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Medicare

February 20, 2019 | Daily News

Rural hospital groups in Pennsylvania are cautiously optimistic about an all-payer demonstration for rural hospitals that began in January, modeled after a similar demo in Maryland that prevented rural hospitals in the state from closing.

February 20, 2019 | Daily News

Providers groups are praising the inclusion of primary care physicians in Maryland’s expansion of an all-payer model run through the CMS’ Center for Medicare and Medicaid Innovation (CMMI).

February 19, 2019 | Daily News

Employers, consumer and insurers have joined forces to push for legislation that would limit surprise billing by setting a low benchmark for out-of-network payments to providers.

February 19, 2019 | Daily News

CMS says the Independence at Home Demonstration saved about $9.1 billion in its third year, once incentive payments to practices were taken into account -- results praised by Sens. Ron Wyden (D-OR) and Ed Markey (D-MA), who would like to make the demonstration permanent.

February 19, 2019 | Daily News

CMS says the Independence at Home Demonstration saved about $9.1 million in its third year, once incentive payments to practices were taken into account -- results praised by Sens. Ron Wyden (D-OR) and Ed Markey (D-MA), who would like to make the demonstration permanent.

February 15, 2019 | Daily News

CMS will require hospitals that administer the expensive new CAR-T gene therapy to participate in a clinical registry or study aimed at determining whether real-world results mirror those from clinical trials used to get the treatments approved, according to a national coverage determination published Friday (Feb. 15) for chimeric antigen receptor (CAR) T-cells therapy.

February 15, 2019 | Daily News

House Ways & Means Chairman Rep. Richard Neal (D-MA) said Tuesday (Feb. 12) that he asked HHS Secretary Alex Azar to consider making prescription drug makers pay rebates to Medicare if they hike Part B drug prices faster than the rate of inflation.

February 15, 2019 | Daily News

Rep. Lloyd Doggett (D-TX) reintroduced his bill requiring hospitals notify patients if the care they are receiving is out of their insurance network, joining efforts by several other Capitol Hill lawmakers to cut back on surprise billing practices.

February 14, 2019 | Daily News

CMS’ Center for Medicare and Medicaid Innovation (CMMI) announced a new model on Thursday (Feb. 14) that would allow emergency ambulances treating Medicare fee-for-service beneficiaries to treat them on-scene or transport them to a location other than a hospital, like an urgent care center, and still receive Medicare payment.

February 14, 2019 | Daily News

Home care organizations were pleased with a bipartisan Senate bill introduced Monday (Feb. 11) that would keep CMS from implementing any behavioral adjustment as part of a new home health pay system until the agency sees how providers react.

February 13, 2019 | Daily News

In an in-person meeting, Senate Finance Committee Democrats on Wednesday (Feb. 13) asked HHS Secretary Alex Azar how the administration plans to eliminate Medicare Part D rebates without letting drug makers pocket that money instead of sharing it with seniors, according to a Democratic committee aide.

February 13, 2019 | Daily News

CMS in an internal transmittal to contractors dated Feb. 15 lays out a proposal for a prospective bundled payment radiation oncology model that would replace fee-for-service payments in randomly selected geographic areas, a move that comes after HHS Secretary Alex Azar indicated the agency was eying a mandatory radiation therapy demonstration.

February 13, 2019 | Daily News

HHS Secretary Alex Azar is scheduled to visit Democrats on the Senate Finance Committee Wednesday (Feb. 13) after holding a similar meeting a month ago with committee Republicans, according to a source familiar with the meeting.

February 13, 2019 | Daily News

An analysis released by the Urban Institute on Monday (Feb. 11) finds that growth in spending per enrollee in Medicare and Medicaid was much slower than in private insurance between 2006 and 2017, with the authors blaming health care cost containment issues on private insurance.

February 13, 2019 | Daily News

Democratic Sens. Debbie Stabenow (MI) and Tammy Baldwin (WI), along with Democratic Reps. Brian Higgins (NY) and Joe Courtney (CT), unveiled legislation that would let people between the ages of 50 and 64 buy into Medicare, and would let them use existing tax credits and federal contributions under the Affordable Care Act to do so.

February 12, 2019 | Daily News

Democrats are embracing proposals that would lower the Medicare eligibility age to either 50 or 55 in an effort to expand health coverage without fully upending the current system, but industry groups are wary of the idea and warn it could be as disruptive as moving to Medicare for All. 

February 12, 2019 | Daily News

A key liberal House Democrat said he is open to more moderate approaches to Medicare price negotiation than his own, but House Republicans oppose Medicare negotiation, especially if the plan were to let the government exclude coverage of drugs.

February 12, 2019 | Daily News

As the American Hospital Association pushes back against a CMS proposal that hospitals be required to send electronic notifications to community providers when a patient is admitted, discharged or transferred, the agency signals that more Medicare data sharing requirements may be on the way.

February 12, 2019 | Daily News

This week is the deadline for CMS to say how Medicare will pay hospitals for expensive CAR-T cancer treatments, and that first-of-its-kind national coverage decision will set a precedent that likely spills over into the commercial market.

February 11, 2019 | Daily News

The Office of the National Coordinator for Health IT on Monday (Feb. 11) unveiled a long-awaited proposed rule implementing the 21st Century Cures Act’s call to prevent information blocking and laying out seven exceptions to what Congress defined as blocking the sharing of electronic information. ONC also asks for information on what pricing information could be included as part of electronic health information to help the public see what they are paying for health care.

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