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Medicaid

January 21, 2015 | Daily News

Chief Justice John Roberts expressed concern during U.S. Supreme Court arguments Tuesday (Jan. 20) that if providers could sue for better Medicaid reimbursement, federal courts could end up overly involved in states' budgets, which he said would be “a prescription for budget-busting across the board.”

January 20, 2015 | Daily News

Senate Finance Committee Chairman Orrin Hatch (R-Utah) on Tuesday (Jan. 20) pegged as high priorities ACA changes, Medicare physician payment reform, CHIP extension and a handful of cost-saving changes to entitlement programs, while also saying he hopes Republicans will unite behind his ACA replacement bill as the Supreme Court prepares to rule on a pivotal ACA case.

January 16, 2015 | Daily News

Doctor lobbyists are quietly exploring ways CMS could administratively increase Medicaid pay for primary-care services because of concerns it is increasingly unlikely Congress will renew a newly expired ACA measure that temporarily paid Medicaid doctors at the higher Medicare primary care rates, sources tell Inside Health Policy.

January 16, 2015 | Daily News

CMS chief Marilyn Tavenner's announcement to her staff Friday that she will leave the agency next month and HHS' plan to hand the reins over to Deputy Administrator Andy Slavitt puts the former UnitedHealth Group official at the helm of the powerful agency just as the Supreme Court is poised to rule on a case that could unravel the ACA, and as the new GOP Congress gears up to aggressively revamp and oversee Obamacare -- the troubled launch of which occurred under Tavenner's watch.

January 15, 2015 | Daily News

CMS sent a letter to state Medicaid directors saying that schools may now be reimbursed for some health services that up to now have been offered to Medicaid-enrolled students free of charge.

January 15, 2015 | Daily News

HHS Secretary Sylvia Burwell said at the New America Foundation Thursday (Jan. 15) that she believes Congress and the administration can find bipartisan agreement on the Children's Health Insurance Program and Medicare's sustainable growth rate formula used to pay physicians, signaling an effort to move on to priorities other than the Affordable Care Act.

January 13, 2015 | Daily News

The National Governors Association is encouraging states to consider amending laws and regulations to give pharmacists a bigger role in delivering care.

January 13, 2015 | Daily News

The White House's Office of Management and Review is reviewing a proposed rule to require parity of medical and behavioral benefits in Medicaid managed care plans, CHIP plans and plans that cover Medicaid-expansion populations.

January 12, 2015 | Daily News

California Gov. Jerry Brown (D) is proposing to renew for another five years the “Bridge to Reform” Medicaid 1115 waiver that the state used to expand coverage prior to implementation of the Affordable Care Act, and also wants to set aside $300 million to help offset the cost of hepatitis C drugs, such as Sovaldi and Harvoni, due to the large number of patients in state programs.

January 12, 2015 | Daily News

Despite losing a similar battle last year, Sen. Patty Murray (D-WA) intends to reintroduce a bill that would extend for two years the ACA's Medicaid primary care pay bump that expired Jan. 1.

January 09, 2015 | Daily News

A federal district court of D.C. last week (Dec. 29) blocked CMS from recouping Medicaid Disproportionate Share Hospital payments from two children's hospitals that sued the agency because of changes to Medicaid DSH reimbursement rules as the case proceeds.

January 02, 2015 | Daily News

Medicare-Medicaid Coordination Office chief Melanie Bella will leave CMS at the end of January, marking the second high-level departure from the agency in early 2015 alongside CMS Medicaid chief Cindy Mann.

December 23, 2014 | Daily News

Nearly 6.4 million Americans enrolled in an insurance plan through the federal health care exchange between the beginning of open enrollment and Dec. 19, HHS Secretary Sylvia Burwell said at a press conference Tuesday (Dec. 23), meaning the administration is two-thirds of the way to its goal of enrolling 9.1 million people in the FFM by the final Feb. 15 deadline.

December 22, 2014 | Daily News

Express Scripts will only include AbbVie's hepatitis C drug Viekira Pak on its National Preferred Pharmacy formulary in exchange for a “significant” discount on the drug, an Express Scripts spokesman said, and there will be no restrictions to access for the 25 million people on that formulary.

December 22, 2014 | Daily News

CMS Medicaid Chief Cindy Mann will leave the agency in late January after serving as the head of CMS' Medicaid and Children's Health Insurance Program for five years, the agency announced Friday (Dec. 19).

December 22, 2014 | Daily News

CMS added about 68,000 payment records to the Sunshine Act and Affordable Care Act's Open Payments database on Friday (Dec. 19).

December 22, 2014 | Daily News

Preliminary CMS data show that 9.7 million more people were enrolled Medicaid and CHIP at October's end than the average monthly enrollment from July to September 2013, although Connecticut and Maine were not included in that count.

December 19, 2014 | Daily News

FDA approved the second hepatitis C drug for use without interferon, called Viekira Pak, and AbbVie is charging $83,319 for a 12-week course of the drug, a company spokesperson said, compared to the $94,500 12-week price of Gilead Science's Harvoni and the $84,000 price of Harvoni's predecessor Sovaldi.

December 19, 2014 | Daily News

FDA approved the second hepatitis C drug for use without interferon, called Viekira Pak -- an approval that Medicaid directors and health plans anxiously awaited in the hopes that the drug's maker, AbbVie, would significantly undercut the price of Gilead Sciences' hepatitis C drugs.

December 15, 2014 | Daily News

Congress' massive spending deal includes two provisions related to the debate over drug prices -- one on the 340B drug discount program and one on hepatitis C drug prices.

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