Medical Associations Ask CMS To Pause New Prior Auth Requirements

The American Medical Association joined dozens of specialty physician groups and patient advocates on Wednesday (April 7) in asking CMS to delay its decision to require prior authorization for two service areas under the calendar year 2021 Medicare hospital outpatient prospective payment rule and to put off any future prior authorization policies until more data are collected. The groups note the rule came just months after CMS implemented prior authorization for five new services in 2020, and they worry this...
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InsideHealthPolicy.com
CMS Issue: 
Inside CMS - 04/15/2021
CMS Volume: 
Vol. 24, No. 15
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Chronic Disease Group Urges MACPAC To Vote Against Rebate Policy

The Partnership to Fight Chronic Disease is urging congressional Medicaid advisers to reject recommendations to increase rebates and impose an additional inflationary rebate on drugs that receive accelerated approvals. The Medicaid and CHIP Payment and Access Commission will vote Thursday (April 8) on those very recommendations. “We are troubled by the commentary at the last MACPAC meeting that insinuates that these drugs somehow evade FDA scrutiny and are unsafe or ineffective,” the Partnership to Fight Chronic Disease states in an...
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InsideHealthPolicy.com
IDP Issue: 
Inside Drug Pricing - 04/12/2021
IDP Volume: 
Vol. 4, No. 15
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Experts: Govt. Standards, Funding Needed For COVID-19 Vaccine Passes

As the Biden administration works to draft guidance for industry around COVID-19 vaccine passports -- digital health passes that can provide proof of vaccination and be used by businesses to screen people for vaccination status -- digital health groups say they want the federal government to play an even bigger role in in the development process, specifically by creating a unifying set of standards for industry, providing funding for developers, and allowing some apps to link up with federal agencies...
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InsideHealthPolicy.com
FDA Issue: 
FDA Week - 04/09/2021
FDA Volume: 
Vol. 27, No. 14
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CMS Is Considering A Post-COBRA Special Enrollment Period

CMS tells Inside Health Policy it is actively considering Democratic leaders’ request for a special enrollment period (SEP) that would allow people getting fully subsidized COBRA under the American Rescue Plan to enroll in ACA coverage through healthcare.gov once their benefits wind down in September. “CMS is actively considering this issue and recognizes the importance of helping individuals with COBRA subsidies gain access to coverage after the subsidies end,” a spokesperson tells Inside Health Policy. On Tuesday...
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CMS Issue: 
Inside CMS - 04/15/2021
CMS Volume: 
Vol. 24, No. 15
HEA Issue: 
Health Exchange Alert Weekly Report - 04/14/2021
HEA Volume: 
Vol. 9, No. 15
Author: 

Becerra: Half A Million Have Enrolled In ACA Coverage Via SEP

HHS Secretary Xavier Becerra on Wednesday (April 7) said more than 528,000 Americans have enrolled in Affordable Care Act coverage in the 36 states that use healthcare.gov since the new special enrollment period (SEP) kicked off Feb. 15, including 322,000 from March 1 through March 31. The SEP will be available through Aug. 15 in the healthcare.gov states, and many state -based exchanges have also extended their SEPs to align with the federal government. “Access to quality, affordable health care...
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HEA Issue: 
Health Exchange Alert Weekly Report - 04/14/2021
HEA Volume: 
Vol. 9, No. 15
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