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CMS Announces Medicare Advantage Value-Based Insurance Design Demo

CMS unveiled Tuesday (Sept. 1) a Medicare Advantage Value-Based Insurance Design (MA-VBID) Model that lets plans tailor benefits as part of a bid to improve enrollees' health and in turn lower costs, such as by eliminating eye exam co-pays for diabetics or by providing extra tobacco-cessation assistance for enrollees with lung disease.

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The White House Office of Management and Budget is reviewing CMS' long-overdue plan for collecting data from laboratories to create a fee schedule that is based on private payer rates, and a CMS official last week told Medicare advisers that the proposed rule should be issued sometime this month.

Congressional Medicare advisers recommend several changes to CMS' first mandatory bundled-pay proposal, including letting hospitals choose physicians with whom they would like to arrange gainsharing, giving hospitals some influence over the post-acute care providers that beneficiaries choose, setting bundled prices that discourage the use of long-term care hospitals and inpatient rehabilitation facilities and adjusting quality measures to avoid encouraging providers to use cheaper joint replacements when more expensive replacements are warranted.

Democratic presidential candidate Bernie Sanders (I-VT) said Tuesday (Sept. 1) he will introduce a measure to curb drug price hikes that includes nearly every Democratic proposal on the issue from past decades.

FDA is cracking down on powdered pure caffeine, which has been linked to two deaths in 2014, sending warning letters Tuesday (Sept. 1) to five dietary supplement distributors that sell the product, advising them that serving size information on their labels makes their products a safety risk.

Members of Premier, Inc., a healthcare performance improvement alliance, are collaborating to track hospital efforts to reduce by 20 percent the inappropriate use of intravenous antibiotic combinations in effort to support the White House's action plan to combat antibiotic resistance starting this month.

CMS is encouraging enrollees that are at risk of losing exchange subsidies because they haven't filed taxes to quickly file their returns and reconcile their advanced payment tax credits (APTCs), and says in guidance out Aug. 25 that it will provide qualified health plans (QHPs) with data on such enrollees so that they can also reach out to them if they choose.

Sandoz pushed back against Amgen's “emergency motion” to block the biosimilar sponsor from bringing its filgrastim product Zarxio to market on Sept. 3, saying in court documents Monday (Aug. 31) that a further marketing delay would cause cancer patients significant harm.

Food stakeholders can expect the preventive controls rules for human and animal food to come out soon as FDA announced Monday (Aug. 31) that it has submitted the final version of the regulations to the Federal Register, in accordance to a court-mandated deadline.