Trump Administration Decides Against Controversial Changes to Medicare Drug Program

Julie CarterMedicare WatchLeave a Comment

Last week, the Trump administration decided to shelve a proposed rule that sought to change the way Medicare prescription drug plans (PDPs) and their pharmacy benefit managers (PBMs) negotiate and pay for drugs within Medicare Part D. The now-abandoned proposal would have eliminated certain types of rebates that currently go from drug manufacturers to PBMs, anticipating that any resulting reductions Read More...

OIG Releases Troubling Reports on Medicare Hospice Benefit

Lindsey CopelandMedicare WatchLeave a Comment

The Department of Health and Human Services, Office of Inspector General (OIG) recently released two reports on the Medicare hospice benefit, identifying key vulnerabilities within the program and outlining opportunities for the Centers for Medicare & Medicaid Services (CMS) to better protect beneficiaries. The reports are extremely troubling: from 2012 to 2016, the majority of hospices—87%—had at least one deficiency Read More...

Affordable Care Act Faces Its Latest Legal Challenge

Lindsey CopelandMedicare WatchLeave a Comment

This week, the U.S. Court of Appeals for the Fifth Circuit heard oral arguments in Texas v. U.S., the latest legal challenge to the Affordable Care Act (ACA). The appeals court is reviewing a federal trial court’s December 2018 decision invalidating the ACA. The underlying lawsuit was brought in 2017 by 20 Republican state attorneys general and governors plus two individuals, challenging Read More...

Court Blocks Drug Ad Pricing Requirement

Julie CarterMedicare WatchLeave a Comment

A rule from the Trump administration that sought to require prescription drug manufacturers to include pricing information in their television advertisements has been blocked by a federal court. The rule was supposed to go into effect on July 9. In the decision, the court ruled that only Congress, not the Department of Health and Human Services, has the power to Read More...

The BENES Act Advances in the House

Lindsey CopelandMedicare WatchLeave a Comment

This week, the House Committee on Ways and Means advanced the Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act (S. 1280/H.R. 2477) in a markup that considered a series of Medicare-related bills. The BENES Act is now included in a larger bipartisan package that was unanimously reported favorably out of Committee—the Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act of 2019 (H.R. 3417). Read More...