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Clinton Mental Health Plan Stresses Payment Innovation, Parity Enforcement

Many mental health patient advocates are thrilled Democratic presidential candidate Hillary Clinton laid out a comprehensive mental health reform plan that intends to have the Center for Medicare and Medicaid Innovation create and implement new pay models in both programs and promote health information technology to better coordinate physical and mental health care.

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Beneficiary advocates say CMS should fix misaligned prior authorization policies in Medicare and Medicaid that lead to denials and delays in accessing durable medical equipment for those dually eligible for both programs, but DME suppliers laid out a longer list of policies that should be changed to improve DME coverage for duals.

Mylan will launch a generic to the EpiPen Auto-Injector that is set to cost $300 per generic two-pack carton, which is a discount of more than 50 percent of the branded product's cost, the company announced Monday (Aug. 29).

House Energy and Commerce Committee Republicans on Monday (Aug. 29) asked FDA officials whether approval criteria is to blame in part for the lack of generic competition to Mylan Pharmaceuticals' EpiPen.

Drug companies aren't allowed to offer coupons to help Medicare beneficiaries with copays, but coupons increasingly are being used in the private sector, and that might be artificially driving up reimbursement for drugs in Medicare Part B, the Government Accountability Office reports.

CMS' plan to automatically place consumers who will lose their exchange coverage into a similar plan has hit a barrier in Wisconsin, after the state confirmed it will neither conduct its own automatic re-enrollment nor let CMS run the process without a fight.

FDA and the medical device industry have agreed that if Congress enacts legislation in fiscal year 2017 allowing the device center to increase pay for scientists and other professional positions, as proposed in the House-passed 21st Century Cures bill, they will craft a plan aimed at retaining key personnel currently funded in part by user fees, according to minutes of recent meetings.

The American Hospital Association is circulating a model letter for members to use in the group's campaign against the site-neutral policy that Congress passed as part of last year's budget deal.

Shortly before the White House budget office began reviewing a final CMS rule updating Medicare and Medicaid requirements for participation for long term care facilities -- namely nursing homes -- consumer groups urged the agency to add language explicitly banning pre-dispute arbitration clauses in nursing home contracts.