Medicare

The American Enterprise Institute and the Brookings Institution are pushing lawmakers to expand site-neutral pay to on-campus hospital outpatient departments, a call that was mirrored in the president’s fiscal 2020 budget.

The HHS budget doubles down on CMS’ plan to increase the use of encounter data as part of a bid to “eliminate excessive payment in Medicare Advantage,” despite plans’ opposition to using risk score calculations to cut back MA payments.

CMS expects to give providers instructions soon on how to choose a claims review option under the tweaked home health demo after the White House Office of Management and Budget (OMB) approved the program.

Sens. Debbie Stabenow (D-MI) and Roy Blunt (R-MO) last Thursday (March 14) introduced a bill to expand the number of states with Medicaid-funded community mental health clinic pilots from eight to 19, and HHS Secretary Alex Azar said he looks forward to working with lawmakers to make sure it passes.

The lobby representing the nation’s dental plans and dozens of lawmakers from both parties are urging CMS to update healthcare.gov so that all Americans, including Medicare beneficiaries, can purchase stand-alone dental plans without having to first buy medical insurance.

HHS Secretary Alex Azar and House Republicans criticized the recently introduced Medicare For All bill at a House Energy & Commerce health subcommittee hearing Tuesday (March 12), saying it would eliminate Medicare Advantage (MA) plans, a claim that the office of Rep. Pramila Jayapal (D-WA) said was true, but the office said the bill would cover everything MA does.

House Energy & Commerce Committee Chair Frank Pallone (D-NJ) said Wednesday (March 13) that drug-pricing policy proposals that are likely to pass in Congress this session would benefit Medicare more than the commercial market.

CMS’ decision to add non-invasive ventilators to the revamped durable medical equipment competitive bidding program set to go into effect in 2021 has upset DME suppliers, with the DME lobby calling it a “terrifying development” for patients and saying the group will press the Trump administration and Congress to stop that addition.

The American Medical Association is pushing the insurance industry to work more quickly to change prior authorization policies that can delay care and harm patients, pointing to the results of a survey out Tuesday (March 12) that found little progress on five recommendations America’s Health Insurance Plans (AHIP) and the Blue Cross Blue Shield Association had supported in January 2018.