The new Bipartisan Budget Act of 2018 (the Act), recently signed into law by President Trump, includes extensive Medicare, Medicaid, and other health policy and payment provisions. Policy changes that will be welcome to health care providers and manufacturers include: repeal of the Independent Payment Advisory Board (IPAB); elimination of the Medicare outpatient therapy caps;
Chronic Care
Chronic Care Legislation Approved by Senate
By Debra A. McCurdy on
The U.S. Senate has unanimously approved S. 870, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 (as amended). The bill is intended to improve care for the chronically ill in fee-for-service Medicare, Medicare Advantage (MA) plans, and accountable care organizations (ACOs). In particular, the bill calls for increased…
Congressional Hearings, Markups Focus on Chronic Care, Drug Pricing, HHS Budget, Other Health Programs
By Debra A. McCurdy on
House and Senate committees have held a number of hearings recently to focus on health policy topics, including the following:
- A Senate Health, Education, Labor & Pensions Committee hearing on “The Cost of Prescription Drugs: How the Drug Delivery System Affects What Patients Pay,” the first of three planned hearings on prescription drug costs.
- A House Ways and Means Committee hearing on Medicare Advantage and coordinated care models such as the Program for All-Inclusive Care.
- Senate Finance Committee and House Ways and Means Committee hearings examining the Trump Administration’s proposed FY 2018 HHS budget request.
- House Energy and Commerce Committee hearings on the HHS response to cybersecurity vulnerabilities and the U.S. public health response to the Zika Virus. A planned June 14 hearing on extension of safety net health programs (the Children’s Health Insurance Program, Federally Qualified Health Centers, and the Community Health Center Fund) has been postponed.
Congressional Panels Tackle FDA Reauthorization Act and Other Health Policy Issues
By Debra A. McCurdy on
On May 11, 2017, the Senate on Health, Education, Labor, and Pensions (HELP) Committee approved S 934, a bill extend Food and Drug Administration user-fee programs for prescription drugs, medical devices, generic drugs, and biosimilar biological products. The legislation also includes various policy changes, including provisions intended to improve the medical device inspection process and modify the regulation of hearing aids, among other things. The bill now moves to the full Senate. Previously, the HELP Committee approved: S 652, to reauthorize a program for early detection, diagnosis, and treatment regarding deaf and hard-of-hearing newborns, infants, and young children; S 849, to support programs for mosquito-borne and other vector-borne disease surveillance and control; S 916, to amend the Controlled Substances Act with regard to the provision of emergency medical services; and S 920, to establish a National Clinical Care Commission.
The House Energy and Commerce Committee also held a hearing regarding improving the regulation of medical technologies. The hearing focused on the following bipartisan bills: HR 1652, the Over-the-Counter Hearing Aid Act of 2017; HR 2009, the Fostering Innovation in Medical Imaging Act; HR 2118, the Medical Device Servicing and Accountability Act, and HR 1736, to amend the Federal Food, Drug, and Cosmetic Act to improve the process for inspections of device. The panel held a separate hearing on “Combating Waste Fraud and Abuse in Medicaid Personal Care Services Program.”
In addition, the following hearings and markups are scheduled next week:
Continue Reading Congressional Panels Tackle FDA Reauthorization Act and Other Health Policy Issues
Finance Committee Invites Suggestions on Medicare Chronic Care Policy
By Debra A. McCurdy on
A bipartisan Senate Finance Committee Chronic Care Working Group is inviting comments on an options paper outlining potential ways to improve care for Medicare beneficiaries with complex chronic conditions. Options under consideration include specific proposals designed to: improve care in the home setting; expand team-based care; promote innovation in benefit design and technology; appropriately pay…
CMS Launches New Medicare Advantage Innovation Model
By Debra A. McCurdy on
The latest CMS “innovation model” focuses on options for redesigning Medicare Advantage (MA) to improve health outcomes while reducing expenditures. Specifically, the Medicare Advantage Value-Based Insurance Design (VBID) Model will allow MA plans in seven states to apply to offer supplemental benefits or reduced cost sharing to enrollees with specified chronic conditions. The five-year initiative…
Upcoming 21st Century Cures Markup, Hearings on Medicare Chronic Care, Competition
By Debra A. McCurdy on
Tomorrow the House Energy & Commerce Health Subcommittee is scheduled to mark up the 21st Century Cures Act; the Subcommittee has posted a substitute amendment that will be considered by the panel. Also tomorrow, the Senate Finance Committee is holding a hearing on improving care for Medicare patients with chronic conditions.
Looking ahead…
CMS Schedules Provider Calls on Medicare Payment, Quality, Coding & Program Integrity Topics
By Debra A. McCurdy on
CMS has scheduled a series of provider calls in February and March on the following topics:
- February 3: Special Open Door Forum on the upcoming Prior Authorization of Non-Emergent Hyperbaric Oxygen Therapy model to be implemented in March in Illinois, Michigan, and New Jersey.
- February 4: Special Door Forum on the introduction of star ratings
…
CMS Releases Updated Hospital Charge Data, New Chronic Conditions & Geographic Variations Files
By Debra A. McCurdy on
Earlier this month, CMS released its first annual update to its Medicare inpatient and outpatient hospital charge databases. Specifically, the updated CMS databases include information on 2012 average hospital charges for the 100 most common Medicare inpatient services and 30 most common Medicare outpatient services. The database now includes two years of data, allowing researchers…
CMS Considering Innovative Episode-Based Payment Models for Outpatient Specialty Practitioner Services
By Debra A. McCurdy on
CMS is requesting public comments on ways to structure new models for delivering and paying for Medicare outpatient specialty practitioner services. The first broad model CMS is considering is a procedural episode-based payment model, where the episode of care would be defined around an outpatient surgical or interventional procedure such as colonoscopy or cardiac…
CMS Proposes Updates to Medicare Physician Fee Schedule, Other Part B Policies for CY 2014
By Debra A. McCurdy on
On July 19, 2013, the Centers for Medicare & Medicaid Services (CMS) published its proposed rule updating Medicare physician fee schedule (PFS) rates and polices for calendar year (CY) 2014. CMS projects that PFS payments will be reduced by approximately 24.4% in 2014, largely due to the statutory Sustainable Growth Rate (SGR) update formula (although Congress is expected to eventually take action to block the automatic cuts, as it has in the past). The rule also includes a number of significant policy proposals, including the following highlights:Continue Reading CMS Proposes Updates to Medicare Physician Fee Schedule, Other Part B Policies for CY 2014
CMS Launches “Medicare Chronic Conditions Dashboard”
By Debra A. McCurdy on
CMS has unveiled its Medicare Chronic Conditions Dashboard – a tool designed to help researchers, health professionals, and policymakers find and analyze spending, demographic and other data regarding beneficiaries with multiple chronic conditions.