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House Suit Unexpectedly Targets ACA Cost-sharing Reduction Payments

The House GOP's long-anticipated lawsuit challenging President Obama's unilateral actions related to the health care law took an unexpected turn Friday (Nov. 21) when lawmakers revealed the suit includes allegations the administration's plan to pay insurers around $175 billion for “cost-sharing reduction” over the next decade is illegal because the funds haven't been appropriated by Congress.

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The Senate on Thursday (Nov. 20) passed hospital-backed legislation to keep CMS from implementing “direct supervision” rules for outpatient services in critical access hospitals in 2014.

Rep. Fred Upton (R-MI) told patient and pharmaceutical groups Friday (Nov. 21) that he is pressing for the long-anticipated 21st Century Cures bill to be on the House floor before Memorial Day and on the president's desk by the end of 2015.

The American Hospital Association and the National Rural Health Association are urging lawmakers to move forward on a host of priorities, including making permanent a range of “extender” policies that are typically tied to the flawed Medicare Sustainable Growth Rate before they expire at the end of March and protecting the 340B program from any efforts to scale it back.

Key brand and generic drug industry associations are throwing their support behind FDA's drug compounding enforcement activities, writing to the agency that it shouldn't be swayed by drug compounders' press to allow some compounding without patient-specific prescriptions.

A source familiar with the issue confirms that immigrants protected from deportation under the executive order announced by the president Thursday (Nov. 20) will not be eligible for federal health insurance subsidies or for Medicaid coverage -- unless the coverage is fully funded by a state.

FDA's generic drug user fee program came under fire Thursday (Nov. 20) during a congressional hearing investigating the cause of generic drug price increases, with one witness suggesting FDA should fast-track applications and waive user fees for products that if approved would break up monopolies.

Sen. Bernard Sanders (I-VT) and Rep. Elijah Cummings (D-MD) on Thursday (Nov. 20) introduced companion bills that would require generic drug companies pay Medicaid rebates when drug prices rises faster than inflation.

A trio of GOP senators is pressing HHS Secretary Sylvia Burwell on whether the department will be taking action to recoup federal dollars spent on failed state-based health insurance exchanges, noting she had indicated support for collecting the money during her confirmation hearing but has since taken no action.