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January 15, 2021 | Daily News

CMS Administrator Seema Verma is resigning her post effective Jan. 20 – when President-elect Joe Biden assumes office, she announced in a tweet Friday (Jan. 15) that spurred comments from some Democrats and consumer advocates happy to see her go.

January 15, 2021 | Daily News

In two years, seniors will be able to compare out-of-pocket costs for drugs, and starting next year, Medicare Advantage and drug plans may create an additional “preferred” specialty tier and plans will be required to disclose pharmacy-performance measures.

January 14, 2021 | Daily News

Post-acute and long-term care organizations are asking the incoming Biden administration to institute a nationwide COVID-19 prevention and vaccination policy, as well as a workforce development plan and continued COVID-19 waivers -- including broader use of telehealth -- groups told Inside Health Policy.

January 13, 2021 | Daily News

Incoming Senate Finance Committee Chair Ron Wyden (D-OR) on Wednesday (Jan. 13) made clear that health care reforms, particularly reining in drug costs, will be a high priority but also warned the budget reconciliation process Democrats are expected to pursue could be a difficult path.

January 12, 2021 | Daily News

In another 11th-hour move, the Trump CMS finalized Tuesday (Jan. 12) a rule, long-sought by the medical device industry, that provides instant Medicare coverage of FDA-designated breakthrough technology.

January 12, 2021 | Daily News

Pharmaceutical benefit managers sued the Trump administration Tuesday (Jan. 12) over a last-minute rule to end Medicare drug rebates that PBMs use to negotiate lower prices for insurers.

January 06, 2021 | Daily News

Democratic control of the Senate sets up a debate between the liberal and moderate wings of the party over how to curb drug prices, but the bigger obstacle to drug pricing legislation could be a Republican filibuster, unless Democrats pay for Bidencare policies with drug pricing measures in budget-neutral legislation that they could pass with a simple majority using a budget process called budget reconciliation.

January 06, 2021 | Daily News

Lobbyists and stakeholders are urging the incoming Biden administration to tackle health care changes through an administrative lens, coming as the courts face pressure to watch how the new administration acts on key policies before moving on cases involving regulations like the public charge rule.

December 31, 2020 | Daily News

The Urban Institute finds in a new analysis that coupling a Medicare buy-in with enhanced ACA tax credits would lead to the largest coverage gains.

December 30, 2020 | Daily News

The National Coalition on Health Care is urging the Biden transition team to make controlling drug prices a priority and suggests the incoming administration let insurers band together as one to negotiate drug prices and use inflationary rebates to curb price inflation.

December 29, 2020 | Daily News

The U.S. Court of Appeals for the District of Columbia Circuit on Tuesday (Dec. 29) ruled that HHS can move forward with its controversial hospital price transparency rule on Jan. 1, agreeing with a lower court just days before the rule was set to go into effect.

December 29, 2020 | Daily News

The Biden administration should immediately work to lower health care costs by quickly implementing the surprise billing compromise in the year-end legislation, extending financial assistance to struggling providers and working with Congress to incentivize states to expand Medicaid, the National Coalition on Healthcare says in a letter to the Biden transition team outlining its priorities.

December 28, 2020 | Daily News

The Center for Medicare Advocacy and the National Association of Accountable Care Organizations are pushing the incoming Biden administration to halt a last-minute effort by the Trump administration to put in place a Medicare geographic direct contracting option -- which the Commonwealth Fund has called one of the biggest changes to Medicare since managed care.

December 24, 2020 | Daily News

The year-end spending package Congress passed Monday night (Dec. 21) includes reforms aimed at increasing Medicare beneficiaries’ access to post-acute care.

December 24, 2020 | Daily News

The 2020 year-end package that passed the House and Senate Monday (Dec. 21) includes a number of policies aimed at improving hospice care, and the National Hospice and Palliative Care Organization says the bill will help provide uninterrupted access to hospice providers during the pandemic -- though the group will closely watch how the program integrity provisions are implemented.

December 23, 2020 | Daily News

By granting a 14-day restraining order to delay the start of the most-favored-nation demonstration on Wednesday (Dec. 23), a federal judge signaled the drug industry will likely succeed in killing the demo.

December 22, 2020 | Daily News

Drug makers are largely unscathed by the year-end government spending bill because Congress instead used hospital surprise billing legislation to pay for coronavirus relief, but the legislative package does include proposals that were part of drug price transparency bills, including one to give congressional Medicare and Medicaid advisers data on closely guarded rebates.

December 21, 2020 | Daily News

As part of the year-end package, lawmakers plan to mitigate effects of changes to the 2021 physician fee schedule that would raise pay for some while drastically cutting pay for others, according to a House Ways & Means Republican summary, and the bill also is expected to extend the Medicare sequester moratorium for three months -- a shorter extension than sought by providers.

December 21, 2020 | Daily News

Federal Judge Catherine Blake said Friday she will rule by Dec. 24 on whether to put on hold the Trump administration’s plan to tie Medicare Part B reimbursement to foreign drug prices.

December 20, 2020 | Daily News

A ban on so-called “gag clauses” between insurers and providers, a push to ensure compliance with mental health parity rules and new disclosures on drug spending’s effect on insurance premiums are in the final COVID-19 relief package, according to an unconfirmed text of the bill floating late Sunday (Dec. 20).