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Medicare

September 11, 2019 | Daily News

The Center for American Progress is pushing a number of policy options to help struggling rural hospitals stay open, some of which echo policy platforms from Democratic presidential hopefuls, and the left-leaning group is also imploring the Trump administration to stop allowing states to waive non-emergency medical transportation benefits in Medicaid.

September 10, 2019 |

The White House on Tuesday welcomed House Speaker Nancy Pelosi’s ideas on drug pricing, hiking President Donald Trump’s pressure on Senate Republicans and the drug industry to back a less aggressive, but strongly pharma-opposed, drug-pricing bill passed by the Senate Finance Committee.

September 10, 2019 | Daily News

The White House on Tuesday welcomed House Speaker Nancy Pelosi’s ideas on drug pricing, hiking President Donald Trump’s pressure on Senate Republicans and the drug industry to back a less aggressive, but strongly pharma-opposed, drug-pricing bill passed by the Senate Finance Committee.

September 10, 2019 | Daily News

A drop-off in Medicaid enrollment was the primary driver of the nation’s uninsured rate climbing to 8.5% in 2018 -- the first year since 2009 that the rate increased, according to national census data released Tuesday (Sept. 10).

September 09, 2019 | Daily News

A draft of House Speaker Nancy Pelosi’s Medicare price negotiation bill circulating among lobbyists calls for using international prices as an upper limit for what Americans pay for drugs and imposing harsh penalties to keep drug makers at the negotiating table, instead of relying on a third-party arbitrator as a backstop to negotiation.

September 09, 2019 | Daily News

Congressional Medicare advisers are considering recommending a unified, value-based incentive program for all post-acute care settings that would score providers on three quality measures and use a 5% withhold from base payments to fund the incentive payments.

September 06, 2019 | Daily News

Congress’ Medicare advisors discussed whether CMS should seek authority from Congress to expand its durable medical equipment competitive bidding program -- potentially even beyond DME -- because the commission views the program as a success.

September 05, 2019 | Daily News

CMS on Thursday (Sept. 5) finalized a sweeping program-integrity rule -- first proposed under the Obama administration -- that gives the agency greater latitude to block health care providers from participating in Medicare, Medicaid or the Children’s Health Insurance Program if they are affiliated with entities who are deemed to pose a heightened risk of fraud, waste or abuse.

September 04, 2019 | Daily News

The American Hospital Association doubled down on claims that hospital mergers drive down costs and improve care for patients on Wednesday (Sept. 4) amid calls from the Federal Trade Commission (FTC) and Democratic presidential candidates for increased oversight of such mergers.

September 03, 2019 | Daily News

Beneficiary advocates complain CMS did a sharp U-turn by not including key beneficiary protections in its recent Medicare marketing and communication guidance, and ask the agency to either revamp the guidance or rescind it.

September 03, 2019 | Daily News

California Health Advocates asks CMS to delay implementing the new Medicare Plan Finder, or at least make changes to how State Health Assistance Insurance Program participants interact with the updated website, and other beneficiary advocates worry they won’t have enough time to learn the new tool before open enrollment starts Oct. 15.

September 03, 2019 | Daily News

CMS delayed requirements for accountable care organizations (ACOs) to notify beneficiaries of their assignment in order to give ACOs time to adjust, but the providers still want the requirement removed.

August 30, 2019 | Daily News

The White House Office of Management and Budget on Thursday (Aug. 22) began reviewing a three-year extension of the Comprehensive Care for Joint Replacement model as well as changes to the model.

August 29, 2019 | Daily News

Substance use disorder and mental health advocates are concerned that loosening the strict privacy scheme that protects substance use treatment records will make it easier for these records to get in the hands of law enforcement and could make people fearful of seeking treatment.

August 29, 2019 | Daily News

Nursing homes are urging CMS to take administrative action to count all time spent in a hospital toward Medicare’s so-called three-day stay requirement after CMS Administrator Seema Verma blasted the policy as bureaucratic red tape in a recent tweet.

August 27, 2019 | Daily News

CMS on Tuesday (Aug. 27) released a revamped Medicare Plan Finder that shows supplemental benefits provided by Medicare Advantage plans, and also helps beneficiaries compare drug plans by bringing in their personal drug information and showing available generic alternatives, but the new site doesn’t include plan provider directories or integrate certain information on Medigap supplemental plans as CMS says such data aren’t available.

August 27, 2019 | Daily News

Democratic presidential candidate and South Bend, Indiana Mayor Pete Buttigieg unveiled a proposal Friday (Aug. 23) to tackle mental illness and substance use disorders by increasing Medicaid reimbursement for related services, requiring Medicare and Medicaid to cover medication-assisted treatment, and tackling social isolation and social determinants of health through Medicare and Medicaid interventions.

August 27, 2019 | Daily News

A federal district court consolidated hospitals’ lawsuits over deep reimbursement cuts for clinic visits at off-campus facilities after the providers in both cases agreed to join their litigation. Hospitals are pushing the court to hear oral arguments in September.

August 27, 2019 | Daily News

The House Ways & Means Committee chair called on CMS and the Department of Justice to provide more information on how they plan to tackle cases of abuse in nursing homes after the HHS Office of Inspector General (OIG) found in June that potential abuse and neglect at nursing homes wasn’t always reported and investigated.

August 26, 2019 | Daily News

Large employers are increasingly open to the government negotiating prices of high-cost drugs, a notable change from previous years that reflects ongoing concern over skyrocketing costs, according to a new survey by the National Business Group on Health (NBGH).

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