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Friday, 23 June 2017

A leaked draft of an alleged White House executive order on drug prices calls for value-based contracts, lower Medicare beneficiary out-of-pocket costs, drug rebate reforms, restricted hospital drug discounts, faster FDA approvals and higher prices in other countries.

Wednesday, 21 June 2017

House Democrats who met with the president in the spring to discuss drug-price policies are urging him to take aggressive action to curb price increases in an anticipated executive order. However, news reports indicate President Donald Trump is considering measures that are friendly to the drug industry.

Tuesday, 20 June 2017

CMS proposed Tuesday (June 20) to exempt more doctors from the performance measures of Medicare's new physician pay rule, delay measuring doctor performance on cost, allow doctors in small and rural practices to form “virtual groups,” award bonus points to the performance scores of doctors in small practice and delay a required upgrade to physicians' electronic health record systems.

Tuesday, 20 June 2017

Policies to watch for in the physician pay system regulation that the White House Office of Management and Budget finished reviewing last week include changes to the reporting burden, the resource use component of the Merit-Based Incentive Payment System and virtual groups.

Friday, 16 June 2017

Changing CMS’ controversial policy of lumping biosimilars that reference the same biologic under a single same billing code is not a high priority for the Trump administration, two sources in touch with the White House said Tuesday (June 13).

Wednesday, 14 June 2017

CMS told doctors in alternative pay models they all should expect 5 percent bonuses in the first year of the new pay system, which a former CMS official said comes as a relief to doctors who weren't sure they qualify for the bonus and now don't have to worry about their performance in the Merit-Based Incentive Payment System.

Tuesday, 13 June 2017

CMS is giving nursing homes more time to comment on a proposal to replace the nursing home pay system with a model that relies on patient characteristics, rather than the amount of therapy provided.

Wednesday, 07 June 2017

A coalition, made up mostly of health plans, is urging House lawmakers to permanently authorize the Medicare Advantage Dual-Eligible Special Needs Plans (D-SNP) program this year when they consider reauthorizing Medicare programs.

Monday, 05 June 2017

The White House Office of Management and Budget finished its review of a proposed rule to revise the contentious provision banning pre-dispute arbitration agreements for long-term care facilities Friday (June 2), coming after OMB officials met with a number of beneficiary advocacy groups last month.

Friday, 02 June 2017

The Alliance for Site-Neutral Payment Reform asks that CMS use the upcoming outpatient pay rule to pay equal rates to hospital outpatient facilities and doctor offices, which is the opposite of hospitals' request.

Thursday, 01 June 2017

The House Ways & Means health subcommittee scheduled a June 7 hearing on Medicare Advantage that will focus on Special Needs Plans, the Program for All-Inclusive Care for the Elderly and emerging value-based insurance design models, according to a committee announcement.

Tuesday, 30 May 2017

A group of Senate Democrats and two Independents are urging their chamber's Appropriations HHS subcommittee to fund the State Health Insurance Assistance Program at the fiscal 2016 level after the most recent fiscal 2017 spending agreement cut $5 million from the program and President Donald Trump seeks to eliminate discretionary funding for the effort in fiscal 2018.

Tuesday, 30 May 2017

CMS is urging providers to start preparing for the new Medicare beneficiary cards without Social Security numbers that will come out next April followed by a 21-month transition period where providers can use either the current Social Security number-based claim number or the new Medicare Beneficiary Identifier.

Friday, 26 May 2017

More than 75 unions, Medicare advocates, consumer groups and others are raising concerns with the American Health Care Act's effects on Medicare and are urging senators to start over in a bipartisan way -- even though Inside Health Policy has reported Senate lawmakers hope to unveil an initial version of the bill after the Memorial day recess.

Friday, 26 May 2017

FDA needs to further loosen restrictions on exchange of healthcare economic information between manufacturers and payers to encourage a move to value-based payment, stakeholders argue in comments on the agency's January 2016 draft payer communication guidance.

Wednesday, 24 May 2017

Providers that care for people on Medicaid are asking Senate Finance Chair Orrin Hatch (R-UT) to make the American Health Care Act’s Medicaid provisions more generous or to scrap the House-passed version of the bill entirely.

Tuesday, 23 May 2017

President Donald Trump's plan to reform the Medicare appeals process includes policies similar to those put forward by the Obama administration last year, though Trump's plan leaves out a few of the Obama-proposed provisions.

Friday, 19 May 2017

House Republicans are considering reauthorizing the Children’s Health Insurance Program separately from extensions of Medicare programs and policies, which would take away a key vehicle for those so-called Medicare extenders.

Thursday, 18 May 2017

The Senate Finance Committee on Thursday (May 18) unanimously passed bipartisan Medicare chronic care legislation that is the culmination of years of work on the issue, though lawmakers suggested the committee still needs to focus on some issues including ways to make the Independence at Home demonstration permanent.

Thursday, 18 May 2017

CMS on Thursday (May 18) delayed until January the start of the cardiac care bundles and the expansion of the hip-and-knee joint replacement bundle. Agency officials want more time to consider changes to those programs.