Medicare

The night before drug-channel middlemen were set to testify before Senate Finance, the committee’s ranking Democrat said drug companies refuse to commit to cutting drug prices if Congress eliminates drug rebates.

Congress’ Medicare advisers will recommend that lawmakers tell CMS to use a payment withhold to incentivize Medicare Advantage plans to submit accurate, complete encounter data and to run MA provider claims through a contractor to ensure encounter data is handled correctly if enough plans don’t submit the data.

CMS on Friday (April 5) finalized policies that will allow Medicare Advantage plans to cover more telehealth services as basic benefits and will streamline benefits and appeals for dually enrolled beneficiaries.

The HHS Office of Inspector General (OIG) will investigate whether CMS Administrator Seema Verma’s reported use of millions in taxpayer money to boost her public image through contracts awarded to Republican consultants violated federal regulations and ethics rules, according to a letter from the inspector general posted to Twitter Friday (April 5) by House Energy & Commerce Chair Frank Pallone (D-NJ).

The overhaul of the Medicare and Medicaid drug rebate systems would be accompanied by a voluntary two-year pilot starting in 2020, according to CMS guidance.

Senate health committee leader Lamar Alexander (R-TN) said Thursday (April 4) he hopes to bring a wide-ranging legislative package to reduce health care costs before his committee by June or July based on more-than 400 recommendations he received from provider groups, policy experts, health plans and others.

Rep. Mark Meadows (NC) is writing what he says is a comprehensive drug-pricing bill with fellow House Republicans that could expand rebate reforms to the commercial market, the Freedom Caucus chair told Inside Health Policy Wednesday (April 3).

CMS is considering potential rulemaking to deal with so-called Duals-Special Needs Plan look-alikes, as the agency says stakeholders’ concerns have reinforced the idea that the proliferation of these plans impedes meaningfully integrated Medicare-Medicaid products.

A federal district court judge denied multiple requests from the federal government to stop a lawsuit beneficiary advocates first brought about eight years ago seeking appeal rights for Medicare beneficiaries that are put under observation rather than admitted to the hospital, and the judge says the suit should quickly move to trial.