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Medicare

April 02, 2019 | Daily News

Sen. Rick Scott said Tuesday (April 2) that he told President Donald Trump he is focused on lowering prescription drug prices, despite the president's request last week that he help lead an effort to replace the Affordable Care Act.

April 01, 2019 | Daily News

Medicare Advantage plans will see a higher overall pay bump in 2020 than projected under the draft call letter, CMS announced on Monday (April 1) when the final rate notice and call letter for next year was released.

April 01, 2019 | Daily News

CMS on Monday (April 1) finalized a policy to let Medicare Advantage (MA) plans offer supplemental benefits for the chronically ill in 2020 -- including those that may increase a beneficiary’s property value -- as part of the MA and Part D call letter for next year.

April 01, 2019 | Daily News

CMS did not eliminate nonpreferred drug tiers or stop insurers from placing generics on brand drugs tiers.

April 01, 2019 | Daily News

CMS on Monday (April 1) finalized its call for Medicare Advantage and Part D plans to do more to reduce opioid dependence among beneficiaries and expand access to naloxone, the opioid overdose reversal drug, by reducing beneficiaries’ costs through new tiering policies, among other possible actions.

April 01, 2019 | Daily News

A health consulting firm is asking CMS to test a nationwide demonstration allowing multi-year Medicare Advantage (MA) plans, which the firm says would allow more plans to tackle social determinants of health through benefit design as well as reduce costs for those with chronic conditions with better care management.

April 01, 2019 | Daily News

Kite Pharma representatives pressed White House budget officials at a March 22 meeting to increase Medicare pay to hospitals for administering CAR-T, according to a White House log of the meeting, and they suggested pilot designs to test new pay arrangements for the expensive cancer treatments.

April 01, 2019 | Daily News

Senate Finance Chair Chuck Grassley (R-IA) on Wednesday (March 27) signaled he would back a bill extending the Trump administration’s proposal to shift rebates to the point of sale to the commercial market.

March 29, 2019 | Daily News

Progressive Democrats’ plans to shine a spotlight on Medicare for All have been put on the backburner due to the renewed focus on the Affordable Care Act and the Trump administration’s call for the law to be scrapped in court and replaced by Republicans.

March 29, 2019 | Daily News

Despite the Government Accountability Office’s concerns about incomplete reporting feeding into the Medicare lab fee schedule -- and an ongoing lawsuit over which labs were required to report in the first place -- CMS Administrator Seema Verma says in a letter to Senate Finance Committee Chair Chuck Grassley (R-IA) that the agency saw an initial 96 percent reporting rate and more reporting wouldn’t change how prices under the revamped fee schedule were set.

March 29, 2019 | Daily News

Hospital clinicians and academics say the HHS Office of Inspector General’s call for more paperwork from providers is the wrong way to fix issues with the three-day stay Medicare requires before it will pay for inpatient care, and CMS -- and lawmakers if necessary -- should line up the clocks for the two-midnights admission policy and the three-day stay so that time in the hospital under both policies starts when care begins.

March 28, 2019 | Daily News

Senate health committee chair Lamar Alexander (R-TN) said Thursday (March 28) that he is working with health committee ranking Democrat Patty Murray (WA), Senate Finance Committee Chair Chuck Grassley (R-IA) and ranking Democrat Ron Wyden (OR) to develop a bill in each committee to lower health care costs by summer.

March 28, 2019 | Daily News

Sen. Ron Wyden (D-OR) on Wednesday (March 27) sketched a proposal to help patients find out in advance how much health care services and prescription drugs will cost, and HHS Deputy Secretary Eric Hargan touted the administration’s regulatory efforts to make pricing information more transparent.

March 27, 2019 | Daily News

Republicans on the House Energy & Commerce Committee tried in vain on Wednesday (March 27) to amend bills aimed at speeding generic competition.

March 27, 2019 | Daily News

CMS’ innovation center announced Wednesday (March 27) the launch of an artificial intelligence (AI) health outcomes competition, offering $1.65 million to AI developers who would be given Medicare claims data to use in their submissions.

March 27, 2019 | Daily News

A health law firm says new flexibilities given to Medicare Advantage (MA) plans to address social determinants of health aren’t enough to fully permit plans to incorporate those benefits into their products any time soon due to time and cost constraints.

March 27, 2019 | Daily News

CMS on Tuesday (March 26) proposed to make it easier for providers to qualify for reimbursement for transcatheter aortic valve replacements (TAVR) under an updated Coverage with Evidence Development scheme the reduces the number of heart procedures required to start a program.

March 26, 2019 | Daily News

The federal government says cutting the pay rates for clinic visits at certain off-campus hospital outpatient facilities is well within CMS’ authority, and the law exempting those facilities from other site-neutral payments doesn’t limit CMS’ ability to change the pay rates for services to control volume.

March 26, 2019 | Daily News

Senate health committee Chair Lamar Alexander (R-TN) praised proposed rules from the CMS and Office of the National Coordinator for Health IT on interoperability, but questioned whether the rules may be pushing too fast after a number of groups have sought more time to comment -- a request CMS does not intend to grant, according to the agency.

March 25, 2019 | Daily News

The Office of Inspector General (OIG) is asking for $10 million in additional funding in fiscal 2020 to target fraud, waste and abuse in home and community-based settings, with a focus on four geographic hotspots that OIG associates with “suspicious behavior” -- Florida, Texas, and select areas in Southern California and the Midwest.

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