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Medicare

May 10, 2019 | Daily News

A study released Thursday (May 9) by the Rand Corporation says many hospitals across 25 states charge private insurers double or triple the rate that Medicare pays for the same services and the researchers called on insurers to use Medicare payment rates as a benchmark, a proposal hospital groups slammed, saying it would jeopardize hospital resources.

May 09, 2019 | Daily News

President Donald Trump said Thursday (May 9) that his administration would allow prescription drug importation from foreign countries if the programs would create significant cost savings.

May 09, 2019 | Daily News

The American Hospital Association is praising legislation it says would undo cuts to Medicare pay for clinic visits at certain facilities exempted from site-neutral policy in the Bipartisan Budget Act of 2015 -- cuts that AHA is separately seeking to overturn through the federal courts.

May 09, 2019 | Daily News

Beneficiaries who switched from traditional Medicare to Medicare Advantage (MA) spend around $1,000 less on average, even if they have complex chronic illnesses, according to a study released by the Kaiser Family Foundation on Tuesday (May 7), and the researchers behind the study are urging policymakers to adjust MA payment rates to avoid overpayments.

May 09, 2019 | Daily News

Provider advocates for stroke patients are calling on state legislators to implement policies that would encourage emergency medical services to transport stroke patients to a stroke center as opposed to the hospital via ambulance while also praising a Center for Medicare and Medicaid Innovation (CMMI) model announced earlier this year that one provider says will be beneficial in encouraging this shift.

May 08, 2019 | Daily News

House Speaker Nancy Pelosi’s (D-CA) office is working on a drug-price negotiation bill that would use arbitration as a backstop to price negotiations between HHS and drug makers on high-cost drugs, and the resulting price could be available to other payers, not just to Medicare plans, sources briefed on the plan told Inside Drug Pricing.

May 08, 2019 | Daily News

As the May 17 final coverage decision looms, bipartisan groups of Senate and House lawmakers are taking the side of drug makers that want Medicare to cover expensive CAR-T cancer therapies for more patients and in more settings.

May 08, 2019 | Daily News

As lawmakers framed the watermark 2015 law that revamped how Medicare pays doctors as a step in the right direction, physician groups bombarded Senate Finance Committee members on Wednesday (May 8) with suggestions on ways to improve the law, including continuing base pay hikes for physicians over the next few years, making the 5% bonus for those participating in alternative pay models permanent and, according to one academic, eliminating the Merit-based Incentive Payment System completely.

May 08, 2019 | Daily News

Drug makers will have to include list prices in television advertisements in about two months from now, unless industry delays the price disclosures with a lawsuit.

May 08, 2019 | Daily News

Plans, providers and accountable care organizations (ACOs) are urging CMS to make the Next Generation Accountable Care Organization model permanent and more closely align its risk adjustment and benchmarking with Medicare Advantage (MA).

May 07, 2019 | Daily News

Sen. Bill Cassidy (R-LA) suggested Tuesday (May 7) that lawmakers may need to weigh how patient privacy could be affected by third-party apps accessing health data, and Senate health committee Chair Lamar Alexander (R-TN) agreed that area needs lawmakers’ attention.

May 03, 2019 | Daily News

CMS recently released guidance on how Medicare Advantage (MA) plans may implement additional supplemental benefits for the chronically ill in 2020, clarifying how these benefits might tackle social determinants of health, expanding upon the list of potential benefits plans can offer and giving some marketing guidance.

May 03, 2019 | Daily News

House Energy & Commerce health subcommittee chair Rep. Anna Eshoo (D-CA) told aides Tuesday (April 30) that she is frustrated with the lack of communication between House Democratic leadership and other members regarding drug-pricing negotiations.

May 02, 2019 | Daily News

The Congressional Budget Office estimates that the HHS proposal to eliminate drug rebates paid to middlemen in Medicare and Medicaid managed care would increase federal spending $177 billion over a decade.

May 02, 2019 | Daily News

Senate Finance Chair Chuck Grassley (R-IA) announced that his committee will hold a hearing next Wednesday (May 8) to evaluate how well the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 is meeting its goals in reforming physician payments and to discuss ways to improve the law’s implementation.

May 02, 2019 | Daily News

CMS Administrator Seema Verma on Thursday (April 2) announced the agency is changing the process for issuing Healthcare Common Procedure Coding System codes to give drug and device makers more opportunities to apply for them, and directed contractors to follow the Local Coverage Determination process for every decision rather than opt to automatically not cover technologies with temporary codes for emerging technology.

May 02, 2019 | Daily News

The House Appropriations Committee’s HHS spending bill for fiscal 2020 increases funding for CMS’ survey and certification activities by $10 million compared to this year and, while nursing homes say the additional funds could make those activities more efficient, the increase is less than the agency requests in the president’s budget.

May 02, 2019 | Daily News

House and Senate Democrats on Wednesday (May 1) introduced two new public option proposals that would allow private insurance to operate alongside a government-funded health care system, coming a day after Congress held its first hearing on more-aggressive Medicare for All legislation, demonstrating the growing policy rift within the Democratic party when it comes to expanding health care.

May 02, 2019 | Daily News

The Trump administration late Wednesday (May 1) told a federal appeals court it agrees with a district judge’s ruling that the entire health care law is invalid, yet also asked the court to retain certain ACA provisions the administration claims would not harm the plaintiffs, including updates to Medicare fraud laws – a move that left key legal experts scratching their heads.

May 01, 2019 | Daily News

The Congressional Budget Office on Wednesday (May 1) said moving to a single-payer health care system could significantly affect the entire economy and laid out key issues for lawmakers to consider when crafting legislation that could affect one-sixth of the gross domestic product, but CBO did not provide a cost estimate or spell out specific recommendations.

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