Once the heat of the campaign dissipates, a majority in both parties will remain susceptible to their main argument that high prices are necessary to promote innovation.
Category: Modern Healthcare
Lawmakers target insulin rebates, pay-for-delay for future reform
The co-chairs of the Congressional Diabetes Caucus want to shake up how insulin manufacturers use rebates, setting a potential template for legislative action on drug pricing next year.
OIG: FDA’s post-market cybersecurity policies and procedures are lacking
The FDA’s post-market medical device cybersecurity plans and procedures don’t go far enough to protect public health in the face of cyber-threats, according to an OIG audit. The FDA, in response, has agreed with the OIG’s recommendations.
Medicare Advantage insurers could be on the hook for billions from audit changes
The CMS wants to make a few dramatic changes to the way it audits Medicare Advantage plans for overpayments. That could leave insurers on the hook for billions of dollars.
CMS will pay for remote patient monitoring by home health agencies
The CMS finalized its plans to pay for remote patient monitoring. It also will increase Medicare payment for home health agencies by 2.2% for 2019, or $420 million.
Wisconsin can impose Medicaid work requirements, time limits, but not drug testing
The CMS on Wednesday gave Wisconsin permission to impose work requirements on beneficiaries. It’s the first state to receive a green light for the policy without expanding Medicaid. The agency rejected the state’s mandatory drug testing proposal.
Provider, insurer task force urges greater consumer input in health plan design
Health plan design principles issued by a multistakeholder group that includes Aetna and the Cleveland Clinic stress the need for engaging consumers to improve health outcomes but don’t address the growing use of high deductibles.
Healthcare industry publishes balance-billing guide as senators pose legislation
Major industry groups have released a consumer guide on surprise out-of-network bills as support mounts for federal curbs on the practice.
Children’s hospitals bear largest brunt of Trump immigration crackdown
Children’s hospitals could see their revenue dip if increased anti-immigration sentiment from the Trump administration causes an exodus from Medicaid. Chronically ill children on Medicaid primarily go to these facilities for their hospital stays.
SSM Health church plan challenge heads toward settlement
SSM Health reached a settlement with pension plan participants legally challenging the non-for-profit corporation’s church plan status, according to court documents filed Monday in U.S. District Court in St. Louis.
