections, House Minority Leader Nancy Pelosi (D-CA) asked the Trump administration to “withdraw from a lawsuit” to eliminate parts of the Affordable Care Act, and Senate Minority Leader Chuck Schumer (D-NY) told Inside Health Policy he would join Pelosi’s call for the GOP to scrap the suit.

November 07, 2018 | Daily News

Medicaid expansion could become a reality in Kansas, Maine and Wisconsin after Democrats won the governor’s mansions in those states Tuesday (Nov. 6).

November 07, 2018 | Daily News

Voters in Idaho, Nebraska and Utah chose Tuesday (Nov. 6) to expand Medicaid eligibility under the Affordable Care Act, but voters in Montana rejected a ballot initiative that would have made that state’s Medicaid expansion permanent.

November 07, 2018 | Daily News

Several Senate Finance members will not return to the committee, as Sens. Claire McCaskill (D-MO) and Dean Heller (R-NV) lost their reelection bids on Tuesday night (Nov. 7), while Florida Democrat Bill Nelson on Wednesday morning called for a recount after initial tallies showed him trailing the state’s outgoing Gov. Rick Scott (R) by less than half a point.

November 07, 2018 | Daily News

Prior to the midterm elections, Senate Democratic staffers prepared for a split Congress, with a GOP-controlled Senate and a Democratic House, by meeting with health care stakeholders and their House counterparts to coordinate next steps and make plans to re-frame the push for Obamacare market stabilization as a way to protect people with preexisting conditions, sources close to the Senate health committee say.

November 07, 2018 | Daily News

House Democrats promise to take on drug prices when they take control of the House next year, but the actual likelihood of aggressive measures becoming law depends largely on whether they will work with the president on legislation and, if so, whether the president can get Senate Republican leaders in line. However, President Donald Trump is pursuing administrative changes to lower drug prices that don't require Congress' blessing, and congressional Democrats may find themselves walking a fine line between not wanting to help Trump and delivering on their own promises to lower drug prices.

November 06, 2018 | Daily News

At least two of the four issuers that failed to convince a full panel of federal appeals court judges to rehear their suit over the ACA's risk corridor program plan to petition the Supreme Court to hear the case.

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