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Medicare

April 08, 2019 | Daily News

CMS’ planned premium risk-reduction demonstration is designed to mask HHS’ bad drug-pricing policy, according to Sen. Ron Wyden (OR), the ranking Democrat on the Finance Committee.

April 08, 2019 | Daily News

Congress’ Medicare advisers will recommend that lawmakers tell CMS to use a payment withhold to incentivize Medicare Advantage plans to submit accurate, complete encounter data and to run MA provider claims through a contractor to ensure encounter data is handled correctly if enough plans don’t submit the data.

April 08, 2019 | Daily News

Congressional Medicare advisers on Friday (April 5) mulled a proposal to fundamentally restructure the Medicare Part D coverage gap and catastrophic phase to prepare the system for an impending influx of high-cost specialty drugs.

April 05, 2019 | Daily News

CMS on Friday (April 5) finalized policies that will allow Medicare Advantage plans to cover more telehealth services as basic benefits and will streamline benefits and appeals for dually enrolled beneficiaries.

April 05, 2019 | Daily News

HHS’ proposed overhaul of drug rebates is expected to lead to higher Medicare Part D premiums, but CMS is helping insurers keep premiums artificially low by letting them choose to have taxpayers cover the cost of setting premiums too low for the first two years, sources say.

April 05, 2019 | Daily News

The HHS Office of Inspector General (OIG) will investigate whether CMS Administrator Seema Verma’s reported use of millions in taxpayer money to boost her public image through contracts awarded to Republican consultants violated federal regulations and ethics rules, according to a letter from the inspector general posted to Twitter Friday (April 5) by House Energy & Commerce Chair Frank Pallone (D-NJ).

April 05, 2019 | Daily News

The overhaul of the Medicare and Medicaid drug rebate systems would be handled as a voluntary two-year pilot starting in 2020, according to CMS guidance.

April 05, 2019 | Daily News

The overhaul of the Medicare and Medicaid drug rebate systems would be accompanied by a voluntary two-year pilot starting in 2020, according to CMS guidance.

April 04, 2019 | Daily News

The House Ways & Means Committee is expected to hold a hearing next week on four bipartisan bills aimed at lowering prices after the House Energy & Commerce Committee this week passed six separate bipartisan bills aimed at speeding generic drug competition.

April 04, 2019 | Daily News

Senate health committee leader Lamar Alexander (R-TN) said Thursday (April 4) he hopes to bring a wide-ranging legislative package to reduce health care costs before his committee by June or July based on more-than 400 recommendations he received from provider groups, policy experts, health plans and others.

April 04, 2019 | Daily News

The White House budget staff are reviewing CMS’ final rule to lower Part D drug costs, which might include eliminating coverage protections in six drug classes, according to the Office of Management and Budget website.

April 03, 2019 | Daily News

Rep. Mark Meadows (NC) is writing what he says is a comprehensive drug-pricing bill with fellow House Republicans that could expand rebate reforms to the commercial market, the Freedom Caucus chair told Inside Health Policy Wednesday (April 3).

April 03, 2019 | Daily News

CMS emphasized the importance of accurate provider directories for Medicare Advantage plans, saying that inaccuracies can bring plans’ network adequacy into question, but did not finalize new policy to improve the directories as part of the MA and Part D call letter for next year.

April 03, 2019 | Daily News

CMS is considering potential rulemaking to deal with so-called Duals-Special Needs Plan look-alikes, as the agency says stakeholders’ concerns have reinforced the idea that the proliferation of these plans impedes meaningfully integrated Medicare-Medicaid products.

April 02, 2019 | Daily News

Democratic senators on Tuesday reintroduced a revised version of their Medicare-X bill that would make a government-run public option available first in areas that lack competition, but by 2025 the plan would be in all individual and small business exchanges.

April 02, 2019 | Daily News

A federal district court judge denied multiple requests from the federal government to stop a lawsuit beneficiary advocates first brought about eight years ago seeking appeal rights for Medicare beneficiaries that are put under observation rather than admitted to the hospital, and the judge says the suit should quickly move to trial.

April 02, 2019 | Daily News

Rep. Michael Burgess said maybe Medicare and Medicaid should cover insulin without cost-sharing because the cost to the health care system of diabetics rationing the drug is likely greater than the additional cost of covering it outright.

April 02, 2019 | Daily News

Sen. Rick Scott said Tuesday (April 2) that he told President Donald Trump he is focused on lowering prescription drug prices, despite the president's request last week that he help lead an effort to replace the Affordable Care Act.

April 01, 2019 | Daily News

Medicare Advantage plans will see a higher overall pay bump in 2020 than projected under the draft call letter, CMS announced on Monday (April 1) when the final rate notice and call letter for next year was released.

April 01, 2019 | Daily News

CMS on Monday (April 1) finalized a policy to let Medicare Advantage (MA) plans offer supplemental benefits for the chronically ill in 2020 -- including those that may increase a beneficiary’s property value -- as part of the MA and Part D call letter for next year.

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