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MedPAC Approves 2021 Pay Recs Despite Industry Pushback

Congress’ Medicare advisers approved 2021 payment recommendations for a variety of health sectors Thursday, including suggestions that Congress eliminate a number of scheduled pay raises for various sectors, despite stakeholder pushback on some of the proposals.

Latest News

Illinois Proposes Extending Postpartum Medicaid Coverage Up To One Year

Illinois has submitted a waiver to CMS asking to extend Medicaid coverage up to one year after a Medicaid beneficiary has had a baby, as opposed to the current 60-day limit.

FDA To Study How Proprietary Drug Names Affect Public Perception

FDA plans to study how proprietary drug names affect public perception and how they can sometimes be misleadingly overstate the safety or efficacy of the drug, expand drug indications or suggest superiority, the agency told the White House budget office on Friday (Jan. 17).

FDA Panel Split On Approval Of Reformulated Bupivacaine For Pain

A panel of FDA advisors were split on whether FDA should approve Durect Corporation’s Posimir (SABER-bupivacaine extended-release solution) for post-surgical pain relief, touted by the company as a drug that would reduce use of opioids for at least 24 hours after surgery.

FTC Says It Is Cracking Down On Anti-Competitive Hospital Behavior

The Federal Trade Commission is moving forward on its efforts to crack down on anti-competitive behavior by hospitals and hospital systems, according to FTC Commissioner Christine Wilson, as called for by some Democrats.

Half-Priced Humalog Highlights Uncertainties Of Insulin Transition

Eli Lilly is halving the list price on two more of its insulin products for consumers who either are uninsured or choose to buy the products without insurance, the company announced Tuesday (Jan. 14).

CMS Rejects Wyoming Air Ambulance Proposal

CMS rejected Wyoming’s proposal to eliminate air ambulance surprise medical bills by making all residents Medicaid-eligible for ambulance services on the grounds that the proposal is at odds with the purposes of the Medicaid program.

OMB Meets With Stakeholders To Discuss Pending Interoperability Rules

The White House Office of Management and Budget has been meeting with industry stakeholders the past several weeks as it reviews the final interoperability rules drafted by the National Coordinator for Health IT and CMS last February.

Labs, Clinicians File Petition Challenging FDA’s Restrictions On PGx Tests

A group of laboratories and clinicians filed a citizen petition challenging FDA’s attempts to stop labs from providing physicians with genetic test data that assess a patient's risk of an adverse response or likelihood to respond to a given drug.

FDA’s Latest Deemed Biologics List Raises Exclusivity Issues For Sanofi

Two Sanofi insulin products will lose exclusivity protections as a result of FDA’s updated list of drugs that will be considered biologics in March, a shift that Sanofi previously argued would violate the Fifth Amendment.

PhRMA: Nearly Half Of 2018 Drug Spending Went To Supply Chain

Nearly half of total 2018 spending on brand name medicines went to the supply chain and brand drug makers are retaining an increasingly smaller share of list prices, according to an industry-funded study by the Berkeley Research Group.

Health Insider

MedPAC Gears Up For Jan. Meeting, E&C Looks At State Opioid Strategies

Congress’ Medicare advisors are set to look at the 340B drug discount program’s effects on expensive drug use, along with options for restructuring Part D, redesigning the Medicare Advantage quality bonus program and improving beneficiary assignment to accountable care organizations, at their meeting this week.

2020 promises to be a big one for health care. Cutting drug prices is a top priority for both the Democratic House and the White House. CMS' innovation center has controversial demos in store. Obamacare is at a crossroads after a federal judge deemed the entire law invalid. Medicaid expansion and work requirements will continue to be lightning rods in statehouses and courthouses around the country. And FDA continues to crank out new policies for regulating emerging technologies.

Despite Being An Off Year, Lots Of State Action On Drug Prices Expected

Although it’s an off year for state legislatures, states are expected to make progress on legislation and initiatives to lower drug prices, and state attorneys general are showing more interest in protecting residents from high drug prices, according to National Academy for State Health Policy Executive Director Trish Riley.

More Debate, But Little Movement On Medicare For All Expected In 2020

The debate over the future of the health care system will continue to be a key issue on the presidential trail in 2020, but as Tuesday’s winnowed-down Democratic debate highlighted, Sen. Bernie Sanders (I-VT) is now the lone top-tier presidential candidate still calling for a quick transition to Medicare for All, while the other Democratic candidates argue that their policy ideas are just as bold.