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GOP Health Reform

October 16, 2018 | Daily News

American Medical Association President Barbara McAneny on Tuesday (Oct. 16) raised concerns with a single-payer system based on Medicare, as well as a Medicaid buy-in being pursued in New Mexico, and said that moving people from commercial coverage to government-funded health care programs could cause practices to close, especially in rural areas, due to inadequate reimbursement.

October 16, 2018 | Daily News

One day after the launch of Medicare’s annual open enrollment period, CMS Administrator Seema Verma touted Medicare Advantage plans while saying traditional Medicare is slow to innovate and riddled with misaligned financial incentives.

October 16, 2018 | Daily News

CMS Administrator Seema Verma on Tuesday (Oct. 16) lamented CMS' lack of adequate legal authority to conduct Medicare prior authorization reviews that are routine in the private sector, coming as American Medical Association President Barbara McAneny told reporters that prior authorization can cause major disruptions to care and contributes to providers' administrative burden.

October 16, 2018 | Daily News

CMS recently announced it will continue pilot testing the exchange plan quality rating system for a third year, and will expand the program from two states to five for the 2019 plan year.

October 16, 2018 | Daily News

More than a dozen health care stakeholders recently filed briefs in support of groups that are asking a federal district court to immediately end implementation of the Trump administration’s rule expanding access to short-term health plans.

October 16, 2018 | Daily News

State politicians and advocacy groups in New Mexico expect the state to pass a Medicaid buy-in program during the 2019 legislative session and hope the plan will serve as a model for other states considering the option.

October 16, 2018 | Daily News

Michigan has asked CMS for permission to enter into outcomes-based contracts with drug manufacturers under its Medicaid program, Michigan Department of Health and Human Services spokesman Bob Wheaton confirmed Monday (Oct. 15).

October 15, 2018 | Daily News

HHS is relying on Medicare and Medicaid law to require brands to post drug prices in TV ads and is counting on drug companies to sue each other when they don’t, HHS officials said Monday (Oct. 15).

October 15, 2018 | Daily News

The Trump administration announced a new Medicaid chief Monday (Oct. 15): Mary Mayhew, a former Maine health official who has vociferously criticized Medicaid expansion and sought to tighten eligibility requirements in traditional Medicaid.

October 15, 2018 | Daily News

TV drug ads will direct consumers to company websites that include information on drug prices, including list prices and estimated out-of-pocket costs, as part of a voluntary program that all 33 companies in the Pharmaceutical Research and Manufacturers of America have agreed to.

October 15, 2018 | Daily News

Brand drug makers are warning against relying on 340B hospitals to execute Louisiana’s plan to pay a subscription for an unlimited supply of hepatitis C drugs over a fixed period.

October 12, 2018 | Daily News

The Trump administration’s final rule providing conscience protections and religious exemptions to the Affordable Care Act’s contraceptive mandate is pending at the White House Office of Management and Budget.

October 12, 2018 | Daily News

A second health plan that sued the government for ending reimbursements for cost-sharing reductions in October 2017 has been awarded money from the U.S. Federal Court of Claims: Sanford Health Plans is set to receive just over $360,000 that the government determined the plan would have been owed for the fourth quarter of that year.

October 12, 2018 | Daily News

A federal trial on delays in Tennessee’s processing of Medicaid applications wrapped up after two days of testimony, but a ruling from the judge is not expected for several months.

October 11, 2018 | Daily News

The average premium for Affordable Care Act benchmark plans will drop 1.5 percent for 2019, making 2019 the first year that premiums have fallen since Obamacare took effect in 2014.

October 11, 2018 | Daily News

Patient advocates plan to meet with HHS officials in the coming weeks to make their case against what they say is an increasingly common insurance industry practice of preventing drug company financial assistance from counting toward consumers’ deductibles and out-of-pocket spending limits.

October 10, 2018 | Daily News

A Democratic resolution to overturn the Trump administration’s rule expanding the duration of short-term health plans failed in the Senate on Wednesday (Oct. 10), despite Sen. Susan Collins’ (R-ME) vote to support the effort.

October 10, 2018 | Daily News

The cost and frequency of surprise out-of-network medical bills have risen dramatically in the individual market over the past few years, causing federal lawmakers from both parties to propose legislation that would prevent insurers from overcharging individuals for treatment by out-of-network providers in emergency care situations.

October 09, 2018 | Daily News

The Senate is expected to vote this week on Sen. Tammy Baldwin's (D-WI) resolution to overturn the Trump administration's rule expanding short-term health plans, forcing senators on both sides of the aisle to go on record about their support of the controversial plans which do not include mandatory coverage for preexisting conditions.

October 09, 2018 | Daily News

The Senate is expected to vote this week on Sen. Tammy Baldwin's (D-WI) resolution to overturn the Trump administration's rule expanding short-term health plans, forcing senators on both sides of the aisle to go on record about their support of the controversial plans which do not include mandatory coverage for preexisting conditions.

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