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Therapy Caps Exceptions Process A Possible Vehicle For Extender Policies In Two Years

The final SGR replacement signed into law Thursday (April 16) continued a package of short-term Medicare payment policies known as “extenders” that traditionally passed alongside SGR for two years -- including the therapy caps exceptions process that one Senate Republican aide said is necessary for the extenders package to carry itself without SGR in two years.

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CMS proposed Friday a rule that would result in a pay increase of 0.3 percent to acute-care hospitals in 2016 compared to this year, and the agency projects that the site-neutral policies for long-term care hospitals contained in the proposal would cut pay 4.6 percent to that sector.

CMS named Vikki Wachino director of the Center for Medicaid and CHIP Services Friday (April 17), and the National Association of Medicaid Directors applauded the move.

Democrats on the House Energy & Commerce health subcommittee urged Republicans Thursday (April 16) to hold off on legislation creating post-acute pay bundles, and Republicans tried to figure out whether it’s possible to structure bundles in some fashion as an interim measure while CMS weighs how to collect data in a way that lets policymakers compare patients across the post-acute care settings.

The focus was on hepatitis C drugs, new biologics, cholesterol drugs, and breakthrough drugs that have yet to be invented as leaders representing Medicaid directors, AARP and others recently met for a Campaign for Sustainable Rx Pricing panel to discuss how their sectors are being affected by high drug prices.

A new study blames pricey hepatitis C drugs and new cancer drugs for the roughly 13 percent increase in spending on medicine in 2014.

Florida GOP Gov. Rick Scott will sue the Obama administration for pulling Low Income Pool funds as a way to coerce the state legislature into expanding Medicaid, the Republican announced Thursday (April 16).

The Generic Pharmaceutical Association on Thursday launched a biosimilars division with “double-digit” membership and more-than $1 million in dedicated funding, with more companies pledging to join, outgoing GPhA CEO and President Ralph Neas told Inside Health Policy.

Pharmaceutical Research and Manufacturers of America President and CEO John Castellani announced Thursday (April 16) that he will be stepping down as head of the pharmaceutical lobby group at the beginning of 2016.