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Medicare

October 10, 2019 | Daily News

Medicare Advantage plans are offering transportation benefits, companionship programs, and pest control as part of their 2020 benefit packages, but beneficiary advocates and Oregon’s senators say the new Medicare Plan Finder tool doesn’t give enough information to beneficiaries on these benefits.

October 09, 2019 | Daily News

New proposals on the anti-kickback statute released Wednesday (Oct. 9) do not include any safe harbors for drug value-based pay arrangements, but HHS Secretary Alex Azar said the agency is still working on opportunities for such arrangements that he hopes to move on as soon as possible.

October 09, 2019 | Daily News

Lobbyists and stakeholders – including providers paid less by Medicare Advantage than fee-for-service Medicare -- are watching closely to see how the Trump administration intends to base Medicare fee-for-service rates on Medicare Advantage-negotiated rates and many say the recent executive order raises lots of unanswered questions, including whether the order would apply when MA pay rates are higher than fee-for-service rates.

October 09, 2019 | Daily News

In line with House Republicans, Blue Dog Democrats on Tuesday (Oct. 8) urged House Speaker Nancy Pelosi to hold votes on several bipartisan drug pricing bills, instead of wrapping them into government price negotiation legislation that Republicans oppose.

October 09, 2019 | Daily News

HHS on Wednesday (Oct. 9) released long-awaited proposals to change the physician-self referral and anti-kickback statute regulations aimed at easing providers’ participation in value-based pay models, including new, permanent exceptions to the Stark Law for value-based pay arrangements within and outside Medicare and a new safe harbor under the anti-kickback statute for certain incentives beneficiaries can access through CMS demonstrations.

October 07, 2019 | Daily News

CMS announced Monday (Oct. 7) that it would be adding an icon to its Nursing Home Compare website to directly notify consumers of nursing homes that have been cited for abuse or neglect, months after Senate Finance leaders called on CMS to display this information more prominently.

October 07, 2019 | Daily News

Amy Bassano, formerly the deputy director of the Center for Medicare and Medicaid Innovation, has been named acting director of the innovation center after the departure of former director Adam Boehler, who was confirmed by the Senate on Sept. 26 to lead the U.S. International Development Finance Corporation.

October 07, 2019 | Daily News

About 20% of the doctors that Congress’ Medicare advisory commission previously counted as primary care physicians were misclassified because they mainly care for hospitalized patients, according to new data, prompting concern from several members of the commission over how to best measure patients’ access to primary care.

October 04, 2019 | Daily News

Congressional Medicare advisers on Friday (Oct. 4) weighed recommending a 20% cut to the hospice aggregate pay cap and linking that cap to the wage index.

October 04, 2019 | Daily News

FDA approved the second HIV prevention drug, Descovy, Gilead said Thursday (Oct. 3), setting the stage for difficult coverage decisions as Gilead touts Descovy as safer than its other HIV prevention drug, Truvada, a year before Truvada goes generic.

October 03, 2019 | Daily News

President Donald Trump on Thursday (Oct. 3) signed a wide-ranging executive order that directs HHS to move towards using market-driven rates for traditional Medicare and paying the same amount for a service regardless of whether it is provided by a physician or other type of clinician like a physician’s assistant.

October 03, 2019 | Daily News

The House Ways & Means Committee Chair Richard Neal (D-MA) called on his committee to look at patient protections for nursing home and hospice residents this fall in a letter sent to committee Democrats on Friday (Sept. 27).

October 03, 2019 | Daily News

Senate Finance Chair Chuck Grassley (R-IA) could lose leverage if the panel’s bipartisan drug pricing package is delayed until early 2020, but he would gain political maneuvering time, sources said.

October 03, 2019 | Daily News

CMS announced Thursday (Oct. 3) that it is exploring releasing program data on social determinants of health from its Accountable Health Communities model and asked stakeholders what type of data from the model would be the most useful.

October 02, 2019 | Daily News

An innovation center official told physicians that by 2025 the center aspires to move all Medicare fee-for-service beneficiaries into alternative pay models that include a significant amount of risk for providers.

October 02, 2019 | Daily News

President Donald Trump tweeted Wednesday (Oct. 2) that House Speaker Nancy Pelosi (D-CA) is “incapable” of working on legislation to lower drug prices and is using the issue to distract from House Democrats’ impeachment inquiry.

October 01, 2019 | Daily News

Hospitals and plans say CMS lacks authority to force hospitals and plans to publish standard charges for items and services, and also argue the agency’s proposed price transparency requirement would lead to higher prices, be burdensome for providers and confuse consumers.

October 01, 2019 | Daily News

Hospitals asked CMS which version of its hospital wage index changes the agency plans to apply to the hospital outpatient pay system and suggest that if it plans to institute changes in a budget-neutral way, doing so would hurt some hospitals.

October 01, 2019 | Daily News

As CMS weighs policy options for setting 340B drug pay rates, it is being tugged in different directions by 340B hospitals, for-profit hospitals that don’t participate in the drug discount program, physicians and drug makers.

September 30, 2019 | Daily News

HHS reduced the backlog of Medicare appeals by about 25% as of June 30, according to a status report submitted to the federal D.C. district court, and the American Hospital Association said that reduction was the result of its lawsuit.

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