Medicare

A lobbying group called Infusion Providers Alliance has formed to oppose international reference pricing for drugs, specialty pharmacy mandates and a measure in the Senate Finance Committee’s drug pricing bill that would lower reimbursement at physician practices that generate a significant part of their revenue from administering drugs.

If the demonstration that caps monthly insulin costs works, CMS might run similar demos for other drugs, Center for Medicare and Medicaid Innovation Center Director Brad Smith said Friday (Oct. 16).

The vast majority of Medicare beneficiaries surveyed by CMS say they did not forego medical care for non-COVID-19 concerns during the pandemic, according to a survey released Friday (Oct. 16), but 21% said they did skip needed medical care and dental care was the most likely to be skipped.

Federal judges seemed unconvinced on Thursday (Oct. 15) that the Trump administration’s hospital price transparency rule violates the First Amendment and exceeds HHS’ statutory authority, as the American Hospital Association argued in an appeal to stop the rule.

CMS on Wednesday (Oct. 14) expanded the list of telehealth services Medicare will reimburse, two months after unveiling a proposed rule to make some of the telehealth flexibilities allowed during the pandemic permanent for rural Medicare beneficiaries.

The Democratic leaders of congressional health care committees asked the Government Accountability Office to quickly review the legality of the president’s plan to send $200 Medicare drug discount cards to seniors before the election.

Though some stakeholders are praising CMS’ proposed increases to evaluation and management payments in the 2021 physician fee schedule, many physicians groups -- including the American Medical Association -- are loudly decrying the budget neutral cuts tied to those pay hikes, and lawmakers recently asked CMS to mitigate the cuts to give Congress time to step in.

Radiation oncologist and other physician groups are asking CMS to push back the radiation oncology demonstration and ease the cuts that are built into the model, especially given the ongoing COVID-19 pandemic.

CMS Administrator Seema Verma on Monday (Oct. 5) said the agency will reach out to providers about new flexibility surrounding the Medicare provider relief loans, as laid out in the newly signed continuing resolution to keep the government open through Dec. 11.