AHIP To CMS: Assess SEP Removal Before Implementing Other Major Proposals

AHIP is applauding CMS’ plan to end the monthly special enrollment period (SEP) for low-income consumers that insurers and others allege opened the door to improper or fraudulent enrollment.

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GLP-1 Makers Score Another Court Victory Against Compounders

In another victory for brand name GLP-1 drugmakers in their fight against compounded versions of their drugs, a district court judge in Texas upheld FDA’s decision to remove tirzepatide from the shortage list.

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Cassidy Links Measles Outbreak To Immigration, Suggests Vaccine Mandate Needed

Senate health committee Chair Bill Cassidy (R-LA) is offering a new line on the measles outbreak impacting numerous U.S. states, saying at a Thursday (May 8) hearing he’s concerned the outbreak is linked to immigration and hinting he’s worried the Trump administration may roll back rules requiring people who enter the United States to be vaccinated.

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ATA Pushes Medicaid Telehealth And DTx, Sidesteps Heated Debate Over Program Cuts

NEW ORLEANS -- The American Telemedicine Association has decided not to engage in the politically charged lobbying over House Republicans’ efforts to glean potentially hundreds of billions in Medicaid savings as the national telehealth lobby separately advocates for states to continue Medicaid telehealth flexibilities and federal and state programs to cover digital therapeutics.

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Info Blocking Regs To Be Fought In Courts Amid Lagging HHS Enforcement

A pair of court cases suggests that courts will likely see more litigation citing federal information blocking regulations designed to discourage electronic health record companies, telehealth and other providers from interfering in the sharing of electronic health data, three lawyers with different firms told Inside Health Policy.

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Makary Tells Reviewers To Use AI By June 30, Says Data-Driven Endpoints Speed Approvals

FDA Commissioner Marty Makary on Thursday (May 8) gave all product reviewers until June 30 to start using artificial intelligence, and days earlier touted the ability of data-driven endpoints to dramatically speed drug approvals.

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Former HUD Secretary Carson Floats AI-Enhanced Medicaid Audits, Doesn’t Weigh In On FMAP, Provider Tax Proposals

Using artificial intelligence (AI) to audit Medicaid more effectively could help root out waste, fraud and abuse in the program, former Housing and Urban Development Secretary Ben Carson told Inside Health Policy Wednesday (May 7).

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Radiologists Push AUC Program Fix To Offset Medicare Overhaul They Want In Reconciliation

Congress could save up to $700 million annually in Medicare if it fixes the appropriate use criteria program for providers requesting radiology services, according to CMS data the American College of Radiology cited Wednesday (May 7) as they urged lawmakers to reform the physician fee schedule as part of the reconciliation bill, and said legislation set to be introduced by Sen. Marsha Blackburn (R-TN) could be an offset.

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House E&C Eyes May 13 Reconciliation Markup, Hospitals Ramp Up Lobbying On Provider Taxes

The House Energy & Commerce Committee is eying a Tuesday (May 13) markup of its still-evolving plan to tap into Medicaid to pay for a GOP reconciliation package, with lawmakers telling Inside Health Policy Thursday morning while major structural reforms remain off the table, it’s still an open question whether provider taxes long-used by states to defray expenses will be ratcheted back.

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BARDA Places $144M Order For Longer-Lasting Mpox Vaccines

HHS has placed a $144 million order for a freeze-dried version of the Jynneos mpox vaccine from Bavarian Nordic after the new formulation, which has a longer shelf life than previous versions, was approved by FDA in March.

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