Medicare

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.

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.

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.

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.

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.

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.

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.

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.

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.