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Rural Health
News by Topic: Pharmacy and prescription drugs

CMS: Medicare Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs Federal Register
Dec 14, 2017 - Corrected republication of a final rule from the Centers for Medicare and Medicaid Services (CMS) revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) Payment System for calendar year 2018. Included in the rule is a provision that reduces Medicare Part B payments to Disproportionate Share Hospitals (DSHs) and Rural Referral Centers (RRCs) for drugs acquired through the 340B Drug Pricing Program. Effective January 1, 2018, payments to affected facilities will be reduced from average sales price (ASP) plus 6 percent, to ASP minus 22.5 percent. Among others, Critical Access Hospitals (CAHs) and rural Sole Community Hospitals (SCHs) are excluded from this payment adjustment. Comments regarding provisions of the rule must be submitted no later than 5:00 p.m. Eastern on December 31, 2017.
Source: Federal Register
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CMS Office of the Actuary Releases 2016 National Health Expenditures
Dec 6, 2017 - The Centers for Medicare and Medicaid Services (CMS) Office of the Actuary has released a study on overall national health spending. The study includes spending growth trends for private health insurance, Medicare, Medicaid, prescription drugs, and out-of-pocket consumer costs.
Source: Centers for Medicare and Medicaid Services
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CMS: Medicare Program; Contract Year 2019 Policy and Technical Changes to the Medicare Advantage, Medicare Cost Plan, Medicare Fee-for-Service, the Medicare Prescription Drug Benefit Programs, and the PACE Program Federal Register
Nov 28, 2017 - Proposed rule from the Centers for Medicare and Medicaid Services (CMS) that would revise Medicare Advantage (Part C) and Prescription Drug Benefit (Part D) regulations to implement certain provisions contained in the Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Act. The proposed rule also clarifies the "any willing pharmacy" requirement, which may work to support independent community pharmacies often found in rural areas, and improve rural beneficiaries' access to specialty drugs. Comments regarding provisions of the rule must be submitted no later than 5:00 p.m. Eastern on January 16, 2018. Additional information is available on the November 16, 2017, CMS fact sheet.
Source: Federal Register
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Massachusetts Grabs Spotlight By Proposing New Twist On Medicaid Drug Coverage
Nov 21, 2017 - Highlights the Massachusetts state Medicaid program's demonstration proposal, submitted to the Centers for Medicare and Medicaid Services (CMS). The proposal would allow the state to negotiate discounts for prescription drugs and to exclude drugs with limited treatment value. Discusses possible ramifications if this proposal were approved and implemented.
Source: Kaiser Health News
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Trump Administration Moves to Alter Drug Discount Program That Many Rural Hospitals Rely On
Nov 21, 2017 - Details the 340B prescription drug program that allows hospitals serving low-income patients to buy medication at a discount and sell it to local pharmacies in order to bolster their bottom lines. In rural areas, this program has prevented hospital closures. A final rule from the Centers for Medicare and Medicaid Services (CMS) scheduled to go into effect on January 1, 2018 would reduce funding for hospitals in the program. Includes commentary from both those who support and those who oppose the rule.
Source: KBIA
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CMS Proposes Policies to Lower the Cost of Prescription Drugs and Combat the Opioid Crisis
Nov 16, 2017 - The Centers for Medicare and Medicaid Services (CMS) have issued a proposed rule intended to provide more affordable prescription drugs to Medicare Part D enrollees and to allow Medicare to combat overprescribing and abuse of opioid medications. A fact sheet on this proposed rule is available.
Source: Centers for Medicare and Medicaid Services
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CMS: Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs Federal Register
Nov 13, 2017 - Final rule from the Centers for Medicare and Medicaid Services (CMS) revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) Payment System for calendar year 2018. Included in the rule is a provision that reduces Medicare Part B payments to Disproportionate Share Hospitals (DSHs) and Rural Referral Centers (RRCs) for drugs acquired through the 340B Drug Pricing Program. Effective January 1, 2018, payments to affected facilities will be reduced from average sales price (ASP) plus 6 percent, to ASP minus 22.5 percent. Among others, Critical Access Hospitals (CAHs) and rural Sole Community Hospitals (SCHs) are excluded from this payment adjustment. Comments regarding provisions of the rule must be submitted no later than 5:00 p.m. Eastern on December 31, 2017.
Source: Federal Register
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CMS Finalizes Policies that Reduce Provider Burden, Lower Drug Prices
Nov 2, 2017 - The Centers for Medicare and Medicaid Services (CMS) highlights two final rules, to be published in the Federal Register on November 15 and 16th respectively. The 2018 Physician Fee Schedule final rule will modernize the Medicare payment system to create greater competition in the biopharmaceutical market to lower costs. The Quality Payment Program final rule allows clinicians in small and rural practices to join together and share the responsibility of participating in value-based payments. This rule also decreases the number of clinicians required to participate, provides additional detail on clinician participation in Advanced Alternative Payment Models (APMs), and includes a new hardship exception for small practices affected by the recent hurricanes.
Source: Centers for Medicare and Medicaid Services
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CMS Finalizes Policies that Lower Out-of-Pocket Drug Costs and Increase Access to High-Quality Care
Nov 1, 2017 - The Centers for Medicare and Medicaid Services (CMS) announced two Medicare payment rules. The Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System and Quality Reporting Programs Changes for 2018 rule is using the 340B Program to reduce the cost of Medicare Part B drugs for hospitals in order to pass those savings on to beneficiaries. It also places a two-year moratorium on the direct physician supervision requirements for rural hospitals and Critical Access Hospitals. The Home Health Prospective Payment System rule will move towards a more patient-centered model.
Source: Centers for Medicare & Medicaid Services
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Avera e-CARE's Telehealth Services Work to Preserve Healthy Rural Hospitals, Communities
Oct 30, 2017 - Highlights Avera Health's telehealth service in South Dakota. Created 25 years ago to reduce burnout in physicians in the rural regions it was serving, the program provided peer support across five Midwest states. Now serving providers in 15 states, this system allows for quick pharmacy, emergency, and other specialty care from specialists and keeps patients in their own communities.
Source: AHA News
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