Medicare

Medicare Advantage grew to almost 26 million enrollees last month, and while plans and MA advocates are pleased, other beneficiary advocates say Congress and CMS need to do a better job about treating the private plans and fee-for-service coverage equally.

The Biden administration recently withdrew an unreleased draft rule on end-stage renal disease conditions of coverage that was expected to address the controversial issue of whether insurers must accept premium payments from third-party charities -- a move quickly applauded by kidney care advocates, although the rule could resurface.

The Biden administration on Friday (Jan. 29) delayed for 60 days a Trump administration rule to eliminate drug rebates that pharmacy benefit managers use to negotiate lower prices.

Congressional Medicare advisers said they are leaning toward recommending that Medicare Part B cover all vaccines, without cost sharing for preventive vaccines, at a meeting Friday (Jan. 15) on potential changes to the reimbursement formula for vaccines.

A bipartisan group of top government health officials representing the National Academy of Medicine are recommending FDA and CMS policies that the Biden administration could use to control drug prices.

President Joe Biden’s health care agenda should focus on increasing value-payments, strengthening primary care via nurse practitioners and non-clinical personnel, building trust in vulnerable communities and improving health care information technology so the country is better prepared for the next pandemic, some experts said at a webinar by The Commonwealth Fund Tuesday (Jan. 26).

The COVID-19 public health emergency is expected to continue through the end of 2021, Acting HHS Secretary Norris Cochran wrote in a Jan. 22 letter to governors, signaling the temporary 6.2% bump in federal Medicaid matching funds and a slew of other Medicare and Medicaid emergency waivers put in place during the pandemic will not end soon.

CMS is using a demonstration to weaken two pillars of patient protections in Part D: protected drug classes and the requirement that insurers cover at least two drugs in each class.

The Medicare Payment Advisory Commission discussed Friday (Jan. 15) how to properly reward skilled nursing facilities who care for the most  dually-eligible patients under their new value incentive program without offering bonuses for poor performance.