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Court Dismisses AHA Lawsuit -- Says Congress & HHS Should Fix Appeals Backlogs, Not Courts

The federal DC District Court dismissed the American Hospital Association's lawsuit to compel HHS to turn around Medicare appeals decisions on time -- within 90 days at the third level of appeals -- and ruled that Congress and HHS should solve the problem, not the courts.

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Issuers must submit their qualified health plan (QHP) applications for participation in the Federally Facilitated Exchange starting March 16 through April 15, two months earlier than last year, and plan agreements will be signed by Sept. 15, a couple weeks before the planned Oct. 1 launch of open enrollment, CMS says in its draft 2016 letter to issuers that provides technical and operational guidance for issuers participating in the FFE.

FDA approved the second hepatitis C drug for use without interferon, called Viekira Pak, and AbbVie is charging $83,319 for a 12-week course of the drug, a company spokesperson said, compared to the $94,500 12-week price of Gilead Science's Harvoni and the $84,000 price of Harvoni's predecessor Sovaldi.

The home health industry said it's too soon for Medicare payment advisers to determine whether home health pay cuts impede seniors from getting good care, even though the Medicare Payment Advisory Commission must report to Congress by year's end on the impact of rebasing on beneficiary access and quality of care.

FDA's release Thursday (Dec. 18) of a long-awaited drug electronic labeling proposed rule that would require prescription drug makers to distribute prescribing information electronically, eliminating the paper form, goes against Senate appropriators' request earlier this year, but is praised by generic drug makers who tout the electronic labeling plan as an alternative to a separate generic drug labeling rule they strongly oppose.

Senate GOP leaders are asking HHS and IRS to inform all federal exchange enrollees and visitors to healthcare.gov that their ACA subsidies could be taken away if the Supreme Court rules against the administration in King v. Burwell.

Dialysis patients are challenging CMS’ dialysis star ratings program, using a law called the Data Quality Act, on the grounds the ratings program confuses patients, disadvantages facilities in states with sicker residents and was created without public input.

Staff with Kentucky's state-based exchange this week will contact about 12,000 enrollees who are eligible for, yet failed to enroll in, qualified health plans that provide cost-sharing reduction (CSR) payments, a move applauded by several consumer advocates.

Several state-based exchange officials said they were seeing strong interest in enrollment as they revealed updated figures and offered insights into the first few weeks of open enrollment during a Families USA-sponsored conference call Wednesday (Dec. 17).