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PA Lawmakers Push To Extend Coordinated Care Demo With One Participant

A bipartisan group of lawmakers from Pennsylvania has asked CMS to extend the Medicare Coordinated Care Demonstration, which is slated to terminated June 30, because they say it saves money and improves care, if only for the riskiest patients at a single demo location.

PhRMA, BIO Urge FDA To Discuss Benefit/Risk Framework In Review Meetings

A framework FDA is developing to evaluate a drug's benefits and risks should be used during mid- and late-cycle meetings with sponsors, advisory committee reviews and be fully integrated into the agency's review process, drug industry trade groups told the agency in response to its proposed plan.

CMS Applies MLR To Drug Plans Despite Strong Opposition From Insurers, PBMs

In a loss for drug plans, CMS is applying to Part D a health law provision dictating what portion of income from premiums plans must spend on clinical services.

MACPAC Meeting Spurs Talk Of Revamping 1115 Waivers To Push Innovation

Revamping the Medicaid 1115 waiver process to focus less on budget-neutrality and more on permanent payment and delivery reform was floated by some congressional Medicaid payment advisers this week, drawing interest from Medicaid officials, as a top CMS official acknowledged the agency already exercises some flexibility in enforcing the budget-neutrality rule.

MACPAC Sees Potential Concerns In DSH Cut Targeting Methodology

CMS' proposed formula for calculating cuts to Medicaid disproportionate share payments is designed to incentivize states to target DSH payments to the most needy hospitals, Congress' Medicaid payment and access advisers said, but commission members expressed concerns that lag time between CMS' calculations and any changes to state policy may take away from those incentives.

GOP's ACA Repeal Vote Spurs White House Bid To Build ACA Network

Hours before the House GOP voted 229-195 in favor of repealing the health reform law, the White House sent out an email plugging key pieces of the law that are viewed as appealing to the Middle Class and urged recipients to sign into a White House website to become part of a network for future ACA messaging.

FDA Diabetic Supply Meeting May Spur Press For Medicare Competitive Bidding Shift

Diabetic test supply makers will present research to FDA Tuesday (May 21) showing that the quality of supplies varies significantly, and makers of diabetic supplies could use that research to press CMS to shift diabetic test supplies from the Medicare competitive bidding program, where it is difficult for higher-quality products to compete at set rates, to Part D, where drug plans negotiate prices with product makers, sources say.

Energy And Commerce Approves Drug Tracing Bill, Rejects Democrats' Changes

Democrats floated four amendments, including one that would bring the House drug traceability bill more in line with the Senate's plan for an electronic interoperable unit-level tracing system, although they were unsuccessful in forging changes before the bill passed out of the House Energy and Commerce Committee Wednesday (May 15).

CMS: Next Round Of Innovation Grants To Focus On Four Reform Models

CMS' Innovation Center is planning a second round of health care innovation grants that will divvy up $1 billion for creative projects focused on four specific payment and delivery reform models that fill in what CMMI Director Richard Gilfillan said Wednesday (May 15) were identified as gaps after the first round.