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Fewer electronic health record requirements, smaller payment reforms and changing the definition of financial risk are some of the changes suggested by major healthcare groups in response to the CMS request for information on future models at the Center for Medicare and Medicaid Innovation (CMMI).

If the Affordable Care Act’s individual mandate is repealed as part of a Republican tax cut plan, premiums will likely rise and insurers will exit the individual market, according to the American Academy of Actuaries.

Massachusetts Gov. Charlie Baker signed a law on Nov. 21 to require insurers cover birth control products without copays, allow women to obtain a year’s supply at once and prevent most employers from opting out of contraceptive coverage on moral or religious grounds.

Alex Azar, President Donald Trump’s nominee for HHS Secretary, was paid nearly $2 million in his final year as an executive at pharmaceutical giant Eli Lilly and built a portfolio worth as much as $20.6 million in his nearly 10-year tenure at the company.

Several changes to Medicare Advantage and Medicare Part D prescription drug plans have been included in a proposed rule by CMS in an effort to fight opioid abuse among seniors while taking another step towards reducing regulations.

 

Recent Headlines

Trump quietly signs FDA user fee reauthorization

With almost zero fanfare, President Donald Trump signed the FDA Reauthorization Act (FDARA) of 2017 into law on Aug. 18, approving the user fee agreements paid by pharmaceutical and medical device companies to the Food and Drug Administration (FDA).

Majority of Americans now support universal health coverage

60 percent of Americans believe it’s the government’s responsibility to provide universal health coverage, representing a major shift in opinion since 2013, according to an analysis published in the New England Journal of Medicine.

Hospital groups split on CMS canceling mandatory bundles

CMS confirmed Tuesday it will cancel two mandatory bundled payment programs and scale back another—and not all hospitals are happy about it.

CMS to cancel mandatory bundles

A rule title posted to the Federal Register on Aug. 10 indicates CMS will cancel two mandatory bundled payment programs, the Advancing Care Coordination through Episode Payment Models (EPMs) and Cardiac Rehabilitation Incentive (CRI) Payment Models, while changing a separate payment program on joint replacements.

Trump to declare ‘national emergency’ on opioid crisis

Following up on recommendations by his own White House commission, President Donald Trump said he will declare a national public health emergency on the opioid addiction epidemic, which would have an impact on healthcare providers.

ACA insurers seeking premium hikes as high as 49% due to policy uncertainty

In an analysis of what Affordable Care Act (ACA) exchange insurers are requesting to charge customers in 21 major cities in 2018, the Kaiser Family Foundation found the cost for the second-lowest silver-level plan will range from $244 to $631 per month, with most enrollees cushioned from the price hikes by federal subsidies.

Senate passes ‘right-to-try’ bill which critics call ‘deceptive’ to terminal patients

The U.S. Senate unanimously passed a bill on Aug. 3 which would allow terminally ill patients the “right to try” experimental treatments that haven’t yet been approved by the Food and Drug Administration (FDA), but critics say it gives patients false hope without allowing for federal oversight.

Senate passes FDA user fee reauthorization

By an easy vote of 94-1, the Senate passed the FDA Reauthorization Act (FDARA) of 2017, approving the user fee agreements paid by pharmaceutical and medical device companies to the Food and Drug Administration.

Hospitals win on $2.4B raise, AO reports, 90-day meaningful use in final IPPS rule

CMS has finalized the Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) payment rules, lowering the total increase to $2.4 billion while removing a controversial proposal to require public release of previously confidential hospital inspections by accrediting organizations (AOs).

Court ruling may stop Trump from cutting off ACA insurer subsidies

The U.S. Court of Appeals for the District of Columbia Circuit has allowed 16 state attorneys general to intervene in a lawsuit surrounding the Affordable Care Act’s cost-sharing reduction subsidies, or CSRs, paid to insurers for lowering deductibles for low-income ACA enrollees.

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