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May 30, 2019 | Daily News

Medicaid beneficiaries who are potentially subject to work requirements are far more likely than privately insured individuals to face obstacles to steady employment, such as a lack of a high school degree, limited English proficiency, limited home internet access, physical or mental health issues and residence in high-unemployment areas, according to a study from the Urban Institute released Thursday (May 30).

May 29, 2019 | Daily News

A new CMS bulletin on spread pricing could pave the way for getting Medicaid managed care plans and pharmacy benefit managers to disclose spread-pricing amounts, according to Alex Shekhdar, founder of Sycamore Creek Healthcare Advisors.

May 28, 2019 | Daily News

CMS on Tuesday (May 28) finalized long-awaited updates to the Programs of All-Inclusive Care for the Elderly, including a reduction in PACE organization audits, a tweaked compliance oversight program and a decision to let some non-physician primary care providers be part of interdisciplinary teams.

May 24, 2019 | Daily News

The Oklahoma Supreme Court is preparing to weigh in on the validity of a proposed ballot measure that seeks to expand Medicaid in Oklahoma, and the legal fight turns on a question raised by a well-known bit of mathematical minutia in the Affordable Care Act: whether the Medicaid expansion eligibility ceiling is best understood as 133% of the federal poverty level or 138% of the federal poverty level.

May 23, 2019 | Daily News

The Kentucky Hospital Association is siding with Kentucky and CMS in the lawsuit challenging the state’s proposed Medicaid work requirements--a rare example of the hospital industry endorsing work requirements as a condition for maintaining health coverage.

May 22, 2019 | Daily News

CMS Administrator Seema Verma on Wednesday (May 22) said the agency is taking its time with a national Medicare coverage policy for new expensive hospital-administered cancer drugs, which was due to be published May 17 but was delayed, because the policy will affect coverage of drugs other than the two chimeric antigen receptor (CAR) T-cell therapies already on the market.

May 22, 2019 | Daily News

CMS Administrator Seema Verma on Wednesday (May 22) said court decisions that struck down 1115 Medicaid work requirement waivers in Kentucky and Arkansas, as well as concerns from the Government Accountability Office about waiver evaluations, won’t change the administration’s plans for Medicaid.

May 22, 2019 | Daily News

After legislative talks between House Speaker Nancy Pelosi (D-CA) and President Donald Trump ground to a halt Wednesday morning, Senate Finance Chair Chuck Grassley (R-IA), who is helping lead negotiations on health care policy, said the Senate was always in the driver’s seat in the drug-pricing debate.

May 22, 2019 | Daily News

President Donald Trump said Wednesday (May 22) that legislative negotiations on drug pricing are on hold until Democrats stop investigations into his potential role in his campaign’s ties to Russia and into other actions he has taken while in office.

May 22, 2019 | Daily News

A Georgetown University report released Wednesday (May 22) says expanding Medicaid is key to reducing maternal mortality and improving preventative care in women of childbearing age, a position shared by maternal health advocates who also say Medicaid coverage can be improved.

May 20, 2019 | Daily News

Melanie Bella, the founding director of the Medicare-Medicaid Coordination Office at CMS, was named on Monday (May 20) as the new chair of the congressional Medicaid advisory commission, and two new members -- health care lawyer Tom Barker and Georgetown University professor Tricia Brooks -- were appointed to the commission.

May 17, 2019 | Daily News

CMS Deputy Administrator and Director of the Center for Medicaid & CHIP Services Chris Traylor announced his departure from CMS Friday (May 17) months after taking on the role, making him the fourth person to leave the role in the last 18 months and the third departure of a top CMS official in the past couple of weeks.

May 17, 2019 | Daily News

CMS should revise its policies to provide more transparency on states’ requests for 1115 waivers in their Medicaid programs, the Government Accountability Office said in a report released Friday (May 17).

May 14, 2019 | Daily News

Rep. Mark Green (R-TN) introduced a bill Tuesday (May 14) that would allow Medicaid enrollees to choose to use a pre-paid “swipe card” to purchase medical care -- a proposal Green said would drive down costs and introduce more competition into the health sector, but one policy analyst said might instead drive up costs.

May 14, 2019 | Daily News

The majority of the House – about 300 lawmakers – is asking House leadership to move legislation delaying by an additional two years the Medicaid Disproportionate Share Hospital Payment cuts set to kick in Oct.1 – though, on the other side of Capitol Hill, Senate Finance Committee Chair Chuck Grassley (R-IA) has said Congress should revamp the payment system instead of simply delaying the cuts again.

May 13, 2019 | Daily News

The attorneys general for five states filed a lawsuit against the Trump administration on Monday (May 13) over a final rule issued earlier this month that repeals an Obama-era rule allowing union dues to be deducted from Medicaid payments made to independent home health workers.

May 13, 2019 | Daily News

CMS would be prevented from moving forward with a planned rule cutting back on non-emergency transportation benefits in Medicaid if a spending restriction pushed by the Congressional Black Caucus and supported by the House Appropriations Committee becomes law.

May 09, 2019 | Daily News

CMS is considering whether to allow states that partially expand Medicaid to receive the enhanced federal funding historically reserved for full Medicaid expansion, CMS Administrator Seema Verma said Wednesday (May 8).

May 09, 2019 | Daily News

Provider advocates for stroke patients are calling on state legislators to implement policies that would encourage emergency medical services to transport stroke patients to a stroke center as opposed to the hospital via ambulance while also praising a Center for Medicare and Medicaid Innovation (CMMI) model announced earlier this year that one provider says will be beneficial in encouraging this shift.

May 08, 2019 | Daily News

House Speaker Nancy Pelosi’s (D-CA) office is working on a drug-price negotiation bill that would use arbitration as a backstop to price negotiations between HHS and drug makers on high-cost drugs, and the resulting price could be available to other payers, not just to Medicare plans, sources briefed on the plan told Inside Drug Pricing.