- Safety Net Providers Oppose 2-Tier Drug Pricing Policy (pharmacytimes.com)
Safety net providers are pushing back on the growing use of “2-tiered” policies among payers and pharmacy benefit managers under the 340B Drug Pricing Program that provide lower reimbursement rates for 340B-covered entities compared with non-340B entities...The practice has been challenged in court, finding its way to state legislatures through safety net providers who argue the practice is impacting their ability to serve more patients and offer comprehensive services…HHS has declined to intervene on the issue of 2-tier pricing under the 340B program, with both the Centers for Medicare and Medicaid Services and the Health Resources and Services Administration suggesting that they do not have authority to regulate this practice...READ MORE
- Regulatory agenda lays out timetable for major rules on drug pricing, interoperability (fiercehealthcare.com)
The Trump administration estimates it will release rules on drug prices and information blocking this month but punted finalizing a rule on interoperability until as late as 2022..The White House Office of Management and Budget released...the unified regulatory agenda for fall 2019...The agenda said that a major rule that would outlaw information blocking among providers is estimated to be released this month...The unified agenda also gives an update on key regulations addressing high drug prices...One such proposal is a demonstration model that would tie the price of physician-administered drugs paid by Medicare Part B to an index made up of cheaper prices paid by other countries...The agenda also provides an estimated release date of January 2020 for a proposed rule to allow the importation of drugs from Canada. The proposed rule would create a pilot project to allow states, wholesalers and pharmacists to import drugs from Canada at a cheaper price than in the U.S...READ MORE
- Seema Verma’s American Dream: Empower Consumers, Unleash Competition (healthleadersmedia.com)
The CMS administrator views her work as public service, aims to put patients in the center of the healthcare decision-making process, and hopes to curb healthcare costs...Verma, a daughter of immigrants from India, says she views her work as 'giving back to this country that has given so much to me.'...Verma emphasizes consumer empowerment and transparent competition as central parts of the solution to the U.S. healthcare system's cost problem…READ MORE
- NCPA to CMS: Recognize pharmacist services beyond dispensing (drugstorenews.com)
The National Community Pharmacists Association is highlighting pharmacists' expanding role in health care to the Center for Medicare and Medicaid Services...NCPA is urging CMS to enhance coverage of pharmacist-provided care services and reevaluate strict supervision requirements, as well as coverage policies for incident-to services...In response to President Trump’s Executive Order #13890 on Protecting and Improving Medicare for Our Nation’s Seniors...In addition to emphasizing that pharmacists improve patient care and outcomes when collaborating with health care professionals, NCPA argues in its comments that restrictive regulations currently hinder pharmacists’ ability to continue providing this care at the federal level, especially when state laws are already expanding to allow health care practitioners to contribute fully to patient care...READ MORE
- GOP, Dems agree on international reference price policy, but the devil is in the details (mmm-online.com)
There is one drug-price policy that Republicans and Democrats can agree on: international reference pricing...Leaders from both parties have proposed the model, but with some differences...It’s an idea that works around the world. Nearly every member of the European Union uses some kind of international reference pricing model. Countries such as Australia, Brazil, Canada, Japan, New Zealand and South Africa also employ it to set prices for their government healthcare systems...a drug’s price would be based on the average cost in several countries. That price would then become the benchmark for U.S. prices...READ MORE
- CMS gets new powers to go after Medicare, Medicaid fraudsters (fiercehealthcare.com)
The Trump administration issued a new rule that aims to prevent payments to Medicare and Medicaid fraudsters by boosting revocation powers and extending the time before troublesome organizations can rejoin the programs...The Centers for Medicare & Medicaid Services said that the final rule...marks a major turnaround from the agency’s normal approach of attempting to recoup fraudulent payments after the fact...“For too many years, we have played an expensive and inefficient game of ‘whack-a-mole’ with criminals—going after them one at a time—as they steal from our programs,”...READ MORE
- Nevada’s 2019 Hospital Safety Rankings Are Out
Leapfrog’s highest “A” rated hospitals for 2019 has remained unchanged from last year. These are Henderson Hospital, Mountainview Hospital, Northern Nevada Medical Center, Renown South Meadows Medical Center, and St. Mary's Regional Medical Center of Reno.
The Leapfrog Group hospital grading system is based on Centers for Medicare & Medicaid Services data collection and represents a single metric that evaluates a hospital’s overall safety performance. The nonprofit is dedicated to transparency and has created the Leapfrog Hospital Safety Grade as a quality standard for comparing health care institutions.
The “B” team consists of North Vista Hospital, Valley Hospital Medical Center, St. Rose Dominican Hospitals - Siena Campus, St. Rose Dominican Hospitals - San Martin Campus, and Renown Regional Medical Center.
The good news is two of these hospitals have shown a marked safety improvement by moving up from a “C” rating to a “B” rating; these are: Valley Hospital Medical Center, and Renown Regional Medical Center.
These hospitals are to be applauded for consistently maintaining high standards and striving to improve patient care.
The bad news is the University Medical Center of Southern Nevada continues to struggle with its’ “D” rating.
By Chase
12.30.2019
- CMS retains 340B, site-neutral payment cuts in final hospital payment rule (fiercehealthcare.com)CMS finalizes payment rules to spur greater use of innovative kidney drugs, home infusion (fiercehealthcare.com)
The Trump administration finalized a hospital payment rule...that retains proposed cuts to off-campus clinics and the 340B drug discount program...The changes outlined in the hospital Outpatient Prospective Payment System rule come despite both cuts being struck down in legal challenges and amid major pushback from providers...The goal is to bring payments to off-campus clinics in line with standalone physicians' offices...“With the completion of the two-year phase-in, the cost sharing will be reduced to $9, saving beneficiaries an average of $14 each time they visit an off-campus department for a clinic visit in [calendar year] 2020,” the Centers for Medicare & Medicaid Services said...CMS also finalized a proposed cut for the 340B program that cuts payments by 22.5% in 2020...READ MORE