Medicare

A bipartisan group of House lawmakers Wednesday (April 10) reintroduced legislation to give CMS the authority to exempt alternative pay models and those under development from some Stark, or physician self-referral, law provisions, shortly after HHS Deputy Secretary Eric Hargan assured attendees at the American Hospital Association that the department would issue rules as fast as it can easing the Stark and anti-kickback statutes’ restrictions on value-based pay.

A provision in the Trump administration’s point-of-sale rebate proposal questioning whether formulary placement-related rebates are protected by the anti-kickback statute generated strong reactions from the generic drug and pharmacy benefit manager lobbies, which are at odds on the issue.

Sen. Elizabeth Warren (D-MA), along with several other 2020 Democratic presidential primary candidates, reintroduced a wide-ranging bill to reform the Affordable Care Act exchanges.

Congressional Medicaid advisers voted unanimously Thursday (April 11) to recommend removing the drug-rebate cap in Medicaid, a recommendation that also is backed by the Trump administration and a key House Republican, after several MACPAC members grew comfortable with removing the cap since initially expressing doubts at a March meeting.

More than 65 provider and hospital groups are pushing lawmakers to back legislation to add 15,000 additional Medicare-funded residency slots over five years, and American Hospital Association Executive Vice President Tom Nickels said a critical mass of lawmaker support is needed before providers can get to the serious conversation of how to get such legislation marked up and possibly paid for.

White House and congressional Republicans immediately pounced on Democratic presidential candidate Bernie Sanders’ (VT) introduction of Medicare for All legislation along with four other Democratic candidates to argue that all Democrats support a government takeover of health care, and they attempted to portray GOP ideas as a realistic alternative.

Senate Finance Chair Chuck Grassley (R-IA) said Wednesday (April 10) if senators cannot reach consensus on a package to lower prescription drug costs by June, such a package may not pass this year.

Sen. Bernie Sanders (I-VT) reintroduced his Medicare for All legislation along with 14 other Democratic senators, pushing the party’s most-left health care proposal once again as other Democrats focus on more-moderate public options.

CMS laid out its vision for the hospice benefit in the expanded Value-Based Insurance Design demonstration on Tuesday (April 9), which is designed to allow Medicare Advantage beneficiaries to opt-in to receive palliative and supportive care services.