Medicare

Academics and beneficiary advocates are continuing to raise concerns with the Medicare Plan Finder tool as open enrollment continues -- namely that the updated website puts too much emphasis on the least expensive Medicare premium, rather than the smallest overall cost, and has missing or inaccurate cost information.

White House Domestic Policy Council head Joe Grogan recently said CMS included controversial cuts to 340B drug reimbursement and certain off-campus clinics in the 2020 hospital outpatient pay rule because it stands by the policies, and if the courts overturn them that just shows lawmakers where statutory changes are needed.

Hospitals want a federal judge to enforce her court order to get rid of deep reimbursement cuts for clinic visits at certain off-campus hospital facilities after CMS in its final 2020 hospital outpatient pay rule said it was forging ahead with the second year of the so-called site-neutral cuts.

White House Domestic Policy Council Director Joe Grogan is not a fan of including drug rebate reform in the Senate’s drug pricing bill, and he would rather spend what little time is left tweaking policies that ensure the bill doesn’t raise premiums and that spread more of the bill’s Part D savings to more seniors.

A proposed Medicare Advantage and Part D rule under review by the White House Office of Management and Budget could execute parts of an October executive order and include controversial extrapolation language previously introduced in a prior MA rule, a former senior CMS official says.

A bipartisan, bicameral bill introduced Thursday (Nov. 7) would increase oversight of hospices after reports released by the HHS Office of Inspector General (OIG) in July identified abuse and neglect of Medicare beneficiaries in hospice.

A bipartisan group of House lawmakers recently introduced legislation to keep CMS from adding noninvasive ventilators to the durable medical equipment competitive bidding program for five years after the agency defended its decision to add the ventilators despite lawmakers’ concerns.

Senate Finance Committee ranking Democrat Ron Wyden (OR) warned that a provision in a bipartisan budget reform measure sponsored by Budget Chair Mike Enzi (R-WY) and Sen. Sheldon Whitehouse (D-RI) could portend the end of traditional Medicare if enacted.  The bill would set up an automatic budget reconciliation process for debt reduction that would kick in should the Congressional Budget Office determine the debt would be higher at the end of a decade than it would be under the budget resolution. The Budget Committee approved the legislation 15-6 on Wednesday.

Senate Finance Committee Chair Chuck Grassley suggested  Tuesday (Nov. 5) that he plans to file an updated drug pricing bill next week, and a White House official said the administration is working with the Iowa Republican and ranking Finance Democrat Ron Wyden (OR) on provisions to limit seniors’ monthly out-of-pocket costs and to help seniors with sharply rising insulin list prices.