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Medicare

September 15, 2020 | Daily News

Patients for Affordable Drugs is launching a multi-million-dollar campaign that calls on voters in swing states and battleground districts to support candidates who have plans to lower the cost of prescription drugs.

September 14, 2020 | Daily News

CMS intends to fully phase in changes to its risk adjustment policies, including relying on encounter data and completing its transition to the 2020 version of the CMS-Hierarchical Conditions Categories model, the agency says in the first part of its 2022 Medicare Advantage advanced notice.

September 14, 2020 | Daily News

CMS on Monday (Sept. 14) announced that accountable care organizations generated $1.19 billion in total net savings to Medicare in 2019, which the agency said proves the success of its revamped ACO program.

September 13, 2020 | Daily News

The White House released an executive order Sunday evening (Sept. 13) that extends the president’s controversial most-favored nation policy to include Medicare Part D in addition to Part B, a move that could eventually drastically lower seniors’ drug costs but that policy experts view as a Hail Mary before the election and expect to be challenged in court.

September 10, 2020 | Daily News

The House Energy & Commerce Committee passed 26 health bills on Wednesday (Sept. 9), including three meant to boost Medicare patient protections and mental health services, sending them to the House floor.

September 09, 2020 | Daily News

HHS in early August unveiled an 84-page roadmap to improve rural health that includes a number of policy initiatives and recommendations, including calls to expand care for postpartum depression, award grants for telehealth expansion and ease state licensure restrictions.

September 09, 2020 | Daily News

The White House is asking Congress to fund certain so-called Medicare and Medicaid extenders -- most of which are set to run through Nov. 30 -- as part of an expected continuing resolution to keep the government open in fiscal 2021, and an Office of Management and Budget document obtained by sister news service Inside Defense also says the White House would consider other policies that often ride along with the extenders, like a delay in cuts to Medicaid Disproportionate Share Hospital payments.

September 04, 2020 | Daily News

After the Congressional Budget Office estimated that the Medicare Trust Fund will become insolvent two years sooner because of the pandemic, Medicare Payment Advisory Commission members said at a meeting on Thursday (Sept. 3) they want to be bold with their recommendations to Congress next year.

September 04, 2020 | Daily News

The Medicare Payment Advisory Commission on Friday (Sept. 4) considered what aspects of telehealth should remain in Medicare after the COVID-19 public health emergency, with some commissioners saying they would support allowing more flexibilities in telehealth for Medicare beneficiaries in alternative payment models than in fee-for-service.

September 04, 2020 | Daily News

After CMS in August said it would begin requiring doctor’s orders for COVID-19 tests for Medicare beneficiaries after an initial test, several private insurers say they will keep their current practices.

September 03, 2020 | Daily News

CMS on Thursday (Sept. 3) launched Care Compare -- a streamlined redesign of eight existing Medicare.gov healthcare compare tools -- to provide beneficiaries a single, user-friendly interface to compare services based on cost, quality of care, volume of services and other data.

September 02, 2020 | Daily News

CMS on Wednesday (Sept. 2) finalized plans to tie Medicare Advantage plans’ negotiated pay rates for hospital inpatient care to Medicare’s fee-for-service inpatient payment rates starting in fiscal 2024, though the agency backed off the idea of tying all third-party payer rates to what Medicare will pay for inpatient hospital care.

September 02, 2020 | Daily News

CMS on Wednesday (Sept. 2) increased Medicare pay to hospitals that administer chimeric antigen receptor T-cell treatments for cancer by creating a national unadjusted pay rate for CAR T that excludes clinical trial cases and unusually low hospital charges from the pay rate calculation.

September 02, 2020 | Daily News

CMS on Wednesday (Sept. 2) finalized an inpatient hospital pay rule for fiscal 2021 that expands new technology add-on payments and increases Medicare spending on acute inpatient services by $3.5 billion, or 2.7%, in fiscal 2021.

September 01, 2020 | Daily News

President Donald Trump again said Tuesday (Sept. 1) he signed a most-favored-nation executive order, and he added drug companies are meeting with White House officials this week to discuss alternatives to that order.

September 01, 2020 | Daily News

President Donald Trump said Tuesday (Sept. 1) that drug companies are meeting with White House officials this week to discuss alternatives to his favored-nation executive order, but a spokesperson for the Pharmaceutical Research and Manufacturers of America said she is not aware of a meeting with PhRMA.

September 01, 2020 | Daily News

President Donald Trump said Tuesday (Sept. 1) that drug companies are meeting with White House officials this week to discuss alternatives to his favored-nation executive order, but a spokesperson for the Pharmaceutical Research and Manufacturers of America said she is not aware of a meeting with PhRMA.

August 31, 2020 | Daily News

CMS on Monday (Aug. 31) proposed a rule to streamline Medicare coverage of breakthrough technologies, more than a year after the White House Office of Management and Budget began reviewing it, although one policy analyst says the proposed definition of “reasonable and necessary” is the rule’s most significant provision.

August 28, 2020 | Daily News

Three Democratic senators are asking the HHS Office of Inspector General to investigate whether CMS exercised appropriate oversight of the use of hydroxychloroquine to treat COVID-19 in nursing homes -- particularly in cases where patients or their families didn’t consent to the experimental drug’s use -- and are also asking CMS whether it has opened any investigations or taken enforcement action.

August 27, 2020 | Daily News

CMS unveiled a memo on Wednesday (Aug. 26) for nursing homes on how often to test their staff for COVID-19 based on community spread, after releasing an interim rule on Tuesday (Aug. 25) that began immediately requiring nursing homes to test staff or face fines.

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