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Medicare

September 25, 2018 | Daily News

The American Clinical Laboratory Association is weighing legal options after the federal DC district court on Friday (Sept. 21) dismissed the group's lawsuit challenging reporting policies that drive down CMS' payment for clinical lab services.

September 24, 2018 | Daily News

The Trump administration has proposed a rule that would allow the government to deny green cards for immigrants who receive Medicare Part D low-income subsidies or Medicaid, but, in a departure from leaked drafts, the proposal wouldn’t target immigrants who receive Affordable Care Act subsidies.

September 24, 2018 | Daily News

Seniors advocacy groups joined dozens of other patient groups, unions and insurers in a letter urging CMS to once again extend Part B penalty relief for Medicare-eligible individuals who are, or were recently enrolled in, exchange coverage and could otherwise be charged a late fee for failing to enroll on time.

September 23, 2018 | Daily News

Senate Minority Leader Chuck Schumer (D-NY) is the key lawmaker in brand drug makers’ play to get Congress to lower their share of seniors’ drug costs, sources on both sides of the lobbying effort say.

September 21, 2018 | Daily News

Former CMS officials, a Democrat and a Republican, discussed the intense political pressure CMS staff would be subject to if Medicare were to negotiate drug prices, and they said the current system is preferable.

September 21, 2018 | Daily News

Rep. Suzan DelBene (D-WA) is drumming up support for a letter that will ask CMS to adjust the low-volume threshold in order to include more providers in the Merit-based Incentive Payment System as part of the final 2019 physician fee schedule – an agency move that would be supported by some stakeholders like Premier and the American Medical Group Association even though the American Medical Association and others want CMS to finalize the exemption as proposed.

September 21, 2018 |

Brand drug makers have inched closer to getting Congress to lower their share of seniors’ drug costs by adding to opioid legislation an unrelated package that combines the brand-backed Part D measure with watered-down pro-generic legislation and a provision that averts steep drug cost increases for seniors in 2020.

September 20, 2018 | Daily News

Brand drug makers have inched closer to getting Congress to lower their share of seniors’ drug costs by adding to opioid legislation an unrelated package that combines the brand-backed Part D measure with watered-down pro-generic legislation and a provision that averts steep drug cost increases for seniors in 2020.

September 20, 2018 | Daily News

Senate Judiciary Chair Chuck Grassley (R-IA) remains concerned that CMS isn't doing enough to oversee nursing home quality, and in a Sept. 19 letter asks when the agency plans to evaluate its new electronic survey of nursing home deficiencies and what steps the agency is taking to improve the collection of data needed to track nursing home quality.

September 19, 2018 | Daily News

CMS faces growing pressure to scrap its controversial plan to allow step therapy for Medicare Part B drugs: Dozens of specialty physician groups and state medical societies are seeking congressional leaders' help in getting the Trump administration to reverse course.

September 18, 2018 | Daily News

A federal Judge on Friday dismissed a suit against Kaiser Permanente that charged the issuer's decision to cover cochlear implants but not hearing aids violated the Affordable Care Act's 1557 non-discrimination provisions, which bars plans from discriminating on the base of race, disability, color, national origin, sex, or transgender status.

September 18, 2018 | Daily News

Sources say brand and generic drug trade groups have agreed in principle on a deal that couples a tweaked version of the generic-backed bill to stop brands from using drug safety requirements to delay competition with brand-backed Part D bills to reduce brands’ contribution to beneficiaries’ donut hole costs and avert the so-called coverage gap “cliff.”

September 18, 2018 | Daily News

HHS Secretary Alex Azar will chair a new cabinet-level interagency biodefense steering committee launched by the White House as part of a new National Biodefense Strategy unveiled Tuesday (Sept. 18).

September 18, 2018 | Daily News

CMS is looking closely at stakeholder suggestions on ways to improve the agency's proposal to simplify evaluation and management codes and consolidate payment, CMS Administrator Seema Verma said on Monday (Sept. 17).

September 17, 2018 | Daily News

Following months of legislative debate involving myriad committees, the Senate on Monday (Sept. 17) passed an extensive package of opioid legislation by a vote of 99-1 but a new version privately hammered out by senators from both parties will be taken to conference with the House, a Senate aide told Inside Health Policy.

September 17, 2018 | Daily News

The Senate voted 98-to-2 for legislation to stop all health plans and pharmacy benefit managers in the commercial market from using gag orders to prevent pharmacists from telling customers, unless asked, when it is cheaper to buy drugs without insurance.

September 17, 2018 | Daily News

CMS on Monday (Sept. 17) proposed changes to Conditions of Participation and Conditions of Coverage for a wide range of providers, including hospitals, home health providers and transplant centers, in a bid to simplify and streamline processes, reduce or change the frequency of certain activities, and do away with obsolete, duplicative or unnecessary requirements.

September 17, 2018 | Daily News

Faster FDA generic drug approvals could help a group of hospitals that are creating their own generic drug making company avoid shortages and price spikes, according to a report by PwC’s Health Research Institute.

September 14, 2018 | Daily News

FDA Commissioner Scott Gottlieb said his agency is discussing with public and private payers the possibility of establishing a subscription-based reimbursement policy that offers an incentive for drug makers to develop new antibiotics while health care providers are pressed to cut down on use of those drugs.

September 14, 2018 | Daily News

The director of public health at Pew Charitable Trusts applauded a broad strategy laid out by FDA Commissioner Scott Gottlieb Friday (Sept. 14) that aims to curb the growth of antibiotic resistant bacteria by facilitating new antibiotic product development using new reimbursement incentives, supporting antimicrobial stewardship, enhancing antimicrobial resistance surveillance and advancing regulatory science.

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