Medicare

CMS on Friday (Nov. 1) finalized changes to the Physician Fee Schedule that will simplify documentation and coding requirements for office visits, add a new Part B benefit for opioid treatment programs and increase pay for care management services provided to beneficiaries after they leave the hospital.

The National Home Infusion Association pushed back after CMS finalized a new home infusion benefit for 2021 as part of a home health pay rule out Thursday (Oct. 31) that excludes pharmacists, instead reimbursing them under the durable medical equipment benefit.

Democratic Primary candidate Sen. Elizabeth Warren (D-MA) responded to pressure from fellow Democrats and released a proposal outlining how she would pay for her Medicare for All policy through a $9 billion tax on employers, a shift of $6 trillion in state funds to Medicare for All, heavy taxes on corporations and the wealthy, and spending cuts to other government agencies.

CMS on Thursday (Oct. 31) halved a proposed behavioral adjustment cut in its final home health pay rule meant to offset potential spending increases under a new home health payment model after industry backlash.

CMS Administrator Seema Verma is setting up an Office of Burden Reduction as the administration’s Patients Over Paperwork effort hits its two-year anniversary, and she said on Tuesday (Oct. 29) the agency will need an ongoing commitment to cutting back on administrative burdens.

The White House sees little chance for enactment of House Speaker Nancy Pelosi’s (D-CA) government drug price negotiation bill and is pushing for passage of the Senate Finance Committee's bill, Domestic Policy Council chief Joe Grogan told Politico on Wednesday (Oct. 30).

House Energy & Commerce health subcommittee ranking Republican Mike Burgess (TX) commended CMS Administrator Seema Verma for committing to tackle prior authorization after she said recently that the agency expects to move on the issue by the end of the year.

Less than a week after CMS delayed the implementation of its new alternative payment model for primary care, HHS Secretary Alex Azar on Tuesday (Oct. 29) touted the model as a centerpiece of the Trump administration’s conservative vision for Medicare.

The House on Monday (Oct. 28) unanimously passed legislation that would require HHS to publish pharmacy benefit managers’ aggregate rebates, discounts and price concessions and require plans to include real-time benefit information on drug costs in Medicare Part D.