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Federal Court Vacates 4 Trump-ERA ACA Policies

A federal court in Maryland on Thursday (March 4) agreed with several cities that a number of policies finalized in the Trump administration’s 2019 exchange rule violate federal law, and vacated provisions related to network adequacy, standardized options, income verification and medical loss ratio.

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The Medicare Payment Advisory Commission generally supported a draft recommendation to reform Medicare Advantage benchmarks, as staff stood by their conviction that the current system pushed up MA costs compared to fee-for-service Medicare.

CMS is crafting an action plan aimed at better aligning quality measures across the agency, federal programs and private payers, Michelle Block Schreiber, director of the Quality Measurement & Value Based Incentives Group at CMS, said at the agency’s Quality Conference Wednesday (March 3).

Every member of the Medicare Payment Advisory Commission said Friday (March 5) they support recommendations that Medicare Part B cover all vaccines, without cost sharing for preventive vaccines, and that Medicare pay doctors 103% of wholesale acquisition cost to administer preventive vaccines, although they have yet to vote on the proposals.

Medicare Payment Advisory Commission staff found that rural beneficiaries have a harder time accessing specialty care than do urban beneficiaries, though the two groups reported similar satisfaction with overall care, and that a decline in inpatient admissions preceded rural hospital closures.

Congress’ Medicare pay advisors generally favored telling HHS to pare down the Center for Medicare and Medicaid Innovation’s collection of demonstrations and focus on a smaller number of more coordinated models -- though Chair Michael Chernew said the commission has a lot of work to do on alternative payment models.

Congress’ investigative arm warned Wednesday (March 3) that FDA needs to prepare for a large backlog of foreign inspections in future years due to its decision to stop onsite reviews during the pandemic and rely on alternative inspection options, and it asked FDA to study whether the alternative tools have worked in place of traditional inspections.

Insurers are working to get 2 million vulnerable seniors COVID-19 vaccines as part of a new Vaccine Community Connectors pilot that was praised by White House COVID-19 Response Senior Advisor Andy Slavitt Wednesday (March 3).

HHS Secretary-nominee Xavier Becerra committed, if confirmed, to look into the disproportionate effects the COVID-19 pandemic has had on nursing home residents and to expand data collection to better track demographic trends from the virus on congregate living settings, but in his response to written questions from Senate Finance Committee members he was vague on how he would work to lessen the impact of private equity ownership on nursing homes.