Policy

CMS published its final rule to update the programs of all-inclusive care for the elderly (PACE), which provides comprehensive medical and social services to help keep elderly individuals who qualify for nursing homes in their homes longer.

 

The Trump administration is expected to release an executive order this week that mandates the disclosure of healthcare prices across the industry, The Wall Street Journal reported. If enacted, the executive order could turn the traditionally opaque healthcare industry on its head.

CMS finalized a rule that aims to boost transparency of the cost of prescription drugs in Medicare Part D and enable Medicare Advantage plans to negotiate better prices for medicines. Notably, the final version backs off a controversial proposal that would have allowed Medicare Part D plans to exclude certain drugs if prices rise beyond a threshold.

 

CMS has issued a new guidance to limit the prevalence of spread pricing in Medicaid and the Children’s Health Insurance Program (CHIP) as part of a broader effort to lower prescription drug costs.

As the Trump administration looks for ways to reduce the burden on Americans when they receive a surprise medical bill, it could borrow ideas from New York, which approved legislation in 2014 that has safeguarded residents in the state from being hit with out-of-network charges.

CVS Health is still embroiled in a dispute over its $69 billion merger with Aetna, which was approved by the Department of Justice last year and closed in late 2018. However, U.S. District Judge Richard Leon isn’t so sure the deal hasn’t crossed any antitrust laws and is reviewing the case in court.

President Trump announced principles to address the issue of surprise billing in healthcare, the White House announced May 9.

The FDA is putting an end to a program that allowed medical device companies to keep the public in the dark about reports of harm and malfunction. The program, called alternative summary reporting, was established in 1997 and its data has not been publicly available.

Adopting the prices of other countries could potentially have helped save Medicare part D as much as $72.8 billion in 2018, as drug prices in the U.S. averaged 3.2 to 4.1 times higher after rebates compared to the U.K., Japan and Ontario, Canada, according to a study published in Health Affairs.

HHS has finalized a rule that will require drug companies to publish the list prices of drugs in television ads. 

CMS is taking steps to streamline the review process for states that apply for section 1915 waivers and state plan amendments, CMS Administrator Seema Verma announced May 7.  

Tennessee is poised to become the first state of the union to ask for Medicaid block granting from the Trump administration, Politico reported.