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Medicare

September 04, 2020 | Daily News

After CMS in August said it would begin requiring doctor’s orders for COVID-19 tests for Medicare beneficiaries after an initial test, several private insurers say they will keep their current practices.

September 03, 2020 | Daily News

CMS on Thursday (Sept. 3) launched Care Compare -- a streamlined redesign of eight existing Medicare.gov healthcare compare tools -- to provide beneficiaries a single, user-friendly interface to compare services based on cost, quality of care, volume of services and other data.

September 02, 2020 | Daily News

CMS on Wednesday (Sept. 2) finalized plans to tie Medicare Advantage plans’ negotiated pay rates for hospital inpatient care to Medicare’s fee-for-service inpatient payment rates starting in fiscal 2024, though the agency backed off the idea of tying all third-party payer rates to what Medicare will pay for inpatient hospital care.

September 02, 2020 | Daily News

CMS on Wednesday (Sept. 2) increased Medicare pay to hospitals that administer chimeric antigen receptor T-cell treatments for cancer by creating a national unadjusted pay rate for CAR T that excludes clinical trial cases and unusually low hospital charges from the pay rate calculation.

September 02, 2020 | Daily News

CMS on Wednesday (Sept. 2) finalized an inpatient hospital pay rule for fiscal 2021 that expands new technology add-on payments and increases Medicare spending on acute inpatient services by $3.5 billion, or 2.7%, in fiscal 2021.

September 01, 2020 | Daily News

President Donald Trump again said Tuesday (Sept. 1) he signed a most-favored-nation executive order, and he added drug companies are meeting with White House officials this week to discuss alternatives to that order.

September 01, 2020 | Daily News

President Donald Trump said Tuesday (Sept. 1) that drug companies are meeting with White House officials this week to discuss alternatives to his favored-nation executive order, but a spokesperson for the Pharmaceutical Research and Manufacturers of America said she is not aware of a meeting with PhRMA.

September 01, 2020 | Daily News

President Donald Trump said Tuesday (Sept. 1) that drug companies are meeting with White House officials this week to discuss alternatives to his favored-nation executive order, but a spokesperson for the Pharmaceutical Research and Manufacturers of America said she is not aware of a meeting with PhRMA.

August 31, 2020 | Daily News

CMS on Monday (Aug. 31) proposed a rule to streamline Medicare coverage of breakthrough technologies, more than a year after the White House Office of Management and Budget began reviewing it, although one policy analyst says the proposed definition of “reasonable and necessary” is the rule’s most significant provision.

August 28, 2020 | Daily News

Three Democratic senators are asking the HHS Office of Inspector General to investigate whether CMS exercised appropriate oversight of the use of hydroxychloroquine to treat COVID-19 in nursing homes -- particularly in cases where patients or their families didn’t consent to the experimental drug’s use -- and are also asking CMS whether it has opened any investigations or taken enforcement action.

August 27, 2020 | Daily News

CMS unveiled a memo on Wednesday (Aug. 26) for nursing homes on how often to test their staff for COVID-19 based on community spread, after releasing an interim rule on Tuesday (Aug. 25) that began immediately requiring nursing homes to test staff or face fines.

August 26, 2020 | Daily News

CMS on Wednesday (Aug. 26) delayed by one year its timeframe for finalizing reforms to the physician self-referral rule -- but the HHS Office of Inspector General made no mention of a similar extension for pending reforms to the anti-kickback statute.

August 26, 2020 | Daily News

Brand drug makers are offering two alternatives to the president’s most-favored-nation executive order: one would hurt doctors and hospitals, instead of drug makers, and the other is loosely based on the Senate Finance Committee drug pricing bill, according to a summary of the proposals obtained by Inside Drug Pricing.

August 25, 2020 | Daily News

The American Hospital Association and the Federation of American Hospitals called on CMS to immediately reverse its plan to potentially remove hospitals from Medicare and Medicaid if they don’t report COVID-19 data to HHS, with AHA calling the changes to hospital conditions of participation unveiled on Tuesday (Aug. 25) disturbing and heavy-handed.

August 25, 2020 | Daily News

HHS Secretary Alex Azar is letting pharmacists temporarily administer vaccines to children during the pandemic, and hospital pharmacists want Azar to use the same authority he relied on for that directive to let pharmacists administer coronavirus vaccines to adults and children once they are available.

August 24, 2020 | Daily News

Lawmakers, providers and other stakeholders are urging the White House to let HHS finalize reforms to the so-called physician self-referral or Stark law and anti-kickback statute, as some lobbyists appear concerned the rules aren’t moving quickly enough through the White House Office of Management and Budget’s clearance process.

August 23, 2020 |

The president tweeted Saturday night (Aug. 22) that he signed last week the executive order to base Medicare reimbursement on the lowest drug prices among developed countries — an order he earlier said he would hold off signing if the drug industry presented an acceptable alternative by Monday (Aug. 24).

August 23, 2020 | Daily News

The president tweeted Saturday night (Aug. 22) that he signed last week the executive order to base Medicare reimbursement on the lowest drug prices among developed countries — an order he earlier said he would hold off signing if the drug industry presented an acceptable alternative by Monday (Aug. 24).

August 21, 2020 | Daily News

With a Monday deadline looming, the drug industry does not seem to have agreed on a policy to present to the White House as an alternative to the president’s plan to base Medicare reimbursement on the cheapest prices for drugs in other developed countries.

August 20, 2020 | Daily News

HHS on Thursday (Aug. 20) announced it has awarded $35 million in grants to 50 rural organizations to boost telehealth, the health care workforce, health research, assistance for rural hospitals and HIV care.

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