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Medicare

September 04, 2019 | Daily News

The American Hospital Association doubled down on claims that hospital mergers drive down costs and improve care for patients on Wednesday (Sept. 4) amid calls from the Federal Trade Commission (FTC) and Democratic presidential candidates for increased oversight of such mergers.

September 03, 2019 | Daily News

Beneficiary advocates complain CMS did a sharp U-turn by not including key beneficiary protections in its recent Medicare marketing and communication guidance, and ask the agency to either revamp the guidance or rescind it.

September 03, 2019 | Daily News

California Health Advocates asks CMS to delay implementing the new Medicare Plan Finder, or at least make changes to how State Health Assistance Insurance Program participants interact with the updated website, and other beneficiary advocates worry they won’t have enough time to learn the new tool before open enrollment starts Oct. 15.

September 03, 2019 | Daily News

CMS delayed requirements for accountable care organizations (ACOs) to notify beneficiaries of their assignment in order to give ACOs time to adjust, but the providers still want the requirement removed.

August 30, 2019 | Daily News

The White House Office of Management and Budget on Thursday (Aug. 22) began reviewing a three-year extension of the Comprehensive Care for Joint Replacement model as well as changes to the model.

August 29, 2019 | Daily News

Substance use disorder and mental health advocates are concerned that loosening the strict privacy scheme that protects substance use treatment records will make it easier for these records to get in the hands of law enforcement and could make people fearful of seeking treatment.

August 29, 2019 | Daily News

Nursing homes are urging CMS to take administrative action to count all time spent in a hospital toward Medicare’s so-called three-day stay requirement after CMS Administrator Seema Verma blasted the policy as bureaucratic red tape in a recent tweet.

August 27, 2019 | Daily News

CMS on Tuesday (Aug. 27) released a revamped Medicare Plan Finder that shows supplemental benefits provided by Medicare Advantage plans, and also helps beneficiaries compare drug plans by bringing in their personal drug information and showing available generic alternatives, but the new site doesn’t include plan provider directories or integrate certain information on Medigap supplemental plans as CMS says such data aren’t available.

August 27, 2019 | Daily News

Democratic presidential candidate and South Bend, Indiana Mayor Pete Buttigieg unveiled a proposal Friday (Aug. 23) to tackle mental illness and substance use disorders by increasing Medicaid reimbursement for related services, requiring Medicare and Medicaid to cover medication-assisted treatment, and tackling social isolation and social determinants of health through Medicare and Medicaid interventions.

August 27, 2019 | Daily News

A federal district court consolidated hospitals’ lawsuits over deep reimbursement cuts for clinic visits at off-campus facilities after the providers in both cases agreed to join their litigation. Hospitals are pushing the court to hear oral arguments in September.

August 27, 2019 | Daily News

The House Ways & Means Committee chair called on CMS and the Department of Justice to provide more information on how they plan to tackle cases of abuse in nursing homes after the HHS Office of Inspector General (OIG) found in June that potential abuse and neglect at nursing homes wasn’t always reported and investigated.

August 26, 2019 | Daily News

Large employers are increasingly open to the government negotiating prices of high-cost drugs, a notable change from previous years that reflects ongoing concern over skyrocketing costs, according to a new survey by the National Business Group on Health (NBGH).

August 23, 2019 | Daily News

CMS plans to vigorously defend in court its cuts to hospital pay for 340B drugs, but the agency is also weighing fallback options in case the D.C. Circuit Court of Appeals sides with 340B hospitals.

August 23, 2019 | Daily News

Hospitals have asked a federal court to update them on their lawsuit over deep reimbursement cuts for clinic visits at off-campus facilities after CMS last month proposed a 2020 hospital outpatient pay rule that doubled down on those cuts.

August 23, 2019 | Daily News

House Ways & Means Democrats are scheduled to meet Sept. 10 and 11 to talk about drug pricing and surprise billing legislation, and the committee might even mark up a bill mid-month, but it’s unclear which measures might be marked up or what they might entail.

August 23, 2019 | Daily News

Three former FDA commissioners are calling for CMS to test using data from multiple sources to gauge outcomes of value-based pay models for high-cost drugs and biologics.

August 22, 2019 | Daily News

Democratic staff of the House Energy & Commerce Committee are not negotiating on drug pricing with staff of the Senate Finance Committee, sources say, even though Finance Chair Chuck Grassley (R-IA) said bicameral drug-pricing talks would occur in August.

August 20, 2019 | Daily News

Provider groups praised a pilot unveiled last month by CMS that will give providers Medicare claims data, but at least one group worries that the pilot will increase provider burden.

August 20, 2019 | Daily News

Three Democratic senators are urging their colleagues to ramp up the traditional Medicare program to include more benefits, some of which are already offered by private Medicare Advantage plans, and the Center for Medicare Advocacy suggests that could be done by reinvesting what it calls wasteful spending on MA plans into new fee-for-service benefits.

August 19, 2019 | Daily News

CMS on Monday (Aug. 19) announced plans to update the way it calculates overall hospital quality star ratings -- with which hospitals have long raised concerns -- but, as it works on the changes, the agency will refresh the star ratings using the current methodology in early 2020, to hospitals’ disappointment.

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