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Medicare

December 15, 2017 | Daily News

While House Republican leaders say they will tackle entitlement reform in 2018 -- which could include Medicare and Medicaid cuts -- lobbyists and analysts say it would be difficult for such cuts to get through the Senate, especially in light of Senator-elect Doug Jones' (D) recent win in Alabama.

December 14, 2017 | Daily News

House Speaker Paul Ryan (R-WI) said Thursday (Dec. 14) that the GOP will revisit problems with the Affordable Care Act in 2018, but did not specify in what way, and also said Republicans plan to pass entitlement reform through the reconciliation process next year, specifically pointing to welfare while not mentioning Medicare, Medicaid or Social Security.

December 12, 2017 | Daily News

A bipartisan group of six senators recently urged the upper chamber's leadership to include a provision to prevent a cut to hospital reimbursement for 340B drugs in an end-of-the-year package -- though it is unclear what legislation lawmakers may look to pass once the current continuing resolution runs out Dec. 22.

December 11, 2017 | Daily News

Clinical laboratories on Monday (Dec. 11) sued the government over the fee schedule for tests.

December 11, 2017 | Daily News

Congressional Medicare advisers outlined a potential post-acute care pay system that CMS could use until a unified system is put into place.

December 08, 2017 | Daily News

Congressional Medicare advisers said Friday (Dec. 8) they plan to look into overhauling the Medicare Advantage star-rating system, and they're particularly bothered by an insurance industry practice that games bonuses.

December 08, 2017 | Daily News

Congress' Medicare pay advisers plan to vote in January on a draft recommendation to eliminate and replace the Merit-based Incentive Payment System, which Commissioner David Grabowski said belongs in the “bad pay for performance hall of fame.”

December 06, 2017 | Daily News

House Speaker Paul Ryan (R-WI) and Deputy Majority Whip Tom Cole (R-OK) both said on Wednesday (Dec. 6) that, after wrapping up the tax bill and the budget, Republicans will move to entitlement reform and work to cut Medicare and Medicaid spending.

December 06, 2017 | Daily News

A National Academy of Sciences report on ways to cut drug prices -- to be featured at a Senate health committee hearing next Tuesday (Dec. 12) -- includes proposals that run counter to the interests of brand drug makers, pharmacy benefit managers and health plans.

December 06, 2017 | Daily News

National health care spending growth decelerated in 2016 following two years of coverage expansion under the Affordable Care Act and high retail prescription drug spending growth, but even though the rate of spending growth declined, the share of the economy devoted to health care grew slightly as that spending increased 1.5 percentage points faster than the gross domestic product.

December 05, 2017 | Daily News

FDA published final guidance Monday (Dec. 4) aimed at helping CMS determine which investigational devices to cover by streamlining the categorization of investigational device exemption (IDE) products -- completing a process launched in 2015 through a Memorandum of Understanding (MOU) between FDA's device center and CMS' Coverage and Analysis group (CAG).

December 05, 2017 | Daily News

House Energy & Commerce ranking Democrat Frank Pallone (NJ) says he is concerned about conflicts of interest and impartiality in the reported rewrite of CMS rules, and he is asking the MITRE Corporation to detail its involvement in CMS rulemaking.

December 04, 2017 | Daily News

The White House Office of Management and Budget is reviewing an interim final rule on “Addressing Extreme and Uncontrollable Circumstances” for the Medicare Shared Savings program.

November 30, 2017 | Daily News

CMS on Thursday (Nov. 30) canceled the Episode Payment Models and the Cardiac Rehabilitation Incentive pay model, and it shrunk the mandatory Comprehensive Care for Joint Replacement demonstration after about half of hospitals participating in that mandatory model earned payments from CMS when preliminary data showed they were below benchmark spending for the model's first year.

November 30, 2017 | Daily News

For the second time, CMS agreed to cover a companion diagnostic on the day FDA approved it.

November 30, 2017 | Daily News

Both the Senate and House are expected to override the 4 percent cut to Medicare provider-pay rates that would be triggered by Republican tax legislation, according to lawmakers, but separately Congress is expected to extend the existing 2 percent Medicare sequester to pay for funding of the Children’s Health Insurance Program and other health care extenders, lobbyists following the CHIP bill said.

November 30, 2017 | Daily News

While senators are continuing to push CMS to take action to deal with elder abuse and other nursing home concerns, including inquiries from Sen. Elizabeth Warren (D-MA) to HHS Secretary-nominee Alex Azar, the subject was not broached at Wednesday's (Nov. 29) hearing by the Senate health committee.

November 30, 2017 | Daily News

CMS recently announced it will expand the Medicare Advantage Value-Based Insurance Design demonstration in 2019 to an additional 15 states and let plans choose which conditions to structure benefit variations around, coming shortly after the agency proposed similar flexibilities for all MA plans.

November 29, 2017 | Daily News

The Senate voted along party lines on Wednesday evening (Nov. 29) on a motion to proceed debate on the GOP tax bill, which still includes a repeal of the ACA's individual mandate and would require $25 billion in Medicare cuts unless pay-go is waived.

November 28, 2017 | Daily News

The HHS Inspector General recommends a legislative change that would lower beneficiary spending on drugs and save taxpayers money, but CMS opposes the change because on rare occasion it would make it difficult for doctors to infuse the drug of their choice.

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