Medicare

CMS on Tuesday (Nov. 4) again extended the prior authorization program for non-emergency, repetitive ambulance trips.

HHS is pushing Congress to consider more site-neutral pay policies in Medicare, repeal the Affordable Care Act’s limit on physician-owned hospitals, relax telehealth restrictions and give Medicare beneficiaries more access to health savings accounts, as part of a new Trump administration report on ways to increase health care choice and competition.

Commercial entities that could serve as vendors between manufacturers and providers are a key part of the Trump administration’s proposed Medicare Part B demo, but it is still unclear which, if any, will decide to participate in CMS’ competitive selection process.

CMS, worried about potential nursing home staff inadequacies after looking at payroll-based staffing data, will send state survey agencies a list of nursing homes with reduced staffing so surveyors can follow up.

Top HHS officials on Thursday (Nov. 29) said they weren’t afraid of using a firm regulatory hand to drive interoperability shortly after CMS Administrator Seema Verma said it would be easier for the agency to use Medicare requirements to compel hospitals and doctors, which received incentive payments for electronic health record use under the previously-called meaningful use program, to share health records with patients than to do so for post-acute care providers that were not part of meaningful use.

HHS on Wednesday (Nov. 28) unveiled numerous draft recommendations aimed at reducing provider burden related to health IT and electronic health records, including standardization in many areas and leveraging of health IT to ease prior authorization.

Continuing drug shortage issues are a result of economic and policy failures that span many years, FDA Commissioner Scott Gottlieb told a crowd of researchers, health care providers, industry representatives and other experts during the agency’s Tuesday (Nov. 27) drug shortages public meeting, held in coordination with the Duke Margolis Center for Health Policy.

The National Association for Home Care and Hospice told the White House Office of Management and Budget and CMS that the decline in the home health improper pay rate in traditional Medicare shows that CMS’ planned Review Choice Demonstration isn’t needed.

Sen. Bernard Sanders (I-VT) and Rep. Ro Khanna (D-CA) on Tuesday (Nov. 20) unveiled a prescription drug-pricing bill that blends Republican and Democratic proposals: The legislative plan would expand the Trump administration’s international reference pricing concept to span the entire U.S. drug market and includes a Democratic proposal to give the government power to invalidate brand-drug makers’ exclusivity if their drug prices are deemed excessively high.