Debra McCurdy

Debra McCurdy

Reed Smith

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HRSA Reopens Comment Period on 340B CMP Proposed Rule

On April 19, 2016, the Health Resources and Services Administration (HRSA) is publishing a notice reopening for 30 days the comment period on its June 17, 2015 proposed rule entitled “340B Drug Pricing Program Ceiling Price...more

4/18/2016 - Civil Monetary Penalty Comment Period Drug Pricing Health Care Providers HRSA Pharmaceutical Industry Prescription Drugs Proposed Regulation Section 340B

GAO Report Shows Medicare Bearing Largest Burden from Sequestration Cuts

Medicare cuts comprised 58% of all sequestration savings in fiscal year (FY) 2014 — $11.3 billion out of $19.4 billion in total sequestration funds — according to a new GAO report. Under current sequestration law,...more

4/18/2016 - Budget Cuts GAO Health Care Providers Medicare Sequestration

CMS Announces Major Multi-Payer Comprehensive Primary Care Plus (CPC+) Model

CMS has launched a new “Comprehensive Primary Care Plus” (CPC+) model to improve how primary care is delivered and reimbursed. According to CMS, the CPC+ initiative (which builds on the ongoing Comprehensive Primary Care...more

4/15/2016 - CMS Fee-for-Service Health Care Providers Health Information Technologies Healthcare Costs Healthcare Reform Medicare Performance Incentives Physicians

OIG Identifies Top 25 Unimplemented Recommendations for HHS Cost Savings/Quality Improvements

The OIG has released the 2016 edition of its “Compendium of Unimplemented Recommendations,” which identifies what the OIG considers to be its top 25 unimplemented recommendations in terms of HHS program savings and/or quality...more

4/14/2016 - Affordable Care Act DMEPOS Electronic Medical Records HHS Medicaid Medicare Part A Medicare Part B OIG ONC

Senate HELP Committee Completes Work on Bipartisan “Cures”/Medical Innovation Legislation

The Senate Health, Education, Labor and Pensions (HELP) Committee has approved the last of its biomedical innovation bills that form its counterpart to the House 21st Century Cures Act. Together with the bills cleared by the...more

4/14/2016 - 21st Century Cures Initiative Antibiotics FDA HELP Innovation Medical Research NIH Precision Medicine Initiative (PMI) Strategic Planning

CMS Delays Enforcement of Medicaid AMP Rules for 5i Drugs until July 1, 2016

CMS has announced that it is delaying until July 1, 2016 enforcement of new rules regarding the determination of the average manufacturer price (AMP) for inhalation, infusion, instilled, implanted or injectable drugs (“5i...more

4/14/2016 - CMS Final Rules Manufacturers Medicaid Pharmaceutical Industry Prescription Drugs

OIG Examines Hospice Medicare Billing for General Inpatient Care

According to a recent OIG report, hospices billed inappropriately almost one-third of Medicare general inpatient care (GIP) stays in 2012, resulting in $268 million in inappropriate Medicare payments. The GIP level of care...more

4/14/2016 - CMS Hospice Inpatient Billing Medicare Medicare Part D OIG Physicians

CMS Issues Final 2017 Medicare Advantage Capitation Rates and Medicare Advantage/Part D Payment Policies

CMS has issued its final 2017 Medicare Advantage (MA) and Part D Rate Announcement and Call Letter, which includes a series of policy and payment changes related to these programs. CMS estimates that the final policies will...more

4/14/2016 - CMS Dual Eligibility Health Plan Sponsors Medicare Advantage Medicare Part D Prescription Drugs Star Ratings Substance Abuse

Senate HELP Committee Approves Mental Health Reform, Public Health Bills

The Senate Health, Education, Labor and Pensions (HELP) Committee recently approved the following health policy bills: - ..S. 2680, the Mental Health Reform Act of 2016 — to improve coordination between federal agencies...more

4/14/2016 - Drug & Alcohol Abuse HELP Mental Health Mental Health Parity Rule Physicians Prescription Drugs Proposed Legislation

Congressional Health Policy Hearings - April 2016

The Senate Special Committee on Aging recently held a hearing on the status of efforts to find a cure for Alzheimer’s disease, and the panel plans an April 27, 2016 hearing to examine prescription drug price increases....more

4/14/2016 - Affordable Care Act Alzheimer's Congressional Committees Congressional Investigations & Hearings Drug Pricing Health Plan Sponsors Prescription Drugs Reinsurance

House Approves Legislation to Speed Development of Zika Virus Treatments

On April 12, 2016, the House of Representatives gave final approval to S. 2512, which would add the Zika virus to the FDA Priority Review Voucher Program that encourages treatments for tropical diseases....more

4/14/2016 - FDA Infectious Diseases Pending Legislation Zika

CMS Posts April 2016 Medicare Part B Drug Files

CMS has posted the payment amounts that will apply to Medicare Part B covered drugs for the second quarter of 2016. CMS notes that average prices for the top Part B drugs increased...more

4/14/2016 - CMS Drug Pricing Medicare Part B Prescription Drugs

CMS Delays Deadline for State Medicaid Access Monitoring Review Plans

CMS has published a notice giving states more time to submit state access monitoring review plans under a November 2015 rule intended to assure access to covered Medicaid services. By way of background, the final rule...more

4/13/2016 - CMS Deadlines Final Rules State Medicaid Programs Time Extensions

CMS Call on 2016 PQRS Reporting & Avoiding 2018 Negative Payment Adjustments

On April 21, 2016, CMS is hosting a provider call on the 2016 Physician Quality Reporting System (PQRS), including how eligible professionals and group practices can satisfactorily participate and report in order to avoid the...more

4/13/2016 - CMS Health Care Providers Physicians PQRS Reporting Requirements

ONC Seeks Input on MACRA EHR Interoperability Requirements

The Office of the National Coordinator for Health Information Technology (ONC) is seeking comments on how to achieve widespread exchange of health information through interoperable certified electronic health record (EHR)...more

4/9/2016 - Comment Period Electronic Medical Records Health Information Technologies Medicare Access and CHIP Reauthorization (MACRA) ONC Raw Data Metrics

New DOJ “Elder Justice Task Forces” to Focus on Nursing Home Care Quality

The Department of Justice has created 10 regional Elder Justice Task Forces “to coordinate and enhance efforts to pursue nursing homes that provide grossly substandard care to their residents.” The Task Forces are comprised...more

4/7/2016 - DOJ Elder Abuse Elder Care Elder Issues Long Term Care Facilities Skilled Nursing Facility Task Force

HHS Proposes Doubling the Buprenorphine Patient Cap to Expand Access to Opioid Dependence Treatment

HHS has proposed increasing from 100 to 200 the patient limit for qualified practitioners who prescribe buprenorphine-based medication-assisted treatment under the Controlled Substances Act to expand access to treatment for...more

4/7/2016 - Comment Period Controlled Substances Act HHS Prescription Drugs Proposed Regulation Substance Abuse

CMS Finalizes MHPAEA Mental Health/Substance Abuse Disorder Parity Rules for Medicaid Managed Care and Alternative Benefit Plans,...

CMS has released its final rule to apply provisions of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) to Medicaid beneficiaries who receive services through managed care organizations or alternative...more

3/30/2016 - CHIP CMS Final Rules Healthcare Reform Long-Term Care Managed Care Contracts Medicaid Mental Health Parity Rule MHPAEA Substance Abuse

CMS Moving Ahead on Medicare Physician Payment Reform; Proposed MACRA Rule at OMB

The White House Office of Management and Budget (OMB) is now reviewing a highly-anticipated Centers for Medicare & Medicaid Services’ (CMS) proposed rule to implement major Medicare physician payment reform provisions...more

3/29/2016 - CMS Medicare Medicare Access and CHIP Reauthorization (MACRA) MIPS OMB Physicians Proposed Regulation

CMS Call on Opportunity to Review Open Payments/Sunshine Act Data (April 12)

CMS is hosting a provider call on April 12, 2016 to discuss the Open Payments program, including the process for physicians and teaching hospitals to review applicable data on payments or transfers of value prior to...more

3/29/2016 - CMS Health Care Providers Open Payments Physicians Sunshine Act Teaching Hospitals

CMS Proposes Testing Medicare Part B Drug Payment Reforms to Promote Value

CMS has released a complex and controversial plan – the Part B Drug Payment Model — to test new Medicare payment methods for certain Part B drugs to determine whether alternative payment designs will reduce Medicare...more

3/26/2016 - Alternative Payment Models (APM) Biologics CMS Comment Period Medicare Part B Prescription Drugs Proposed Regulation Value-Based Purchasing

MedPAC Releases Annual Recommendations to Congress on Medicare Policy

The Medicare Payment Advisory Commission (MedPAC) has released its annual recommendations to Congress on Medicare policies, including Medicare fee-for-service (FFS) payment updates and a status report on the Medicare...more

3/26/2016 - CMS Fee-for-Service Health Care Providers Medicare Medicare Advantage Medicare Part D MedPAC Section 340B

House Budget Committee Clears FY 2017 Budget Resolution with Medicare, Medicaid Cuts

The House Budget Committee has approved the budget resolution providing instructions to Congressional committees on the federal spending framework for FY 2017. The resolution calls for the adoption of major reforms to the...more

3/26/2016 - Affordable Care Act Congressional Committees Federal Budget Healthcare Reform Medicaid Medicare Proposed Legislation

CMS Ahead of Schedule in Push for Medicare Alternative Payment Models

CMS has announced that has reached its goal of tying 30% of Medicare payments to alternative payment models that reward quality of care rather than volume of service — 11 months ahead of the target CMS set last year....more

3/25/2016 - ACOs Alternative Payment Models (APM) CMS Fee-for-Service Healthcare Reform Medicare Shared Savings Program State Medicaid Programs

Senate Approves Comprehensive Addiction and Recovery Act

The Senate has overwhelmingly approved S. 524, the Comprehensive Addiction and Recovery Act, which includes a number of provisions to prevent drug abuse, treat addiction, and reduce overdose deaths. Major provisions include:...more

3/25/2016 - Controlled Substances First Responders Law Enforcement Pending Legislation Prescription Drugs Substance Abuse

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