Inside Health Reform
The GOP leader of the Florida state Senate sees the impending departure of HHS Secretary Kathleen Sebelius as an opportunity to "recalibrate" the balance of authority in Medicaid and has urged secretary-nominee Sylvia Mathews Burwell to seize a chance to tip unwilling states to embrace Medicaid expansion by adopting a more flexible approach to draw down federal money.
Featured Story: Eyes On HHS For More Details On The 8 Million Sign-Ups
The White House announced that 8 million people chose plans on the exchanges by April 15, but more details are on the way because HHS has yet to release key demographic information on those enrollees and a breakdown of all the states' figures.
Lobbyists expect CMS to propose major ACO policy changes this fall aimed at keeping accountable care organizations from dropping out during the second round of contracts in the program, which agency officials often tout as a key example of how the Affordable Care Act is reforming the health care system.
Centene Corp., in an earnings call this week touting double-digit revenue growth, said that about 39,700 people have enrolled in and paid premiums for qualified health plans (QHPs) the company is offering through the exchanges in nine states but the insurer still expects to have about 70,000 paid enrollees by the second business quarter.
House Oversight Committee Chair Darrell Issa (R-CA) quickly jumped on reports that Oregon is likely to scrap its problem-plagued state-based exchange and instead use federal technology for most exchange functions in 2015, saying the state should be asked to return the $305 million spent on the site.
CMS held the first in a series of discussions with stakeholders on developing an electronic template to help doctors fill out the face-to-face documentation that is required -- though often filled out incorrectly -- before home health providers can be paid.
FDA hopes to set up a formal process for device makers to meet simultaneously with FDA and CMS prior to the start of clinical trials to discuss data requirements, a top FDA official said Wednesday (April 23), a day after FDA unveiled an expedited device approval initiative that has some stakeholders nervous the plan's reliance on post-market data collection will stifle reimbursement.
CMS is seeking comments from issuers on several policies still under consideration for the federally facilitated small business marketplace (FF-SHOP), including whether to let employees enroll outside of the initial window that the employer chooses and potentially change their qualified health plan selection via the SHOP call center after that enrollment period ends.
Danielle Moon, who heads the CMS division in charge of Medicare Advantage and drug plans, is leaving the agency for an outside consulting firm at the end of May, according to an April 23 internal agency email.
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Drug Pricing Debate
Medicaid health plans are readying a public push to voice their worries about new, costly Hepatitis C medications that have recently come onto the market and plan to send a letter to state Medicaid directors this week about developing solutions so that plans and the program remain financially solvent, the head of Medicaid Health Plans of America tells Inside Health Policy.