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Medicare

February 12, 2020 | Daily News

The Ways & Means Committee unanimously passed a hospice reform bill meant to increase authority for HHS and CMS to penalize low-quality Medicare hospice providers at a committee markup on Wednesday (Feb. 12).

February 12, 2020 | Daily News

Key lawmakers and a top HHS official signaled potential legislative and administrative action to address rural providers' concerns as rural health advocates renewed calls Tuesday (Feb. 11) for Congress to stymie Medicare cuts and pass bills that would provide regulatory relief for hospitals in danger of closing.

February 12, 2020 | Daily News

Beneficiary advocates say they are pleased CMS appears to be taking seriously the issues with so-called look-alike plans that mimic Dual Eligible Special Needs Plans yet don’t have the same Medicare and Medicaid integration requirements –  but some worry that CMS' proposed threshold for stopping these plans may be set too high.

February 11, 2020 | Daily News

CMS Administrator Seema Verma told the American Medical Association on Tuesday (Feb. 11) that CMS will tackle prior authorization this year, calling the process indefensible just one day after the president’s fiscal 2021 budget proposed to add prior authorization requirements to traditional Medicare.

February 11, 2020 | Daily News

Senate Majority Leader Mitch McConnell (R-KY) threw cold water on the chances of the Senate agreeing on drug pricing legislation hours after Sen. Chuck Grassley (R-IA) said he is gathering GOP support for his bill (S. 2543), and Senate Minority Leader Chuck Schumer (D-NY) insisted that senators also get a chance to vote on House Democrats’ Medicare drug price negotiation plan if the Senate takes up drug pricing legislation.

February 11, 2020 | Daily News

Senate Finance Chair Chuck Grassley said Tuesday (Feb. 11) he is updating his drug pricing bill to get more GOP support, but the Iowa Republican’s office said he is not axing the inflationary rebates that most Republicans oppose.

February 10, 2020 | Daily News

The president’s fiscal 2021 budget proposes to rework Medicare Advantage quality bonus pay, eliminating both caps on what plans can receive and the so-called double bonuses certain plans can get, and to confirm beneficiaries’ diagnoses before CMS makes risk-adjusted payments to a plan.

February 10, 2020 | Daily News

The president’s 2021 budget proposal assumes drug pricing legislation would save $135 billion -- a similar amount to the estimated savings from the Senate Finance Committee’s drug pricing bill -- but the budget does not endorse the Senate bill, an administration official said.

February 07, 2020 | Daily News

The moderate New Democrat Coalition has endorsed a slate of bills that aim to improve the Affordable Care Act and hope the measures, along with a number of others the group previously endorsed, will be included in a health reform package that Democratic leadership hopes to unveil around the 10th anniversary of the ACA this March.

February 07, 2020 | Daily News

A leading telehealth company and health plans suggest closing the gap on access to mental and behavioral health services is a top priority for virtual care in 2020 as they continue to adjust telehealth services to consumers’ needs and push lawmakers to pass legislation expanding access to such services.

February 06, 2020 | Daily News

HHS Secretary Alex Azar touted the department’s work on cutting back the Medicare appeal backlog as part of his State of the Department address on Thursday (Feb. 6), and the American Hospital Association says it is pleased HHS has taken seriously the court order that required it to tackle the backlog.

February 06, 2020 | Daily News

The biosimilars industry and FDA will grapple with myriad regulatory shifts in 2020, with one of the most immediate challenges being the drug-to-biologic transition that some brand and generic drug makers will face next month.

February 05, 2020 | Daily News

CMS projects Medicare Advantage plans will see about a 1% pay bump in 2021, according to an advanced notice of how the agency plans to set rates, and that notice was paired with a proposed rule laying out policy recommendations instead of a draft call letter that has typically accompanied it.

February 05, 2020 | Daily News

CMS on Wednesday (Feb. 5) proposed to loosen network adequacy requirements for Medicare Advantage plans in rural areas and offered further flexibility for plans if they provide telehealth in 2021 to ease rural beneficiaries' access to specialty providers.

February 05, 2020 | Daily News

Nearly 400 lawmakers signed a letter to CMS Administrator Seema Verma affirming their support for Medicare Advantage and outlining their vision for the program in 2021 ahead of the release of the 2021 MA and Part D proposed rule late Wednesday (Feb. 5)

February 05, 2020 | Daily News

The 2021 Medicare Advantage and Part D proposed rule released Wednesday (Feb. 5) seeks to implement several new policies aimed at reducing opioid abuse in Medicare, including requiring Part D plans to establish drug management programs that would limit a beneficiary’s access to opioids if the beneficiary were deemed to be at risk of abuse.

February 05, 2020 | Daily News

The Community Oncology Alliance is pushing for passage this spring of a bipartisan House bill that would create guardrails on demonstrations from CMS’ innovation center.

February 05, 2020 | Daily News

The House Oversight & Reform Committee is already probing the Trump administration’s national drug strategy that was released Monday (Feb. 4), continuing the work of the late Chair Elijah Cummings (D-MD) who last year questioned the White House Office of National Drug Control Policy (ONDCP) on what he called an inadequate strategy.

February 05, 2020 | Daily News

The president on Tuesday (Feb. 4) gave a nod to Senate Finance Committee Chair Chuck Grassley (R-IA) and his drug pricing bill, but it’s unclear whether that mention during the State of the Union address was strong enough to convince Senate Republicans to back the bill.

February 04, 2020 | Daily News

The Trump administration is criticizing drug pricing policies in the Netherlands, even though the Netherlands is among the countries President Donald Trump plans to rely on for setting Medicare drug prices.

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