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Medicare

December 04, 2018 | Daily News

HHS Secretary Alex Azar on Tuesday (Dec. 4) said that Medicare Advantage may account for a larger share of Medicare than fee-for-service in the next five to 10 years, and if that happens HHS may have to rethink the system so that innovation occurs first in the MA space and the rest of the program follows suit.

December 04, 2018 | Daily News

HHS Secretary Alex Azar on Tuesday (Dec. 4) said that Medicare Advantage may account for a larger share of Medicare than fee-for-service in the next five to 10 years, and if that happens HHS may have to rethink the system so that innovation occurs first in the MA space and the rest of the program follows suit.

December 04, 2018 | Daily News

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

December 04, 2018 | Daily News

Arkansas told a federal judge evaluating the legality of the state’s Medicaid work requirements to ignore early data showing substantial coverage losses in the early months of the program.

December 03, 2018 | Daily News

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.

December 03, 2018 | Daily News

The administration criticized state laws that open up restricted pharmacy networks, because administration officials believe those laws make it difficult for plans and pharmacy benefit managers to negotiate discounts from providers, which increases costs to consumers.

December 03, 2018 | Daily News

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.

December 03, 2018 | Daily News

Sen. Bill Cassidy (R-LA) told Inside Health Policy that he is in the early stages of developing a bill that would address payment models for high-cost prescription drugs such as gene therapies.

November 30, 2018 | Daily News

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.

November 30, 2018 | Daily News

A case that could define the extent of CMS’ authority to issue legal interpretations without conducting notice-and-comment rulemaking will be argued before the Supreme Court on Jan. 15.

November 30, 2018 | Daily News

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.

November 29, 2018 | Daily News

Incoming Senate Finance Chair Chuck Grassley outlined his agenda for lowering drug prices in a floor speech Thursday (Nov. 29) that included praise for actions taken by the Trump administration but made no mention of HHS’ controversial proposal to base Medicare Part B reimbursement on drug prices set by foreign governments.

November 28, 2018 | Daily News

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.

November 27, 2018 | Daily News

Medicare beneficiary advocates are again raising concerns that the administration appears to be promoting Medicare Advantage over traditional Medicare in its education and outreach materials for open enrollment, this time pointing to CMS’ eMedicare initiative and the email campaign the agency is conducting as beneficiaries choose their coverage option for 2019.

November 27, 2018 | Daily News

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.

November 26, 2018 | Daily News

MS proposed Monday (Nov. 26) letting Part D plans exclude drugs in protected classes from Part D formularies when their makers raise prices faster than inflation or when drug companies make new formulations of drugs already on the market.

November 26, 2018 | Daily News

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.

November 26, 2018 | Daily News

CMS said the most recent improper pay rates show that, for the first time since the data has been reported, improper payment rates went down in Medicare fee-for-service, Medicare Advantage, Medicaid and the Children’s Health Insurance Program, and the fiscal 2018 Medicare fee-for-service improper pay rate is at the lowest since the 2010 rate.

November 20, 2018 | Daily News

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.

November 19, 2018 | Daily News

Kaleo CEO Spencer Williamson offered to lower the $4,100 price of the opioid overdose reversal drug Evzio as long as insurers give patients greater access to it, during his appearance on CBS’ “60 Minutes” on Sunday.

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