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Medicare

January 18, 2019 | Daily News

CMS proposed Friday (Jan. 18) to share with insurers savings from lower Part D catastrophic spending in return for plans agreeing to penalties when they exceed spending targets.

January 18, 2019 | Daily News

CMS on Friday (Jan. 18) announced a nation-wide expansion and several new features of its Value-Based Insurance Design model, which provides flexibility to Medicare Advantage plans with the goal of encouraging beneficiaries to consume high-value clinical services.

January 17, 2019 | Daily News

Federal Medicare advisers grappled Thursday (Jan. 17) with how CMS could better track opioid use in hospitals and encourage non-opioid alternatives, and it must report to Congress on those issues by March due to a mandate in last year’s landmark opioid bill.

January 17, 2019 | Daily News

The Medicare Payment Advisory Commission voted Thursday (Jan. 17) on 2020 payment recommendations for provider services ahead of CMS’ release of its annual pay rules and policies.

January 16, 2019 | Daily News

The White House Office of Budget and Management’s review of CMS’ tweaked home health pre-claims review demonstration, now called the Review Choice Demonstration for Home Health Services, has seemingly stalled since CMS submitted it to OMB for review, leaving Illinois providers preparing for a demonstration with an uncertain start date.

January 15, 2019 | Daily News

Several Supreme Court justices expressed skepticism Tuesday (Jan. 15) about CMS’ authority to issue legal interpretations that affect Medicare reimbursements without going through notice-and-comment rulemaking.

January 14, 2019 | Daily News

Sen. Ben Cardin (D-MD) recently introduced legislation to add oral health -- including routine dental care -- to Medicare Part B to the delight of beneficiary advocates, and House Ways & Means Chair Richard Neal (D-MA) has also indicated interest in addressing Medicare coverage of oral health.

January 11, 2019 | Daily News

The Congressional Budget Office released a statement Friday (Jan. 11) that their report determining if enacted legislation for the current fiscal year exceeds discretionary budget limits will be delayed until funding for all 12 annual appropriations bills can be accounted for.

January 11, 2019 | Daily News

Senate Finance Committee Chairman Sen. Chuck Grassley (R-IA) will discuss a bill on pharmacy benefit manager transparency this session with his committee, a spokesman for the senator told Inside Health Policy.

January 11, 2019 | Daily News

A White House Office of Management and Budget senior official said Thursday (Jan. 10) that automatic Medicare cuts resulting from the so-called PAYGO rules are on hold due to a lapse in appropriations that prevents an accurate update of the PAYGO scorecard laying out the final amount of those cuts, with one lobbyist calling the chances of losing Medicare pay remote.

January 10, 2019 | Daily News

The National Association of Accountable Care Organizations says CMS should give ACOs more time to apply to the revamped ACO program after the agency set a Feb. 19 deadline.

January 10, 2019 | Daily News

House Ways & Means leaders from both parties worry CMS is unilaterally using demonstrations to revamp Medicare law, and call on the agency to be open about how they create demonstrations that test new approaches to paying for goods and services.

January 10, 2019 | Daily News

Newly tapped Senate Finance Chair Chuck Grassley (R-IA) said Wednesday (Jan. 9) he opposes Medicare drug price negotiation, but he seemed to imply he’s open to either changing or eliminating the risk corridors that help protect Part D drug plans from losing money.

January 10, 2019 | Daily News

Senate Finance Committee Chair Chuck Grassley (R-IA) said he is waiting to see what CMS formally proposes before passing judgment on the International Pricing Index demonstration, but he nevertheless opposes the most important aspect of the informal proposal: indexing U.S. drug prices to those set by foreign countries.

January 10, 2019 | Daily News

CMS Administrator Seema Verma said Thursday (Jan. 10) that an updated 2018 requirement that hospitals post price information online in a machine-readable format is just a ‘first step’ to helping patients understand health costs, and that hospitals themselves can go further with price transparency.

January 09, 2019 | Daily News

Senate Finance Committee Chair Chuck Grassley (R-IA) on Wednesday (Jan. 9) said he expects to spend time looking at Medicare and Medicaid waste, fraud and abuse now that he has resumed the chairmanship, along with health care anti-trust issues.

January 09, 2019 | Daily News

CMS says in recently released guidance that states do not need to obtain a Medicare denial for certain durable medical equipment coverage before Medicaid, which acts as a secondary payer for those dually eligible for Medicare and Medicaid, can pay for the equipment.

January 08, 2019 | Daily News

House Budget Committee Chairman John Yarmuth (D-KY) asked the Congressional Budget Office to study the design and policy implications of developing a single-payer health care system.

January 07, 2019 | Daily News

HHS recently told stakeholders it will prioritize models out of the Physician-Focused Payment Model Technical Advisory Committee that reduce mortality or are expected to reduce spending by at least $10 billion annually once expanded nationally, and the department has pegged six model areas for close consideration.

January 07, 2019 | Daily News

House Democrats say they haven't yet determined whether to push for Medicare price negotiation of all drugs or just the expensive ones.

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