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Medicare

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.

November 11, 2019 | Daily News

White House Domestic Policy Council Director Joe Grogan is not a fan of including drug rebate reform in the Senate’s drug pricing bill, and he would rather spend what little time is left tweaking policies that ensure the bill doesn’t raise premiums and that spread more of the bill’s Part D savings to more seniors.

November 08, 2019 | Daily News

Medicare payment policies are encouraging hospital systems to buy up physician practices, leading to higher costs for both the government and beneficiaries, according to data presented to the Medicare Payment Advisory Commission Thursday (Nov. 7).

November 08, 2019 | Daily News

A proposed Medicare Advantage and Part D rule under review by the White House Office of Management and Budget could execute parts of an October executive order and include controversial extrapolation language previously introduced in a prior MA rule, a former senior CMS official says.

November 08, 2019 | Daily News

Congressional Medicare advisors weighed proposals to reform Medicare Advantage’s quality bonus program and the benchmarks in the MA pay system, but the advisors asked staff to complete analyses on the impacts of the proposed reforms before developing policy recommendations.

November 08, 2019 | Daily News

A bipartisan, bicameral bill introduced Thursday (Nov. 7) would increase oversight of hospices after reports released by the HHS Office of Inspector General (OIG) in July identified abuse and neglect of Medicare beneficiaries in hospice.

November 07, 2019 | Daily News

The House Ways & Means Committee will hold a hearing Thursday (Nov. 14) on caring for aging Americans, and a spokesperson told Inside Health Policy the hearing will likely cover a wide range of issues including care in the home, hospice, nursing homes, antipsychotic use in nursing homes and other long-term care issues.

November 07, 2019 | Daily News

A bipartisan group of House lawmakers recently introduced legislation to keep CMS from adding noninvasive ventilators to the durable medical equipment competitive bidding program for five years after the agency defended its decision to add the ventilators despite lawmakers’ concerns.

November 07, 2019 | Daily News

The charity that says it will be forced to stop operations in California due to a state law enacted earlier this month continues to be on the defense over its industry-backed premium assistance program that has been at the heart of a longstanding battle among issuers, unions and dialysis firms.

November 07, 2019 | Daily News

Senate Finance Committee ranking Democrat Ron Wyden (OR) warned that a provision in a bipartisan budget reform measure sponsored by Budget Chair Mike Enzi (R-WY) and Sen. Sheldon Whitehouse (D-RI) could portend the end of traditional Medicare if enacted.  The bill would set up an automatic budget reconciliation process for debt reduction that would kick in should the Congressional Budget Office determine the debt would be higher at the end of a decade than it would be under the budget resolution. The Budget Committee approved the legislation 15-6 on Wednesday.

November 06, 2019 | Daily News

HHS has teamed up with the National Kidney Foundation and the American Society of Nephrology on a public awareness initiative about kidney disease that President Donald Trump called for in an executive order. Both stakeholder groups praised the initiative, but some have criticized the administration for not also reforming kidney treatment payment and coverage policies.

November 06, 2019 | Daily News

Senate Finance Committee Chair Chuck Grassley suggested  Tuesday (Nov. 5) that he plans to file an updated drug pricing bill next week, and a White House official said the administration is working with the Iowa Republican and ranking Finance Democrat Ron Wyden (OR) on provisions to limit seniors’ monthly out-of-pocket costs and to help seniors with sharply rising insulin list prices.

November 05, 2019 | Daily News

Hospitals called on CMS to release final guidance on how hospitals can avoid violating Medicare conditions of participations when creating policies to reduce risk in patients who may cause harm to themselves and others or sharing locations with other providers.

November 05, 2019 | Daily News

The American Kidney Fund (AKF) and Dialysis Patient Citizens (DPC) and two kidney failure patients have sued California over legislation enacted last month that the advocates say will cause irreparable harm to patients with end-stage renal disease.

November 01, 2019 | Daily News

CMS on Friday (Nov. 1) finalized changes to the Physician Fee Schedule that will simplify documentation and coding requirements for office visits, add a new Part B benefit for opioid treatment programs and increase pay for care management services provided to beneficiaries after they leave the hospital.

November 01, 2019 | Daily News

CMS on Friday (Nov. 1) finalized controversial proposals in the 2020 hospital outpatient pay rule to continue cuts to 340B drug reimbursement and to pay for clinic visits at certain off-campus facilities, despite federal district judges ruling against both polices.

November 01, 2019 | Daily News

The National Home Infusion Association pushed back after CMS finalized a new home infusion benefit for 2021 as part of a home health pay rule out Thursday (Oct. 31) that excludes pharmacists, instead reimbursing them under the durable medical equipment benefit.

November 01, 2019 | Daily News

CMS Administrator Seema Verma said the upcoming rural health demonstration will be focused on giving rural areas seed money to redesign their health care systems and encouraging providers in those areas to participate in value-based care.

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