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December 04, 2019 | Daily News

Two Democratic senators are calling on CMS, the Federal Trade Commission and five health care companies to ensure artificial intelligence tools used in health care are not biased, amid recent interest by CMS in using artificial intelligence in Medicare.

December 04, 2019 | Daily News

The Energy & Commerce health subcommittee will hold a hearing next Tuesday (Dec. 10) to review a slate of bills that aim to achieve universal coverage either through a public option, Medicare or Medicaid buy-ins, or providing Medicare for all residents with or without maintaining private alternatives.

December 04, 2019 | Daily News

In the lead up to the last week of Medicare open enrollment, CMS said it is already seeing the positive impact of the new Medicare Plan Finder and blames the media for talking about glitches or malfunctions, but the Center for Medicare Advocacy says the agency is not acknowledging that problems with the new system could hurt beneficiaries.

December 03, 2019 | Daily News

The White House Council of Economic Advisers estimates that House Democrats’ drug pricing bill would thwart up to 100 drug inventions over a decade, compared to the eight to 15 fewer drugs that the nonpartisan Congressional Budget Office estimated would result from H.R. 3.

December 03, 2019 | Daily News

Democratic presidential candidate Pete Buttigieg proposed giving the Center for Medicare and Medicaid Innovation authority to pilot new payment models that would tackle social determinants of health and requiring Medicare and Medicaid develop and meet health equity standards as well as collect and protect demographic health data to reduce inequity in health care.

December 02, 2019 | Daily News

Accountable Care Organizations view CMS’ new Direct Contracting demonstration as laying the groundwork for the next generation of ACOs -- particularly with the Next Generation ACO demo set to sunset soon -- and PACE organizations view the Direct Contracting demo as a way to reach new patients who could benefit from the Program of All-Inclusive Care for the Elderly care model.

November 26, 2019 | Daily News

Researchers in a study released Thursday (Nov. 21) suggested reforming Medicare by building a premium-support type system based solely on Medicare Advantage as an alternative to Democrats’ Medicare for All built off the current system, but the researchers said a premium support system should be set up without a public option and MA risk adjustment would need to be retooled first.

November 25, 2019 | Daily News

When President Donald Trump took to Twitter Friday (Nov. 22) to weigh in on drug pricing reforms, he gave House Republicans cover to vote against House Democrats’ bill to let Medicare negotiate drug prices, instead of leaning on Senate Republicans to support the less-aggressive bipartisan drug pricing legislation in that chamber, even though White House adviser Joe Grogan said recently that the administration backs the Senate bill.

November 22, 2019 | Daily News

The Medicare fee-for-service improper pay rate dropped again, according to the HHS fiscal 2019 financial report, dipping below the Medicare Advantage improper pay rate -- though that program’s improper pay rate dropped too, as did the Medicare Part D improper pay rate.

November 21, 2019 | Daily News

Massachusetts Sen. Elizabeth Warren reiterated her commitment to covering all Americans under Medicare in her first term, but also embraced her new strategy of first building off the Affordable Care Act and lowering the existing Medicare program to adults age 50 and above, while Sen. Bernie Sanders (VT) said he’d push for Medicare for All his first week in office, in a Democratic presidential debate that featured only a few minutes on the topic, far less than in earlier events.

November 20, 2019 | Daily News

Tensions between a congressionally mandated panel charged with recommending alternative physician pay models and CMS’ innovation center culminated in two members of the panel resigning this week over what they view as the agency’s refusal to take the panel’s recommendations seriously.

November 20, 2019 | Daily News

HHS plans to propose this month the controversial International Pricing Index demonstration that the president announced in October of 2018, according to the fall regulatory agenda that the administration published Wednesday (Nov. 20).

November 19, 2019 | Daily News

The House voted Tuesday (Nov. 19) to fund the government through Dec. 20 with a package that includes so-called heath extenders that are set to expire on Nov. 21.

November 18, 2019 | Daily News

Democratic Presidential Candidate Elizabeth Warren laid out a strategy for transitioning to Medicare for All under which she would use her first 100 days as president to reverse the Trump administration’s regulatory changes to the Affordable Care Act, defend the law from the GOP challenge in Texas, and support using reconciliation to pass a Medicare-like public option that would be available for all Americans, reform the ACA and lower the Medicare eligibility age to 50.

November 15, 2019 | Daily News

Academics and beneficiary advocates are continuing to raise concerns with the Medicare Plan Finder tool as open enrollment continues -- namely that the updated website puts too much emphasis on the least expensive Medicare premium, rather than the smallest overall cost, and has missing or inaccurate cost information.

November 15, 2019 | Daily News

The House Ways & Means Committee's rural health and underserved area task force is asking stakeholders what issues should be considered as lawmakers draft bipartisan legislation -- in particular, the task force wants to pinpoint policies that have had a demonstrable, positive impact on health outcomes and workforce shortages in rural and underserved areas as well as the availability of long-term care.

November 14, 2019 | Daily News

White House Domestic Policy Council head Joe Grogan recently said CMS included controversial cuts to 340B drug reimbursement and certain off-campus clinics in the 2020 hospital outpatient pay rule because it stands by the policies, and if the courts overturn them that just shows lawmakers where statutory changes are needed.

November 12, 2019 | Daily News

Federal circuit court judges asked government lawyers to explain why CMS believes it has authority to cut back 340B reimbursement, and HHS’ legal team responded that it is not compelled to overpay hospitals.

November 12, 2019 | Daily News

Hospitals want a federal judge to enforce her court order to get rid of deep reimbursement cuts for clinic visits at certain off-campus hospital facilities after CMS in its final 2020 hospital outpatient pay rule said it was forging ahead with the second year of the so-called site-neutral cuts.

November 12, 2019 | Daily News

Sources suggest that California progressive Rep. Ro Khanna’s legislation that would give states flexibility to design a single-payer health system using money from all existing public programs would be a heavy political lift, particularly since seniors are wary of changes to Medicare and employers oppose policies that give states authority over self-insured large group plans.