Labs Pleased CMS Opening Process For Revising Medicare Pay Rates

Laboratories are pleased that CMS is opening the process of setting reimbursement for laboratory services, just as it is doing for physician services, which will give labs more say over pay rates. The change, which is part of the annual Physician Fee Schedule rule unveiled late last week, adds to the run of positive developments for labs that started when Congress replaced CMS' plan to change clinical lab fees based on technological changes in the patch to the Sustainable Growth...
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Newsletter Volume: 
Vol. 17, No. 28
Newsletter Issue: 
Inside CMS - 07/10/2014
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Moran Report: Outpatient Chemo Costs Higher Than Clinics

Patients who receive chemotherapy in hospital outpatient departments cost Medicare more than those who receive the same care in cancer clinics, according to a Moran Company report for the US Oncology Network and Community Oncology Alliance. The oncologists are using the report to fight CMS' proposal to pay the same rates for cancer care in physician offices and outpatient departments. The Moran report finds that outpatient chemotherapy spending per beneficiary was 25 percent to 47 percent higher than physician clinic...
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Novavax Hopes To Negotiate New Pact With Gavi After Ending Vaccine Agreement

Novavax hopes to negotiate a new agreement with Gavi to ensure its COVID-19 vaccine and other pipeline vaccines can be distributed across the world, after having terminated its prior agreement over a procurement spat this week, a Novavax spokesperson told Inside Health Policy. Novavax announced Monday (Nov. 21) it was ending an Advance Purchase Agreement with Gavi, the Vaccine Alliance, that would have delivered doses of Novavax’s COVID-19 vaccine to low- and middle-income countries, because Gavi didn’t follow...
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Court Sides With FTC, Orders Delisting Of Narcolepsy Drug REMS Patent

A district court judge in Delaware has ordered Jazz Pharmaceuticals to remove its risk evaluation and mitigation strategy (REMS) distribution patent for the narcolepsy treatment Xyrem (sodium oxybate) from FDA’s Orange Book, agreeing with the Federal Trade Commission that it was an improper listing that impedes competition. The move could hike pressure on FDA to scrutinize Orange Book listings and dissuade drug makers from listing REMS distribution patents in the future. FTC told the court in an amicus brief that,...
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MedStar, Epic, Ascension: Telehealth Will Not Increase Costs For CMS

Multiple member organizations from the Partnership to Align Social Care such as MedStar Health, Epic and Ascension Health have collected Medicare, Medicaid and private insurer data they say prove that telehealth care is substitutive for in-person care in certain consultative specialties and for patients who see their primary care providers four or more times a year. The health care systems plan to share their results with federal policy makers in hopes of settling the debate over whether telehealth is additive...
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CMS Gives HCBS Sector Last Compliance Warning Ahead Of Deadline

After finding numerous home and community-based services programs are not meeting regulatory requirements in the run-up to CMS’ hard compliance deadline, the agency last Wednesday (Nov. 16) gave the sector a final warning ahead of an impending Dec. 1 cutoff for providers to submit corrective action plans. “Today's conversation is in the name of information sharing, technical assistance, reiterating expectations that we are a partner in adhering to the settings regulation, and yet we're quite serious that it needs to...
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Debate Over PASTEUR Heats Up Ahead Of Year-End Legislative Push

Medical experts and consumer advocates are at odds over how best to combat antimicrobial resistance and the debate has intensified as Congress gears up for its year-end legislative push that some hope includes passage of a key antibiotic funding bill that aims to spur development of new antibiotics. Some proponents of the antibiotic legislation argue that physicians should have multiple antibiotics to choose from, and that restricting which antibiotics come to market, including by requiring new therapies to prove they’re...
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InsideHealthPolicy.com
FDA Issue: 
FDA Week - 11/25/2022
FDA Volume: 
Vol. 28, No. 47
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