The start of Donald Trump’s second presidency and Republican control in the 119th Congress raises questions about the future of the IRA’s Medicare Drug Price Negotiation Program (the Negotiation Program), which could be...more
Welcome back. This week, the Senate Finance Committee is set to meet privately to discuss the drug pricing legislation being developed by the committee. All signs point to a deal being close with a few outstanding provisions,...more
As of June 2015, 24 states utilize a traumatic or acquired brain injury waiver,1 as provided under section 1915(c) of the Social Security Act, which are designed to help individuals with traumatic brain injury (TBI) live in...more
FDA Reform Tops Spring Work Period Agenda -
The next work period basically runs from April 4 to May 27, with a both chambers adjourning for a week long recess the week of May 2nd. Following this work period, there will...more
Senate HELP Committee Set for Second Mark Up on Cures Effort -
This week, the Senate Committee on Health, Education, Labor and Pensions (HELP) will hold its second legislative mark-up on its counterpart to the...more
3/8/2016
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Drug & Alcohol Abuse ,
EHR ,
Employee Retirement Income Security Act (ERISA) ,
Food and Drug Administration (FDA) ,
Food Labeling ,
GMO ,
HELP ,
Legislative Agendas ,
Medicaid ,
Medicare Access and CHIP Reauthorization (MACRA) ,
Prescription Drugs ,
SCOTUS
What to Expect from Congress this Work Period -
The next Hill work period basically runs from February 22nd to March 23rd. As Congress returns, here’s a brief look at the pending health care issues on the radar for this...more
2/23/2016
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Federal Budget ,
Food and Drug Administration (FDA) ,
Hospitals ,
Justice Scalia ,
Legislative Agendas ,
Medicaid ,
Medicare Advantage ,
Physicians ,
Prescription Drug Coverage ,
Recovery Audit Contractors (RACs) ,
Substance Abuse
The Administration is Ramping Up Drug Pricing Response -
The President’s budget makes clear for all to see that the Administration wants to do something related to drug pricing. Unfortunately for the Administration,...more
2/17/2016
/ 60-Day Rule ,
Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
CMMI ,
Congressional Committees ,
Drug Pricing ,
Federal Budget ,
Food and Drug Administration (FDA) ,
Justice Scalia ,
Overpayment ,
Prescription Drugs ,
Proposed Legislation ,
SCOTUS ,
Substance Abuse ,
Zika
Martin Shkreli Not the Big Story on the Hill Last Week -
Congress’s complex relationship with prescription drugs was on display last week in the House of Representatives. In the House Committee on Oversight and...more
2/16/2016
/ Affordable Care Act ,
Biosimilars ,
BPCIA ,
Cancer ,
Centers for Disease Control and Prevention (CDC) ,
Centers for Medicare & Medicaid Services (CMS) ,
Congressional Investigations & Hearings ,
Drug Pricing ,
GDUFA ,
Martin Shkreli ,
Mental Health ,
Prescription Drugs ,
Telemedicine ,
Zika
Drug Pricing Issues Heat Up Following HHS Forum -
Last week, the Department of Health and Human Services (HHS) hosted a forum on prescription drug costs which featured players from every corner of the industry, including...more
Ways & Means Leadership Changes – Health Policy Implications Looming:
As Congress pushes forward with a two-year budget deal, and new Speaker Paul Ryan begins his tenure as the top Republican in the House of...more
11/4/2015
/ 21st Century Cures Initiative ,
Affordable Care Act ,
Automatic Enrollment ,
Centers for Medicare & Medicaid Services (CMS) ,
Co-Op ,
Congressional Committees ,
Congressional Investigations & Hearings ,
Contraceptive Coverage Mandate ,
Department of Justice (DOJ) ,
Department of Labor (DOL) ,
Drug Pricing ,
E-Cigarettes ,
Federal Budget ,
Food and Drug Administration (FDA) ,
FTEs ,
Generic Drugs ,
Health Care Providers ,
Health Information Technologies ,
Healthcare ,
Healthcare Reform ,
Home Health Care ,
Hospitals ,
ICD-10 ,
Medicare ,
Medicare Part B ,
MedPAC ,
Mental Health ,
New Legislation ,
Open Enrollment ,
OPPS ,
Prescription Drugs ,
Proposed Legislation ,
Rebates ,
Rulemaking Process ,
SCOTUS ,
Substance Abuse ,
Telehealth ,
Telemedicine ,
Tobacco Regulations ,
Two-Midnight Rule ,
U.S. Treasury
Major Medicaid Drug Payment Rule Under OMB Review: Last week a highly anticipated rule that could set the standards for the Medicaid Drug Rebate program arrived at the White House for final review. The Medicaid Outpatient...more
8/11/2015
/ Affordable Care Act ,
Amarin ,
Caronia ,
Centers for Medicare & Medicaid Services (CMS) ,
Cybersecurity ,
Department of Health and Human Services (HHS) ,
FCC ,
First Amendment ,
Food and Drug Administration (FDA) ,
Hackers ,
Health Care Providers ,
ICD-10 ,
Medicaid ,
Off-Label Promotion ,
OIG ,
OMB ,
Pending Legislation ,
Pharmaceutical Industry ,
Prescription Drug Coverage ,
Regulatory Agenda
CMS Releases Final Payment Rules (IPPS, IRF, LTCHs, Hospice, and Psych): At the end of last week, the Centers for Medicare and Medicaid Services (CMS) released a set of final 2016 payment rules affecting acute care hospitals...more
8/4/2015
/ Affordable Care Act ,
Alternative Payment Models (APM) ,
Centers for Medicare & Medicaid Services (CMS) ,
Congressional Investigations & Hearings ,
DSH ,
Electronic Medical Records ,
Final Rules ,
Health Care Providers ,
Health Information Technologies ,
Healthcare ,
Healthcare Reform ,
Hospitals ,
Long Term Care Facilities ,
Medicaid ,
Medicare ,
Proposed Legislation ,
Psychiatric Hospitals ,
Regulatory Agenda ,
Two-Midnight Rule ,
Value-Based Purchasing
ACA Repeal Votes Continue: As part of a rare Senate Sunday session to consider a bill to replenish the highway trust fund for six years, Majority Leader Mitch McConnell (R-KY) brought up an amendment to repeal the ACA—in...more
7/29/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Congressional Investigations & Hearings ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Health Insurance ,
Health Insurance Exchanges ,
Healthcare ,
Healthcare Reform ,
Medicaid ,
Medicaid Expansion ,
Medicare ,
Obama Administration ,
Proposed Legislation ,
Regulatory Agenda ,
Substance Abuse
Congress Slowly Works on Budget Reconciliation; ACA Reform Proposals Still Up in the Air -
The FY 2016 budget resolution, which was agreed to by Congress this past April, included broad reconciliation instructions...more
7/21/2015
/ Affordable Care Act ,
AHRQ ,
Budget Reconciliation ,
Centers for Medicare & Medicaid Services (CMS) ,
Congressional Investigations & Hearings ,
Drug Pricing ,
Electronic Medical Records ,
Federal Budget ,
Fraud Prevention ,
GAO ,
Health Care Providers ,
Health Information Technologies ,
Healthcare ,
Healthcare.gov ,
Home Health Care ,
ICD-10 ,
Legislative Agendas ,
Long Term Care Facilities ,
Medicaid ,
Medical Records ,
Medicare ,
Mental Health ,
Obama Administration ,
OMB ,
ONC ,
Pending Legislation ,
Prescription Drugs ,
Regulatory Agenda ,
Telehealth ,
Telemedicine
In This Issue:
- Recent Mandatory APMs Signal Evolution in Delivery Reform Efforts
- Implementation of the Affordable Care Act
- Federal Regulatory Initiatives
- Congressional Initiatives
- Upcoming...more
7/14/2015
/ Affordable Care Act ,
Alternative Payment Models (APM) ,
Centers for Medicare & Medicaid Services (CMS) ,
CMMI ,
Congressional Investigations & Hearings ,
Contraceptive Coverage Mandate ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Home Health Care ,
Medicaid ,
Medicare ,
New Regulations ,
Telehealth
On July 7th, the House introduced much anticipated bipartisan telehealth legislation. The Medicare Telehealth Parity Act of 2015, introduced by Representative Mike Thompson (D-CA) and co-sponsored by Representatives Gregg...more
7/14/2015
/ Centers for Medicare & Medicaid Services (CMS) ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Patients ,
Pending Legislation ,
Physicians ,
Telehealth ,
Telemedicine
In This Issue:
- Medicare Releases Set of Payment Rules, Physician Fee Schedule on Deck
- Implementation of the Affordable Care Act
- Federal Regulatory Initiatives
- Congressional Initiatives
- Other...more
7/8/2015
/ Affordable Care Act ,
Ambulatory Surgery Centers ,
Centers for Medicare & Medicaid Services (CMS) ,
Congressional Investigations & Hearings ,
Department of Health and Human Services (HHS) ,
Ebola ,
ESRD ,
Food and Drug Administration (FDA) ,
Health Care Providers ,
Health Insurance ,
Health Insurance Exchanges ,
Home Health Agencies ,
Hospitals ,
Medicaid ,
Medical Devices ,
Medicare ,
Medicare Payment Reform ,
OIG ,
OPPS ,
Physician Fee Schedule ,
Premiums ,
Regulatory Agenda ,
Reinsurance ,
SAMHSA ,
Unique Device Identifiers
In This Issue:
- CMS Finalizes ACO Program Rules; Scales Alternative Payment Model
- Implementation of the Affordable Care Act
- Federal Regulatory Initiatives
- Congressional Initiatives
- Other...more
In This Issue:
- Federal Regulatory Initiatives
- Congressional Initiatives
- Upcoming Congressional Hearings
- Excerpt from Federal Regulatory Initiatives:
CMS Releases Draft Rules on Medicaid...more
In This Issue:
- House Energy and Commerce Unanimously Advances 21st Century Cures Legislation
- Implementation of the Affordable Care Act
- Federal Regulatory Initiatives
- Congressional...more
In This Issue:
- SGR Bill Facing Final Hurdles This Week
- Implementation of the Affordable Care Act
- Other Federal Regulatory Initiatives
- Congressional Initiatives
- Other Health Care...more
4/14/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Congressional Investigations & Hearings ,
Health Care Providers ,
Healthcare ,
ICD-10 ,
Legislative Agendas ,
Medicare ,
Physician SGR Formula ,
Regulatory Agenda ,
Revenue Growth
In This Issue:
- King v. Burwell before the Supreme Court and the Potential Congressional Response
- Implementation of the Affordable Care Act
- Other Federal Regulatory Initiatives
- Congressional...more
3/8/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Congressional Investigations & Hearings ,
Department of Health and Human Services (HHS) ,
Health Insurance ,
Health Insurance Exchanges ,
Healthcare ,
HELP ,
Infectious Diseases ,
IRS ,
King v Burwell ,
Medical Devices ,
Medicare ,
Public Health Insurance Marketplace ,
Section 340B ,
Subsidies ,
Ways and Means Committee
In This Issue:
- Changes Ahead for Health Policy In 2015
- Implementation of the Affordable Care Act
- Other Federal Regulatory Initiatives
- Congressional Initiatives
- Other Health Care...more
In This Issue:
- FDA Releases Menu Labeling Rule
- Implementation of the Affordable Care Act
- Other Federal Regulatory Initiatives
- Upcoming Congressional Hearings
- Excerpt from FDA...more
12/3/2014
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Fast-Food Industry ,
Food and Drug Administration (FDA) ,
Food Safety ,
Health Insurance ,
Health Insurance Exchanges ,
Labeling ,
Legislative Agendas ,
Medicare Part D ,
Restaurant Industry
In This Issue:
- CMS Releases Final Medicare Payment Rules
- Implementation of the Affordable Care Act
- Other Federal Regulatory Initiatives
- Other Congressional Initiatives
- Other Health...more