Wednesday, April 23, 2014

Inside Health Reform

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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Health Exchange Alert
Health Exchange Alert

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.

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Top Story

Blum Leaves CMS After More Than A Decade In The Thick Of Medicare Reforms

It will be difficult to replace CMS Principal Deputy Administrator Jon Blum with someone as steeped in both the details and politics of Medicare policy, Republican and Democratic lobbyists and consultants said Tuesday (April 22) upon learning Blum will leave the agency.

Latest News

E&C Republicans Ready To Discuss Alternatives To Generic Labeling Rule

A group of House Energy and Commerce Committee Republicans said they stand ready to talk with FDA about alternative approaches to the agency's controversial proposed generic drug labeling rule, according to a letter sent Tuesday (April 22) to FDA Commissioner Margaret Hamburg.

Ascension Health Gave Enroll America $1 Million After 2013 Talk With Sebelius

The country's largest Catholic and non-profit health system pledged $1 million to Enroll America following a March 2013 call between HHS Secretary Kathleen Sebelius and Ascension Health's CEO that focused on educating consumers about new coverage options made possible by the ACA, a new Government Accountability Office report reveals.

United Eyes Move To More Exchanges, Optum Seen As Key To Growth

The nation's largest insurer during its 2014 first quarter earnings call suggested it will be moving into more public exchanges in the coming year but also noted that it continues to face headwinds due to the Affordable Care Act's insurance tax, sequestration and rate cuts to Medicare Advantage.

Push For UDI Incorporation Into Claims Forms Met With Support, But Challenges

The Pew Charitable Trust's bid to get FDA-mandated Unique Device Identifiers incorporated into insurance claims forms has been bolstered by several stakeholders that foresee benefits, like enabling the inclusion of medical devices in FDA's Sentinel postmarket surveillance system.

SCOTUS Justices Critical Of Coca-Cola's View That FDCA Preempts False Label Claims

Supreme Court justices challenged Coca-Cola's argument Monday (April 21) that Congress intended for FDA's authority to preempt mislabeling claims brought under the Lanham Act, saying the nutrition labeling law's preemption of state laws does not directly imply federal preemption and a label that gets through FDA could still be misleading.

CMS Adds Inpatient Psychiatric Facility Data To Hospital Compare, Punts On Discharged-Patient Data

Inpatient psychiatric facilities' quality measures will be posted on the "Hospital Compare" website for the first time, though quality measures on patients discharged on multiple antispsychotics medications won't become public until next year due to unexpected technical issues.

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Health Reform Insider

CBO Finds SGR Reform Cost Rising, Offers New Scores On Potential Offsets

Stakeholders are digesting updated Congressional Budget Office scores that show the cost of fixing the flawed Medicare physician pay formula is creeping back up and the savings linked to many of the likely offsets are shifting, signaling the task may become more difficult if lawmakers resume efforts to replace the flawed Sustainable Growth Rate formula next year.

Drug Pricing Debate

Medicaid Plans To Voice Concerns To States About Costly New Hepatitis C Drugs

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.

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