Archive for the NewsLine Weekly Category

CMS Proposes to Lower Drug Costs by Targeting “Backdoor Rebates” and Encouraging Direct Discounts to Patients

The Centers for Medicare & Medicaid Services (CMS) has released a proposed rule that would amend the safe harbor regulation concerning discounts, which are defined as certain conduct that is protected from liability under the Federal anti-kickback statute, Section 1128B(b) of the Social

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Advance Notice of Methodological Changes for CY 2020 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies and 2020 Draft Call Letter

CMS released proposed changes that “will take significant steps in continuing the agency’s efforts to maximize competition among Medicare Advantage and Part D plans. These proposals will increase plan choices and benefits and include important actions to address the opioid crisis.” CMS released

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HRSA to Award Grants to Expand Rural Substance Use Disorder Services

The Health Resources and Services Administration’s Federal Office of Rural Health Policy plans to award about 75 grants of up to $1 million each to expand opioid and other substance use disorder services in high-risk rural communities. The agency expects to release a notice on

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Clinicians Can Look Up Preliminary 2019 MIPS Eligibility Status

Clinicians can now look up their preliminary eligibility status for the Merit-based Incentive Payment System, one of two payment pathways for clinicians under the Medicare Access and CHIP Reauthorization Act of 2015. Physicians, physician assistants, nurse practitioners, clinical nurse specialists and certified registered nurse anesthetists

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Study Calls for CJR Strategies to Address Safety-net Hospitals’ Disadvantage

Hospitals that serve a disproportionate share of low-income patients were less likely to qualify for financial rewards in the first year of Medicare’s Comprehensive Care for Joint Replacement model, according to a study reported this week in Health Affairs. “Continuation of this trend into subsequent

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Survey: More Adults Underinsured Since 2010

About 29 percent of adults with health insurance last year were underinsured, with high deductibles and out-of-pocket expenses relative to their income, according to the latest Biennial Health Insurance Survey by the Commonwealth Fund. That’s up from 22 percent in 2010, when the Affordable Care

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Study: Insulin Payment Strategy Could Reduce Costs for Insurers, Patients

A new study adds to a growing body of literature suggesting that human insulins may result in similar clinical outcomes as higher cost insulin analogues for many patients with type 2 diabetes, according to a report last week in JAMA. The study looked at an

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FDA: Don’t Use Certain Test Strips to Monitor Blood Thinner Dosing

The Food and Drug Administration recently warned physicians and patients who use medical devices to monitor levels of the blood thinner warfarin that certain test strips used with the devices may provide inaccurate results and should not be relied on to adjust the drug dosage.

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FDA Updates Providers on Lymphoma Risk Associated with Breast Implants

The Food and Drug Administration recently updated health care providers about a type of lymphoma associated with breast implants and recommendations to inform patients about the risk and report, evaluate and treat the condition. Providers, patients and manufacturers have reported 457 cases of breast implant-associated anaplastic large cell

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NCHF Disaster Relief Fund Continues Distributing Checks

The North Carolina Hospital Foundation (NCHF) Disaster Relief Fund has been distributing checks to support the North Carolina healthcare workers who suffered significant property loss to their homes during Hurricane Florence and the subsequent flooding. More than 160 organizations and individuals in North Carolina and

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