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Medicare

December 14, 2018 | Daily News

CBO on Thursday (Dec. 13) added two options to reduce Medicare Advantage plan payments to its suggestions on ways to reduce the deficit -- change payments to plans for beneficiary health risks and reduce quality bonus payments to MA plans.

December 14, 2018 | Daily News

Janssen Pharmaceuticals, which is a subsidiary of Johnson & Johnson, announced Thursday (Dec. 13) that it entered into an outcome-based contract with Oklahoma’s Medicaid program for a long-acting injectable drug used to treat schizophrenia.

December 12, 2018 | Daily News

The top regulatory officer at HHS said Wednesday (Dec. 12) that rebates are an “obvious problem” driving up list prices for prescription drugs, and noted that Pfizer recently raised list prices to make up for rebates it pays to pharmacy benefit managers.

December 11, 2018 | Daily News

House Ways & Means Republicans put a spotlight on a package of bills Tuesday (Dec. 11) as part of their Medicare Red Tape Relief Project, including legislation to give providers an annual vehicle to tell CMS how to reduce administrative burden, codify CMS’ quality measure removal factors, permanently get rid of physician supervision requirements for critical access hospitals, repeal the 96-hour rule for critical access hospitals, and require prior authorization notification and a study on simplification.

December 11, 2018 | Daily News

National Coordinator for Health IT Don Rucker told lawmakers on Tuesday (Dec. 11) he is optimistic that his office’s upcoming rule implementing the 21st Century Cures Act will be helpful in pushing providers to share data.

December 11, 2018 | Daily News

Senate health committee Chairman Lamar Alexander (R-TN) called on think tank leaders to help craft legislation to lower health care costs, saying the federal government will not be able to cut health insurance costs until it can lower the overarching costs of healthcare.

December 11, 2018 | Daily News

Senate health committee Chairman Lamar Alexander (R-TN) called on think tank leaders to help craft legislation to lower health care costs, saying the federal government will not be able to cut health insurance costs until it can lower the overarching costs of healthcare.

December 11, 2018 | Daily News

The White House Office of Management and Budget on Friday (Dec. 7) began reviewing two parts of the advanced notice of Medicare Advantage and Part D changes for 2020, including the call letter and 2020 capitation rates.

December 11, 2018 | Daily News

The Republican and Democratic senators who recently introduced a Medicaid-rebate bill support the House Medicare/Medicaid legislative package that their bill is being used to help pay for.

December 11, 2018 | Daily News

The PBM lobby said that the vendor role in the Trump administration’s Medicare Part B demo should be filled by entities such as pharmacy benefit managers or specialty pharmacies, but not by manufacturers in comments submitted to HHS and CMS on Thursday (Dec. 6).

December 10, 2018 | Daily News

Insurers, beneficiary advocates, retailers and employers floated guiding principles they hope will drive an expected bipartisan effort by the incoming Congress to tackle “surprise medical billing,” and urged lawmakers to end surprise medical billing and standardize payments to out-of-network physicians.

December 07, 2018 | Daily News

The House is using Medicaid-rebate legislation, introduced Dec. 4 in the Senate, to pay for a bill that combines a handful of Medicaid and Medicare bills from the past two years, according to legislation on the House floor schedule for the week of Dec. 10.

December 07, 2018 | Daily News

Congress’ Medicare payment advisers discussed possible 2020 pay for a wide range of providers at their December meeting Thursday and Friday (Dec. 6 and Dec. 7), including draft recommendations to tie some hospital pay to the advisers’ Hospital Value Incentive Program, but the commissioners plan to look again at what to pay long-term care hospitals in January as they didn’t agree on whether to provide LTCHs a pay increase in 2020.

December 07, 2018 | Daily News

Senate Finance Committee Ranking Democrat Ron Wyden (OR) called on CMS Thursday (Dec. 6) to “be straight with the seniors about all of their health care options” amid concerns from some beneficiary advocates that the agency is favoring Medicare Advantage over traditional Medicare.

December 07, 2018 | Daily News

Congressional Medicare advisers said Thursday (Dec. 6) that Medicare spending on drugs doctors administer is growing fast, and on the same day, CMS actuaries said Medicare retail drug spending growth has slowed.

December 07, 2018 | Daily News

HHS hit back at conservative critics of its international price referencing Medicare Part B demo Thursday (Nov. 6) in a blog post authored by its new senior adviser for drug pricing reform, John O’Brien.

December 06, 2018 | Daily News

Spending on health care grew at a slower rate in 2017 than in 2016 in part because Medicaid spending slowed due to the lull in Medicaid expansions and drug spending growth slacked off following the spike in spending to treat hepatitis C, according to the CMS actuary’s office.

December 05, 2018 | Daily News

The White House Office of Management and Budget on Monday (Dec. 3) began reviewing a final rule aimed at improving the Medicare provider enrollment process in order to beef up program integrity.

December 05, 2018 | Daily News

The Trump administration is pushing ideas that could improve health care price transparency but says those steps will be futile without changes that put consumers in direct control of their health spending.

December 04, 2018 | Daily News

The American Hospital Association and Association of American Medical Colleges sued CMS Tuesday (Nov. 4) over deep reimbursement cuts for clinic visits at hospital off-campus facilities that were included in a site-neutral policy in the final 2019 hospital outpatient pay rule.

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