CMS Proposes to Require Manufacturers to Disclose Drug Prices in Television Ads
Oct 15, 2018 - The Centers for Medicare and Medicaid Services (CMS) have proposed requiring that prescription drugs covered by Medicare and Medicaid include the Wholesale Acquisition Cost of the drugs in direct-to-consumer television advertisements. This proposed rule is intended to increase transparency and to lower drug prices.
Source: Centers for Medicare and Medicaid Services
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CMS Accelerates Innovation and Promotes Patient Access to Medical Technology
Oct 5, 2018 - The Centers for Medicare and Medicaid Services (CMS) published a revision to Medicare's Program Integrity Manual which changes the way contractors decide which technologies are covered. This change is in response to the 21st Century Cures Act's requirement for more transparency around local coverage determinations and aims to simplify the process so patients have access to therapies and devices more quickly.
Source: Centers for Medicare and Medicaid Services
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CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2019 Rates; Quality Reporting Requirements for Specific Providers; Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs (Promoting Interoperability Programs) Requirements for Eligible Hospitals, Critical Access Hospitals, and Eligible Professionals; Medicare Cost Reporting Requirements; and Physician Certification and Recertification of Claims; Correction Federal Register
Oct 3, 2018 - Notice from the Centers for Medicare and Medicaid Services making corrections to the August 17, 2018 final rule. The changes are effective as of October 1, 2018. Includes considerations for rural providers throughout.
Source: Federal Register
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Medicare Advantage Premiums Continue to Decline While Plan Choices and Benefits Increase in 2019
Sep 28, 2018 - The Centers for Medicare and Medicaid Services (CMS) announced that for the coming year Medicare Advantage premiums are expected to decline while plan choices and benefits increase. Medicare Advantage enrollment is also projected to reach an all time high. Medicare Open Enrollment for 2019 Medicare health and drug plans begins on October 15, 2018, and ends December 7, 2018.
Source: Centers for Medicare and Medicaid Services
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Medicaid Expansion Particularly Helped Rural Areas, Small Towns, Report Finds
Sep 26, 2018 - Details a new report by Georgetown University's Health Policy Institute and the University of North Carolina's NC Rural Health Project which found that Medicaid expansion has been especially beneficial to low-include adults in small towns and rural areas. Links lower uninsured rates to greater access to care for individuals, more reliable funding sources for hospitals, and less uncompensated care.
Source: Healthcare Dive
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Bipartisan Committee Leaders Announce Opioid Legislation Agreement
Sep 25, 2018 - Press release from the U.S. House of Representatives Committee on Ways and Means announcing the agreement of a bipartisan, bicameral committee on opioid legislation. Both legislative bodies passed separate opioid legislation, requiring that discrepancies between the two bills be addressed by this committee. Includes full text of the revised legislation.
Source: U.S. House of Representatives Committee on Ways and Means
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CMS Awards Funding for Quality Measure Development
Sep 21, 2018 - The Centers for Medicare and Medicaid Services (CMS) awarded new cooperative agreements to partner with the agency in developing, improving, updating, and expanding quality measures for Medicare's Quality Payment Program (QPP). Through these partnerships, CMS will work with external organizations to develop and implement measures that are intended to improve patient care.
Source: Centers for Medicare and Medicaid Services
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CMS: Medicare and Medicaid Programs: Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction Federal Register
Sep 20, 2018 - Notice of proposed rule from the Centers for Medicare and Medicaid Services to reform Medicare regulations that have been identified as unnecessary, obsolete, or excessively burdensome on healthcare providers and suppliers, allowing them to devote more time to delivering high quality patient care. Discusses the impact on rural providers and facilities throughout. Comments on the proposed rule must be received by November 19, 2018.
Source: Federal Register
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AHA, Hospital Leaders Announce 340B Good Stewardship Principles
Sep 18, 2018 - Press release from the American Hospital Association (AHA) announcing new principles for ensuring good stewardship of the 340B program on behalf of leaders from both the AHA and individual 340B hospitals. These principles are designed to help 340B hospitals strengthen the program as well as communicating the value of the program directly.
Source: American Hospital Association
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USDA to Implement Regulatory Reforms to Increase Access to Capital in Rural Areas
Sep 5, 2018 - The U.S. Department of Agriculture (USDA) is hosting listening sessions to solicit feedback on a plan to increase access to capital in rural areas by streamlining regulations for four Rural Development loan guarantee programs. These programs are the Community Facilities Guaranteed Loan Program, the Water and Waste Disposal Guaranteed Loan Program, the Business and Industry Loan Guarantee Program, and the Rural Energy for America Program. These listening sessions can be attended virtually, and will take place in Colorado, Kentucky, Missouri, Pennsylvania, and Washington, D.C.
Source: U.S. Department of Agriculture
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Brady, Roskam Write to CMS, Petition for Medicare Red Tape Relief
Sep 4, 2018 - Press release from the U.S. House of Representatives Committee on Ways and Means announcing that the committee Chairman Kevin Brady (R-TX) and the U.S. House of Representatives Subcommittee on Health Chairman Peter Roskam (R-IL) wrote three letters to the Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma. These letters praise deregulation efforts so far and encourage further steps related to hospitals, post-acute care providers, and physicians.
Source: U.S. House of Representatives Committee on Ways and Means
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CMS Provides New Flexibility to Increase Prescription Drug Choices and Strengthen Negotiation for Medicare Enrollees
Aug 29, 2018 - The Centers for Medicare and Medicaid Services (CMS) is offering Medicare Part D plans new tools and flexibility to expand choices and lower drug prices for patients. By giving Medicare Part D plans more flexibility in which prescription drugs they offer for which conditions, CMS intends to increase their power to negotiate discounts for their beneficiaries.
Source: Centers for Medicare and Medicaid Services
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ACOs Taking Risk in Innovative Payment Model Generate Savings for Patients and Taxpayers
Aug 27, 2018 - The Centers for Medicare and Medicaid Services (CMS) released an evaluation report for the first performance year of the Innovation Center's Next Generation Accountable Care Organization (ACO) Model. Results demonstrated positive outcomes related to quality and cost when providers are responsible for managing to a budget.
Source: Centers for Medicare and Medicaid Services
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HHS: Request for Information Regarding the 21st Century Cures Act Electronic Health Record Reporting Program Federal Register
Aug 24, 2018 - Request for Information from the U.S. Department of Health and Human Services (HHS) on the Electronic Health Record (EHR) Reporting Program, established by the 21st Century Cures Act. Specifically requested is input on priorities on the intersection of health IT product-related reporting criteria and healthcare provider reporting criteria, as well as input on specific focus areas, including the reporting criteria categories required by the 21st Century Cures Act. Comments accepted through October 17, 2018.
Source: Federal Register
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VA: Notice of Request for Information Regarding Health Care Standards for Quality Federal Register
Aug 24, 2018 - Request for information from the U.S. Department of Veterans Affairs (VA) to assist in establishing health care standards for quality regarding hospital care, medical services, and extended care services furnished by the VA, including through non-Department healthcare providers. Comments accepted through September 24, 2018.
Source: Federal Register
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CMS: Medicare Program; Certain Changes to the Low-Volume Hospital Payment Adjustment Under the Hospital Inpatient Prospective Payment Systems (IPPS) for Acute Care Hospitals for Fiscal Years 2011 Through 2017 Federal Register
Aug 23, 2018 - Notice from the Centers for Medicare and Medicaid Services (CMS) announcing changes to the low-volume hospital payment adjustment under the hospital inpatient prospective payment systems (IPPS) for acute care hospitals for fiscal years 2011-2017 relating to the application of mileage criterion for Indian Health Service (IHS) and non-IHS hospitals.
Source: Federal Register
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CMS Releases Formal Approach to Ensure Medicaid Demonstrations Remain Budget Neutral
Aug 22, 2018 - The Centers for Medicare and Medicaid Services (CMS) released a letter to State Medicaid Directors outlining how states must calculate budget neutrality for Medicaid demonstration projects. Also announces a standardized budget neutrality reporting form that consolidates financial data for each demonstration into a unified report to support a more streamlined approach to expenditure reporting for Medicaid demonstrations.
Source: Centers for Medicare and Medicaid Services
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CMS Awards $8.6 Million in Funding to States to Help Stabilize Markets
Aug 20, 2018 - The Centers for Medicare and Medicaid Services (CMS) awarded $8.6 million to 30 states and the District of Columbia to strengthen health insurance markets through innovative measures that aim to support market reforms and consumer protections under the Patient Protection and Affordable Care Act (PPACA). These funds come from unspent State Rate Review Grant funding from prior years, provided by the PPACA to improve the process for how states review proposed health insurance rates.
Source: Centers for Medicare and Medicaid Services
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