CMS has extended from March 13 to April 10 the deadline for comments on changing the way outpatient specialist practitioners are paid for both chronically ill beneficiaries and for one-time patients, building on the Bundled Payments for Care Improvement model for episodes of care in inpatient hospital stays.
CMS is considering instituting restrictions on Medicare Advantage plans that move to narrow provider networks in the middle of a plan year -- a move that some beneficiary advocates back but others question because they say narrow networks are necessary to curb costs.
CMS says the health reform law prohibits federal trust funds for a Basic Health Program from being spent on anything outside of lowering enrollees' premiums and cost-sharing and providing them additional benefits, so the agency must retain its prior stance that states cannot use Basic Health trust funds on program implementation and administrative costs, according to a final rule issued Friday (March 7).
House Ways & Means Republicans pounced on a letter from the Medicare Payment Advisory Commission in opposition to CMS' proposal to open preferred-pharmacy networks to nonpreferred pharmacies, using MedPAC's concerns to bolster their case that the Part D proposed rule should be scrapped.
Most employers in the small group insurance market likely won't move any time soon to ACA-compliant plans now that HHS is giving insurers the option to renew non-compliant policies for another two years, a health policy expert with Avalere Health tells Inside Health Policy.
HHS since fiscal year 2010 has spent roughly $304 million of the $1 billion Health Insurance Reform Implementation Fund that was established by the health law to help cover administrative expenses related to the ACA's implementation, according to new exchange spending details that were required by the omnibus appropriations legislation passed earlier this year.
Outgoing CMS insurance chief Gary Cohen told a gathering of insurance executives Thursday (March 6) that the agency is not collecting data that would quantify how many previously uninsured individuals are joining the health insurance exchanges -- coming the same day a new McKinsey & Company survey found that people who have been insured are signing up for exchange plans at much higher levels than those who had been without coverage.
Outgoing Center for Consumer Information and Insurance Oversight (CCIIO) Director Gary Cohen told reporters Thursday (March 6) that he had always intended for his stint at CMS to be temporary and that his decision to leave at the end of the current open enrollment period is not related to the widely panned roll out of healthcare.gov.
Rep. Renee Ellmers (R-NC), backed by House Energy & Commerce committee leadership, introduced a bill Thursday (March 6) to block HHS from moving forward with the controversial Part D rule that CMS proposed in January.
MedPAC Backs CMS Bid To Ax Protected Drug Classes; Opposes Rule's Pharmacy, MTM, Plan Limit Policies
Congressional Medicare advisers support CMS' plan to remove protected status for three drug classes, although they think the beneficiary appeals process is broken, and they agree CMS should crack down on prescribing abuses, but the advisers take issue with other key policies included in the agency's contentious Part D proposed rule.
A coalition of 21 healthcare organizations Thursday (March 6) bolstered the generic drug industry's press for a major overhaul of FDA's controversial proposed generic drug labeling rule by writing to FDA that the rule would expose pharmacists and physicians to additional liability and hike drug costs.
Physician groups on Friday (March 7) issued thinly veiled warnings that Congress' hard-fought legislation to reform the Medicare physician-pay formula could slip away if House Republicans more forward on a plan that emerged Thursday to pay for reforming physician pay by repealing Obamacare's individual mandate, an offset no one believes Democrats will accept.
The National Community Pharmacists Association touts four recent congressional letters to CMS reflect support for the "any willing pharmacy" provision contained in CMS' broader proposed . . .
House lawmakers Ami Bera (D-CA) and Charles Boustany (R-LA) are trying to build support for their legislation that would delay the ACA's insurer . . .
More than 600 physician groups are sending a letter to Congress Wednesday (March 5) urging lawmakers to replace the Medicare Sustainable Growth Rate formula . . .
Senate Finance Committee Chairman Ron Wyden (D-OR) tapped Joshua Sheinkman as staff director and Jocelyn Moore as deputy staff director, both of whom have extensive . . .
The Arkansas legislature has passed the necessary appropriation for the state to renew its unique Medicaid expansion approach that uses ACA matching dollars to help . . .