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Medicare

September 13, 2018 | Daily News

The House Energy & Commerce Committee passed a number of Medicaid and anti-fraud bills on Thursday (Sept.13), including a one-year extension of the Medicaid Money Follows the Person demonstration and a tweaked version of the ACE Kids Act.

September 12, 2018 | Daily News

The Advanced Medical Technology Association praised a Local Coverage Decision transparency bill that passed the House by voice vote Wednesday (Sept. 13), but the College of American Pathologists is urging the Senate to reinsert a key provision removed by Ways & Means and said the bill's appeals language was weakened prior to the House vote.

September 12, 2018 | Daily News

The White House’s budget office is reviewing a Medicare Part D proposed rule that could include some of the president’s proposals to control drug prices, but the rule is no longer designated as economically significant.

September 12, 2018 | Daily News

Several dozen provider groups are urging CMS to return to its previous policy of prohibiting Medicare Advantage plans from using step therapy for Part B drugs.

September 11, 2018 | Daily News

CMS’ proposal to consolidate Medicare payment rates for office visits continues to generate overwhelming opposition from physician groups, including groups that could stand to benefit financially from the change.

September 11, 2018 | Daily News

The National Association of Accountable Care Organizations and Institute for Accountable Care say CMS should back away from cuts to the shared savings rate for ACOs in its new model, give providers at least three years and as many as five before they need to take on risk and allow beneficiary risk scores to change by up to 5 percent during ACO contracts.

September 11, 2018 | Daily News

A device industry lawyer said a draft guidance FDA issued Sept. 5 shows the agency is willing to accept greater premarket risk in the device development process, as long as postmarket controls and data collection procedures are in place.

September 10, 2018 | Daily News

The House on Wednesday (Sept. 12) is set to consider, likely under suspension of the rules, several bills passed by the Ways & Means Committee last week, including legislation to make CMS' Local Coverage Decision process more transparent and to direct HHS to finish updating regulations for the Programs of All-Inclusive Care for the Elderly, according to House Majority Leader Kevin McCarthy's (R-CA) weekly schedule.

September 10, 2018 | Daily News

A federal judge on Friday (Sept. 7) struck down a 2014 CMS rule that imposed a strict definition of Medicare Advantage overpayments and an exacting liability standard for when MA plans were required to report such overpayments and return them to CMS.

September 07, 2018 | Daily News

FDA floated a number of possible ways to avert drug shortages as it announced plans to hold a public meeting Nov. 27 to gather stakeholders' advice on how the federal government could step in without negatively affecting health care financing and delivery.

September 06, 2018 | Daily News

HHS Secretary Alex Azar on Thursday (Sept. 6) said that moving to value-based care may require mandatory models under the CMS innovation center, as well as other mandatory reforms, but at the same time Azar said HHS doesn’t want to micromanage how providers reach good outcomes.

September 05, 2018 | Daily News

The House Ways & Means Committee passed four bipartisan health care bills on Wednesday (Sept. 5) -- which would test the use of smart cards to stem fraud, codify a Medicare enrollment fix, require final regulations for the Programs of All-Inclusive Care for the Elderly program and tweak the local coverage determination process -- but some Democrats complained the measures deal with problems on the periphery of Medicare and the health care system.

September 05, 2018 | Daily News

The American Hospital Association, Association of American Medical Colleges and America’s Essential Hospitals refiled their lawsuit to reverse CMS’ cut to Part B reimbursement for 340B drugs.

September 05, 2018 | Daily News

House Ways & Means Chair Kevin Brady (R-TX) and health subcommittee chair Peter Roskam (R-IL) urged CMS to reconsider proposed changes to evaluation and management coding and the amount Medicare pays for new drugs, in a letter sent to CMS Administrator Seema Verma Tuesday (Sept. 4) highlighting Medicare red tape faced by physicians.

September 05, 2018 | Daily News

House Ways & Means Chair Kevin Brady (R-TX) and health subcommittee Chair Peter Roskam (R-IL) welcomed CMS' efforts to revamp Medicare accountable care organizations and said they appreciate the agency's proposal to extend current contracts by six months to prevent the mass exit of ACOs -- but they also asked the agency to reconsider reducing shared savings down to 25 percent for those ACOs that don't take on risk.

September 04, 2018 | Daily News

The National PACE Association is pleased the House Ways & Means Committee is taking up legislation that would direct HHS to finalize regulations from 2016 that would let providers determine who should update care plans, let PACE facilities contract with primary care providers and reduce the number of on-site audits.

August 31, 2018 | Daily News

The California legislature on Thursday (Aug. 30) passed legislation that would reduce financial incentives for dialysis firms to charge higher, commercial insurance rates by limiting the reimbursement to providers that directly or indirectly pay a patient's premium to the lower of Medicare or the patient's health plan rate.

August 31, 2018 | Daily News

The House Ways & Means Committee will mark up four Medicare-related bills Wednesday (Sept. 5), including one measure that would test using smart-card technology for beneficiaries’ Medicare cards and another that would finalize regulations for the Programs of All-Inclusive Care for the Elderly.

August 31, 2018 | Daily News

Medicare ACOs saved the program $314 million in 2017, which the National Association of Accountable Care Organizations says shows ACOs' value -- but CMS says the fact that 2017 is the first time ACOs wielded net savings underscores a need to overhaul the Medicare Shared Savings Program.

August 31, 2018 | Daily News

The head of CMS’ innovation center did not take kindly to suggestions from the Pharmaceutical Research and Manufacturers of America (PhRMA) that CMMI’s authority should be spelled out in rulemaking and that the center is not an ideal place to test value-based payments for drugs.

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