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Medicare

October 17, 2019 | Daily News

CMS tells Inside Health Policy it made a number of changes to the revamped Medicare Plan Finder between its public rollout and the start of Medicare open enrollment on Oct. 15, including allowing users to sort plans by the total cost of estimated drug costs plus premiums and displaying drug tier costs.

October 16, 2019 | Daily News

House Democrats on key committees plan to amend Speaker Nancy Pelosi’s (D-CA) drug pricing bill to restrict drug launch prices, extend price negotiation to more drugs and let seniors who hit catastrophic spending limits early in the year smooth out those payments in installments, according to a summary of amendments distributed by the House Energy & Commerce and Education & Labor committees.

October 16, 2019 | Daily News

House Democratic leadership announced on Wednesday (Oct. 16) that the Ways & Means Committee will mark up the government drug price negotiation plan spearheaded by House Speaker Nancy Pelosi (D-CA) the week of Oct. 21, and that the bill will hit the floor vote the week of Oct. 28 if the committees are ready to report out.

October 16, 2019 | Daily News

While many industry attorneys praise the administration’s proposed Stark Law and anti-kickback statute reforms, some provider groups are skeptical the changes would help make much difference for those navigating the regulations, particularly for those in rural areas, and suggest Congress needs to step in.

October 16, 2019 | Daily News

The House Energy & Commerce and Education & Labor committees will mark up House Speaker Nancy Pelosi’s prescription drug pricing bill on Thursday (Oct. 17), the same day the House Ways & Means Committee will hold a full committee hearing on drug pricing.

October 15, 2019 | Daily News

The American Health Care Association called on CMS on Friday (Oct. 11) to change its new nursing home alert icon, saying it will completely deter consumers from nursing homes rather than help them understand the quality of the nursing home.

October 15, 2019 | Daily News

Hospitals and physicians say CMS shouldn’t aim for site neutrality by bringing everyone’s payments to the lowest rate, and hospitals also say CMS doesn’t have authority to continue site-neutral pay cuts to certain clinics in light of a recent court ruling that found those cuts unlawful.

October 15, 2019 | Daily News

California Democratic Gov. Gavin Newsom signed controversial legislation designed to eliminate the financial incentives for dialysis firms to contribute to charitable premium assistance programs by limiting reimbursement for certain patients that receive such assistance, and a kidney charity has already said it will stop operating in the state Jan. 1 due to the law.

October 10, 2019 | Daily News

Medicare Advantage plans are offering transportation benefits, companionship programs, and pest control as part of their 2020 benefit packages, but beneficiary advocates and Oregon’s senators say the new Medicare Plan Finder tool doesn’t give enough information to beneficiaries on these benefits.

October 09, 2019 | Daily News

New proposals on the anti-kickback statute released Wednesday (Oct. 9) do not include any safe harbors for drug value-based pay arrangements, but HHS Secretary Alex Azar said the agency is still working on opportunities for such arrangements that he hopes to move on as soon as possible.

October 09, 2019 | Daily News

Lobbyists and stakeholders – including providers paid less by Medicare Advantage than fee-for-service Medicare -- are watching closely to see how the Trump administration intends to base Medicare fee-for-service rates on Medicare Advantage-negotiated rates and many say the recent executive order raises lots of unanswered questions, including whether the order would apply when MA pay rates are higher than fee-for-service rates.

October 09, 2019 | Daily News

In line with House Republicans, Blue Dog Democrats on Tuesday (Oct. 8) urged House Speaker Nancy Pelosi to hold votes on several bipartisan drug pricing bills, instead of wrapping them into government price negotiation legislation that Republicans oppose.

October 09, 2019 | Daily News

HHS on Wednesday (Oct. 9) released long-awaited proposals to change the physician-self referral and anti-kickback statute regulations aimed at easing providers’ participation in value-based pay models, including new, permanent exceptions to the Stark Law for value-based pay arrangements within and outside Medicare and a new safe harbor under the anti-kickback statute for certain incentives beneficiaries can access through CMS demonstrations.

October 07, 2019 | Daily News

CMS announced Monday (Oct. 7) that it would be adding an icon to its Nursing Home Compare website to directly notify consumers of nursing homes that have been cited for abuse or neglect, months after Senate Finance leaders called on CMS to display this information more prominently.

October 07, 2019 | Daily News

Amy Bassano, formerly the deputy director of the Center for Medicare and Medicaid Innovation, has been named acting director of the innovation center after the departure of former director Adam Boehler, who was confirmed by the Senate on Sept. 26 to lead the U.S. International Development Finance Corporation.

October 07, 2019 | Daily News

About 20% of the doctors that Congress’ Medicare advisory commission previously counted as primary care physicians were misclassified because they mainly care for hospitalized patients, according to new data, prompting concern from several members of the commission over how to best measure patients’ access to primary care.

October 04, 2019 | Daily News

Congressional Medicare advisers on Friday (Oct. 4) weighed recommending a 20% cut to the hospice aggregate pay cap and linking that cap to the wage index.

October 04, 2019 | Daily News

FDA approved the second HIV prevention drug, Descovy, Gilead said Thursday (Oct. 3), setting the stage for difficult coverage decisions as Gilead touts Descovy as safer than its other HIV prevention drug, Truvada, a year before Truvada goes generic.

October 03, 2019 | Daily News

President Donald Trump on Thursday (Oct. 3) signed a wide-ranging executive order that directs HHS to move towards using market-driven rates for traditional Medicare and paying the same amount for a service regardless of whether it is provided by a physician or other type of clinician like a physician’s assistant.

October 03, 2019 | Daily News

The House Ways & Means Committee Chair Richard Neal (D-MA) called on his committee to look at patient protections for nursing home and hospice residents this fall in a letter sent to committee Democrats on Friday (Sept. 27).

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