Clashing Guardrails Pitched To DEA In Formal Special Telehealth Registration Talks

Stakeholders pitched the Drug Enforcement Administration on differing guardrails the agency could include in a special telehealth registration system, expected to be proposed this fall, during telemedicine listening sessions held by DEA earlier this month. A key tension that arose was how involved DEA should get in restricting clinical decision making and prescribing authority by installing number-based caps on controlled substances prescribed per telehealth provider. The American Telemedicine Association argued DEA should not be getting into the weeds of clinical...
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McMorris Rodgers Aims To Pass House Tri-Committee Bill By Year’s End

House Energy & Commerce Committee Chair Cathy McMorris Rodgers (R-WA) said it was “unbelievable” that the Lower Costs, More Transparency Act was pulled from a planned floor vote on Monday (Sept. 18), but said she is committed to getting the bill passed by both chambers and to the president’s desk -- even though some say Republicans are more focused on the budget and a lobbyist says Ways & Means Democrats have expressed reservations about the bill. “As we all recognize,...
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Following the canceled House vote,
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Inside CMS - 09/28/2023
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Vol. 26, No. 39
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Hospices Raise Special Focus Program Concerns In White House Meeting

Hospice care providers urged White House officials in a meeting Monday (Sept. 18) to revise a controversial proposed rule that CMS says would beef up elements of the Hospice Special Focus Program. The meeting comes after an August announcement from CMS that more than 400 hospices across the country could face administrative action -- including revoked billing privileges or deactivation -- after the agency’s unannounced site visits to over 7,000 hospices this year turned up potentially fraudulent practices. The Monday...
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Hospitals Call For Sanders-Marshall Bill Edits As CHCs Urge Passage

As lawmakers in both chambers of Congress hustle to get a bipartisan health care package moving before the end of the fiscal year, hospitals are calling for big changes to a newly inked deal between Senate health committee Chair Bernie Sanders (I-VT) and Sen. Roger Marshall (R-KS) while community health centers are pressing quick passage of the package to be marked up Thursday (Sept. 21). The Sanders-Marshall Primary Care and Health Workforce Expansion Act has also faced opposition from health...
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AARP To Court: Taxpayers Fund R&D For 99% Of Drugs, Continue Price Negotiation

In an amicus brief filed Monday (Sept. 18) in the Merck case trying to stop Medicare drug negotiations, AARP argues American taxpayers support research on 99% of drugs and the negotiation program supports innovation while lowering drug prices. The nation’s largest seniors group counters an argument the pharmaceutical companies make in Merck & Co. v. HHS that allowing the government to negotiate Medicare drug prices will stifle innovation of new medicines. AARP says the industry argument sets up a...
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Inside Drug Pricing - 09/25/2023
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Vol. 6, No. 39
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Second House Oversight PBM Hearing Breeds Potential Committee Legislation

As pharmacy benefit managers are engaged in a final stretch to convince Congress not to take up legislation that would upend current industry practices and regulations, House Oversight & Accountability Committee Chair James Comer (R-KY) told reporters Tuesday (Sept. 19) that his committee may soon enter the fray and craft its own PBM reform bill if a broader transparency bill awaiting a House vote or bills awaiting further movement in the House Energy & Commerce Committee are not successful. Until...
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Inside Drug Pricing - 09/25/2023
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Second House Oversight PBM Hearing Breeds Potential Committee Legislation

As pharmacy benefit managers are engaged in a final stretch to convince Congress not to take up legislation that would upend current industry practices and regulations, House Oversight & Accountability Committee Chair James Comer (R-KY) told reporters Tuesday (Sept. 19) that his committee may soon enter the fray and craft its own PBM reform bill if a broader transparency bill awaiting a House vote or bills awaiting further movement in the House Energy & Commerce Committee are not successful. Until...
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Inside CMS - 09/21/2023
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Vol. 26, No. 38
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CHCs Push Congress For Funding Amid Fiscal Year Countdown

The National Association of Community Health Centers is calling on lawmakers to act quickly to reauthorize community health center funding as future movement on the joint House health care package is unclear after a House vote was abruptly canceled Monday (Sept. 18) night. The Senate health committee will mark up its own bill Thursday, funded in part with pharmacy benefit manager reforms. The health center lobby is also urging lawmakers to factor funding for CHCs, the National Health Service Corps...
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Inside CMS - 09/21/2023
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Health Exchange Alert - 09/27/2023
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Vol. 11, No. 34
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Health Committee Uses Own PBM Reforms To Fund Primary Care Bill, Markup Thursday

Senate health committee Chair Bernie Sanders (I-VT) and primary health panel ranking Republican Roger Marshall (KS) said they will use pharmacy benefit manager reforms and other measures passed by their committee to pay for their community health center and primary care bill heading to markup Thursday (Sept. 21), after a staffer for Marshall previously told Inside Health Policy they were also looking at potential offsets under other committees’ turfs . The $10 billion in pay-fors identified by Sanders and...
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Inside CMS - 09/21/2023
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CMS Agrees To Work With E&C On Digital Therapeutics, Remote Monitoring Bills

Lawmakers secured a verbal commitment from a CMS official to work with them on remote monitoring and prescription digital therapeutics legislation during a House Energy & Commerce Committee hearing Sept. 19. At the hearing, focused on improving Medicare beneficiaries’ access to medications and medical technologies, lawmakers discussed several bills, including two aimed at boosting Medicare coverage and payment for remote monitoring and digital therapeutics: the Expanding Access to Remote Monitoring and the Access to Prescription Digital Therapeutics Act. Rep. Bill...
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