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Medicare

March 21, 2019 | Daily News

CMS says about 250 Medicare providers dropped out of the Bundled Payments for Care Improvement Advanced demonstration, and, after the March 1 deadline to withdraw without facing any financial risk, about 1,300 providers remain as part of about 1,100 participating entities– which the agency called robust participation.

March 21, 2019 | Daily News

A new Urban Institute report out Thursday (March 21) suggests policymakers consider capping provider rates at Medicare levels or introducing a public plan option in exchange rating areas that continue to struggle with competition.

March 21, 2019 | Daily News

The American Enterprise Institute and the Brookings Institution are pushing lawmakers to expand site-neutral pay to on-campus hospital outpatient departments, a call that was mirrored in the president’s fiscal 2020 budget.

March 21, 2019 | Daily News

Durable medical equipment lobbyists took their fight against adding ventilators to the competitive bidding program to the White House Domestic Policy Council after vowing to pressure the administration and Congress to change the policy.

March 20, 2019 | Daily News

The HHS budget doubles down on CMS’ plan to increase the use of encounter data as part of a bid to “eliminate excessive payment in Medicare Advantage,” despite plans’ opposition to using risk score calculations to cut back MA payments.

March 20, 2019 | Daily News

Provider groups and plans are calling on Congress to give them greater access to claims data and to make the true cost of services transparent as the Senate health committee looks for possible solutions to driving down health care costs.

March 19, 2019 | Daily News

CMS expects to give providers instructions soon on how to choose a claims review option under the tweaked home health demo after the White House Office of Management and Budget (OMB) approved the program.

March 18, 2019 | Daily News

Congressional Medicare advisers blasted Congress for changes to the Medicare coverage gap last year and asked lawmakers to make plans responsible for a larger share of prescription drug costs in Part D.

March 18, 2019 | Daily News

Sens. Debbie Stabenow (D-MI) and Roy Blunt (R-MO) last Thursday (March 14) introduced a bill to expand the number of states with Medicaid-funded community mental health clinic pilots from eight to 19, and HHS Secretary Alex Azar said he looks forward to working with lawmakers to make sure it passes.

March 15, 2019 | Daily News

Rep. Pete Olson (R-TX) called on Congress to support a bill to bolster artificial intelligence (AI) in health care, saying it would promote quicker recovery times and more accurate diagnoses.

March 15, 2019 | Daily News

The lobby representing the nation’s dental plans and dozens of lawmakers from both parties are urging CMS to update healthcare.gov so that all Americans, including Medicare beneficiaries, can purchase stand-alone dental plans without having to first buy medical insurance.

March 14, 2019 | Daily News

A bipartisan group of more than 70 House lawmakers wants CMS to withdraw a proposal to weaken coverage protections in six classes of drugs, according to a March 13 letter to HHS Secretary Alex Azar.

March 14, 2019 | Daily News

HHS Secretary Alex Azar and House Republicans criticized the recently introduced Medicare For All bill at a House Energy & Commerce health subcommittee hearing Tuesday (March 12), saying it would eliminate Medicare Advantage (MA) plans, a claim that the office of Rep. Pramila Jayapal (D-WA) said was true, but the office said the bill would cover everything MA does.

March 14, 2019 | Daily News

A bipartisan bill is being introducing Thursday (March 14) to let CMS share drug-pricing data with congressional advisers for Medicare and Medicaid policies.

March 14, 2019 | Daily News

House Energy & Commerce Committee Chair Frank Pallone (D-NJ) said Wednesday (March 13) that drug-pricing policy proposals that are likely to pass in Congress this session would benefit Medicare more than the commercial market.

March 13, 2019 | Daily News

House Energy & Commerce Committee Chair Frank Pallone (D-NJ) said Wednesday (March 13) that his focus in 2019 will be to block the Trump administration’s health care agenda, rather than to promote ambitious Democratic proposals to overhaul Medicare, which Pallone said have almost no chance of passing in the current Congress.

March 12, 2019 | Daily News

CMS’ decision to add non-invasive ventilators to the revamped durable medical equipment competitive bidding program set to go into effect in 2021 has upset DME suppliers, with the DME lobby calling it a “terrifying development” for patients and saying the group will press the Trump administration and Congress to stop that addition.

March 12, 2019 | Daily News

Lawmakers in the House and Senate reintroduced a bill to count beneficiaries’ time spent under observation toward the three-day hospital stay required before Medicare covers nursing home care, and a wide-ranging group of stakeholders says support for the policy shift continues to grow.

March 12, 2019 | Daily News

The American Medical Association is pushing the insurance industry to work more quickly to change prior authorization policies that can delay care and harm patients, pointing to the results of a survey out Tuesday (March 12) that found little progress on five recommendations America’s Health Insurance Plans (AHIP) and the Blue Cross Blue Shield Association had supported in January 2018.

March 12, 2019 | Daily News

Senate Finance Committee Chair Chuck Grassley (R-IA) and ranking Democrat Ron Wyden (OR) Tuesday (March 12) invited five executives of pharmacy benefit manager companies to testify before the committee on April 3.

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