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Medicare

January 25, 2019 | Daily News

The generic, brand and biologic drug lobbies have joined a coalition that is organizing against Medicare for All proposals.

January 24, 2019 | Daily News

Piggybacking on providers’ requests, a bipartisan group of four House lawmakers is pressing CMS to delay the Feb. 19 deadline for applications to participate in the revamped accountable care organization program that kicks offs in July.

January 23, 2019 | Daily News

Medicare for All is picking up support among the American public and federal lawmakers are beginning to consider the idea more seriously.

January 23, 2019 | Daily News

The president, HHS secretary and other administration officials touted the administration’s efforts to lower drug prices at a White House meeting Wednesday (Jan. 23) where the president talked of his amazement upon recently learning that generics work as well as the brands they copy.

January 23, 2019 | Daily News

Senate Finance Committee Chair Chuck Grassley (R-IA) will hold a drug-pricing hearing Tuesday (Jan. 29), the same day the House oversight committee will hold its own hearing on drug prices and a day before HHS Deputy Secretary Eric Hargan will speak at the Brookings Institution about the anti-kickback law’s treatment of drug value-based pay arrangements.

January 23, 2019 | Daily News

America’s Health Insurance Plans (AHIP) is calling on CMS to withdraw changes to the Medicare Advantage Risk Adjustment Validation (RADV) program included in a proposed MA and Part D rule, even though other groups have backed the agency’s proposals.

January 22, 2019 | Daily News

Accountable care organizations, hospitals, doctors and others are asking CMS to push back the Feb. 19 deadline for applications to participate in the revamped Medicare Shared Savings program, with 12 stakeholder groups asking CMS to move the deadline to March 29 and AMGA urging CMS to push it back further to April 19.

January 22, 2019 | Daily News

An analysis from the National Association of Accountable Care Organizations says CMS’ changes to the threshold for differentiating high-revenue and low-revenue ACOs is estimated to keep more physician-affiliated ACOs and those affiliated with Federally Qualified Health Centers from having to take on risk at a faster rate under the new Medicare Shared Savings program rules, but NAACOS says concerns remain that the system could keep ACOs from integrating specialty care.

January 22, 2019 | Daily News

Multiple organizations applauded CMS’ regulatory proposal to provide additional telehealth benefits to Medicare Advantage enrollees in 2020, while some also called for CMS to take more aggressive steps and others urged caution.

January 18, 2019 | Daily News

CMS proposed Friday (Jan. 18) to share with insurers savings from lower Part D catastrophic spending in return for plans agreeing to penalties when they exceed spending targets.

January 18, 2019 | Daily News

CMS on Friday (Jan. 18) announced a nation-wide expansion and several new features of its Value-Based Insurance Design model, which provides flexibility to Medicare Advantage plans with the goal of encouraging beneficiaries to consume high-value clinical services.

January 17, 2019 | Daily News

Federal Medicare advisers grappled Thursday (Jan. 17) with how CMS could better track opioid use in hospitals and encourage non-opioid alternatives, and it must report to Congress on those issues by March due to a mandate in last year’s landmark opioid bill.

January 17, 2019 | Daily News

The Medicare Payment Advisory Commission voted Thursday (Jan. 17) on 2020 payment recommendations for provider services ahead of CMS’ release of its annual pay rules and policies.

January 16, 2019 | Daily News

The White House Office of Budget and Management’s review of CMS’ tweaked home health pre-claims review demonstration, now called the Review Choice Demonstration for Home Health Services, has seemingly stalled since CMS submitted it to OMB for review, leaving Illinois providers preparing for a demonstration with an uncertain start date.

January 15, 2019 | Daily News

Several Supreme Court justices expressed skepticism Tuesday (Jan. 15) about CMS’ authority to issue legal interpretations that affect Medicare reimbursements without going through notice-and-comment rulemaking.

January 14, 2019 | Daily News

Sen. Ben Cardin (D-MD) recently introduced legislation to add oral health -- including routine dental care -- to Medicare Part B to the delight of beneficiary advocates, and House Ways & Means Chair Richard Neal (D-MA) has also indicated interest in addressing Medicare coverage of oral health.

January 11, 2019 | Daily News

The Congressional Budget Office released a statement Friday (Jan. 11) that their report determining if enacted legislation for the current fiscal year exceeds discretionary budget limits will be delayed until funding for all 12 annual appropriations bills can be accounted for.

January 11, 2019 | Daily News

Senate Finance Committee Chairman Sen. Chuck Grassley (R-IA) will discuss a bill on pharmacy benefit manager transparency this session with his committee, a spokesman for the senator told Inside Health Policy.

January 11, 2019 | Daily News

A White House Office of Management and Budget senior official said Thursday (Jan. 10) that automatic Medicare cuts resulting from the so-called PAYGO rules are on hold due to a lapse in appropriations that prevents an accurate update of the PAYGO scorecard laying out the final amount of those cuts, with one lobbyist calling the chances of losing Medicare pay remote.

January 10, 2019 | Daily News

The National Association of Accountable Care Organizations says CMS should give ACOs more time to apply to the revamped ACO program after the agency set a Feb. 19 deadline.

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