Sunday, April 20, 2014

Inside Health Reform

MACPAC Eyes Short-Term CHIP Extension To Spur Fixes To Children's Exchange Coverage

Congressional advisers on Friday (April 11) voted on a draft recommendation that would extend the Children's Health Insurance Program for two years to keep down costs and to pressure Congress into fixing flaws in Obamacare's treatment of children's health insurance available on the exchanges.

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Health Exchange Alert
Health Exchange Alert

Featured Story: Advocates Say Navigators Should Be Able To Assist Consumers By Phone

Consumer groups awaiting HHS' next announcement about navigator grant funding want the administration to let assisters provide help to people over the phone, arguing in a recent letter to HHS that it's burdensome and inefficient for people to have to always return in person to continue receiving help on their applications, especially if that person lives in a rural area.

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Top Story

CMS Clarifies Risk Corridor Pay Adjustments To Achieve Budget Neutrality

CMS' new guidance on keeping the ACA risk corridor program budget neutral is a mixed bag for plans but provides a ray of hope that insurers will be made whole for payments in 2016, sources tell Inside Health Policy.

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ASCO To Release Framework On Assessing Value Of High-Cost Cancer Drugs

The drug industry and the cancer center stakeholders say that they support the American Society of Clinical Oncology (ASCO) effort to provide better information on the value of cancer drugs, but say that the information should be presented in such a way that it could not be misconstrued or result in physicians restricting treatments.

PCAST Looks At FDA Policy, Role Of Animals In Antibiotic Resistance

Rep. Louise Slaughter (D-NY) cautioned President Barack Obama's scientific advisors to not be "distracted" by FDA's policy for curbing antibiotic use in animals as they move ahead with recommendations to address antibiotic resistance, including the role of animal uses.

CBO Projections Increase Savings From LIS Copay, Medigap Surcharge Policies

A Congressional Budget Office analysis of the president's fiscal year 2015 budget request dramatically raised the savings estimates for a Part D low-income subsidy copay policy that would encourage greater use of generics and a Medigap surcharge on first dollar coverage compared with the White House Office of Management and Budget's figures.

Solicitor General: False Advertising Claims Not Broadly Precluded By FDA Law

The Solicitor General recently told the Supreme Court, in a case slated to be heard next week, that companies cannot bring false advertising cases when FDA explicitly regulates a product, although FDA laws do not broadly prevent them from doing so.

Inspector General: Congress Should Close Duals Financing Loophole

The HHS Inspector General recommends that CMS ask Congress to prevent states from using a financing loophole to get federal funding for dually eligible beneficiaries with nearly no investment from states.

2015 Premiums Subject Of Talks Between President, State Insurance Officials

The White House on Thursday (April 17) suggested that during a meeting between President Barack Obama and insurance commissioners it put pressure on state insurance regulators to limit exchange plan premium increases for 2015, shortly before the president announced that 8 million people signed up for qualified health plans on the exchanges during 2014 open enrollment and the just-ended special enrollment period.

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Focus On Hospitals

AHA Sues HHS Over Two Midnight Hospital Inpatient Admissions Policy

In a move that one lobbyist says should not be a surprise, the American Hospital Association is challenging HHS over the controversial two-midnights inpatient admission policy, arguing in two related lawsuits filed Monday (April 14) that the rule burdens hospitals with unlawful, arbitrary standards and deprives hospitals of proper Medicare payment for caring for patients.

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