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Medicare

February 20, 2004 | Daily News

Consumer advocates are petitioning a federal court to order HHS to release documents pertaining to the use of semi-skilled workers in nursing homes, claiming CMS repeatedly ignored their requests for the information. Advocates believe CMS' refusal to produce the data suggests it has no evidence to back up its much-criticized decision to let workers with minimal training feed nursing home residents.

February 20, 2004 | Daily News

Amgen has failed in a recent effort to get lawmakers to publicly endorse a contested interpretation of the Medicare reform law that would bar CMS from tying physician reimbursement of its anti-anemia drug to the lower cost of Procrit, which is made by its archrival Johnson & Johnson.

February 20, 2004 | Daily News

FDA food safety specialist Lester Crawford will be tapped as acting FDA commissioner when current FDA chief Mark McClellan moves over to head up CMS, the administration announced this morning. Crawford will be surrounded by three new acting deputies: Janet Woodcock, who has headed FDA's drug center for many years; Murray Lumpkin, a drug policy and international affairs expert in the commissioner's office; and Amit Sachdev, a former congressional staffer who has shepherded FDA's legislative affairs shop.

February 18, 2004 | Daily News

Various disease coalitions are vying for coverage under a $500 million demonstration by arguing that congressional intent behind the provision in last year's Medicare law points to coverage of drugs for their members.

February 18, 2004 | Daily News

Despite pressure from stakeholders for a quick start to a demonstration providing interim Medicare coverage for select self-administered prescription drugs, CMS may not be able to meet a March 8 deadline as it continues to wrestle with complex questions about the structure of the two-year program.

February 18, 2004 | Daily News

The American Society of Clinical Oncology has launched an effort to amend the Medicare reform law to stave off projected reimbursement cuts for cancer care, even as it acknowledged congressional leadership is reluctant to revisit the law and last year's fight over the issue had strained the group's relations with some lawmakers.

February 13, 2004 | Daily News

The HHS Office of Inspector General (OIG) is recommending wider use of a controversial policy setting Medicare reimbursement rates for the anti-cancer drug Lupron based on payment for a cheaper, clinically comparable competitor drug, arguing the move would save the program $40 million a year.

February 13, 2004 | Daily News

The chair of the Senate Finance Committee has called in the General Accounting Office (GAO) to assist the panel's probe of Medicare payments for power wheelchairs, citing fears that the program's reimbursement policy is providing easy pickings for fraudulent providers.

February 13, 2004 | Daily News

CMS has scheduled a listening session for power wheelchair providers, but the agency still has not promised to respond to industry complaints about restrictive new coverage policies issued by Medicare carriers.

February 13, 2004 | Daily News

President Bush is expected to within days announce FDA Commissioner Mark McClellan as the White House's pick to become the new CMS administrator, sources indicate.

For weeks the FDA head has been rumored to be the frontrunner to replace Tom Scully, who left his post as CMS chief in December. Several sources suggest Bush will soon nominate McClellan to the job, likely next week, according to another source.

February 12, 2004 | Daily News

A Bush administration plan to seek passage of a new budget enforcement law that would force any future changes to entitlement programs -- such as a Democratic push to close the gap in Medicare's new drug benefit -- to be paid with cuts to other entitlements programs has sparked debate. The administration's refusal to also require offsets for new tax cuts, which has aroused the opposition of Senate Democrats, could doom the proposal, according to Senate sources.

February 12, 2004 | Daily News

A House Democratic leader on Medicare policy is seeking a temporary freeze on Medicare reimbursements for new long term acute care hospitals, citing questions about their rising cost to the Medicare program and the possibility that nursing homes could serve as appropriate and cheaper substitutes.

February 11, 2004 | Daily News

CMS and Congressional Budget Office actuaries will face off in a March House Ways and Means Committee hearing designed to explore the basis for the extra $139 billion CMS tacked on to the cost of the prescription drug bill. The revelation last week of the higher cost projections also prompted Sen. Max Baucus (D-MT) to push for legislation requiring public disclosure of cost projections by the CMS actuary.

February 11, 2004 | Daily News

CMS has responded to pressure from congressional leaders by setting new criteria that could allow hospitals that dominate their local labor market and facilities next to higher wage areas to secure higher reimbursement through appeals of their wage index classification.

February 11, 2004 | Daily News

the new benefits and premiums flowing from the Medicare bill's boost to private plan payments in the face of renewed Democratic criticism that the law overpays private plans some $32 billion.

February 10, 2004 | Daily News

Families USA, a consumer group that opposed the Medicare reform bill, has enlisted Walter Cronkite -- one of the nation's most trusted figures -- to help front an upcoming campaign to educate seniors on what they can expect from Medicare's new prescription drug benefit. The move comes as Democrats continue their assault against the reform law with calls for separate investigations into the Bush administration's new Medicare advertisements.

February 10, 2004 | Daily News

Before leaving the Biotechnology Industry Organization at the end of this year, BIO President Carl Feldbaum hopes to improve the biotechnology industry's relationship with FDA and help BIO get ready to address Medicare drug benefit implementation issues.

Feldbaum announced his retirement plans Feb. 2 (see related story).

February 09, 2004 | Daily News

The large-scale chronic care pilot program authorized by the new Medicare reform law calls for financial results, not just clinical ones, and it will be run like a commercial function of Medicare, a CMS official said.

The entities awarded contracts for the pilots will assume fiscal risks for saving Medicare sums at least equal to the fees they are paid by the system if not more. They will also be evaluated by three more-traditional markers: beneficiary satisfaction, clinical improvement and health care quality improvement.

February 09, 2004 | Daily News

Medicare quality improvement organizations (QIOs) will have expanded duties in their next round of contracts that will likely include helping physician practices broaden their work to include additional preventive services and chronic care services -- two areas emphasized in the recently enacted Medicare law.

February 06, 2004 | Daily News

Congress has instructed CMS to broaden the definition of vital "blood products" so as to protect life-saving plasma products such as intravenous immune globulin (IVIG) from deeper reimbursement cuts and users from subsequent access problems. The push by Congress, included in the Omnibus spending package, follows on the heels of a similar recommendation last year by an HHS advisory committee.

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