OMB: Proposed Designation of Databases for Treasury's Working System Under the Do Not Pay Initiative
Notice from the Office of Management and Budget (OMB) proposing which databases to include in the Treasury's Working System under the Do Not Pay (DNP) Initiative. Proposed databases include the Department of Agriculture's National Disqualified List (NDL) and the Center for Medicare and Medicaid Services (CMS) National Plan and Provider Enumeration System (NPPES), among others. Comments are due by February 22, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - January 22, 2021 Category: Rural Health Source Type: news

Beshear opposes bill that would cut out three Medicaid companies
Gov. Andy Beshear worries that reducing the number of Medicaid companies in Kentucky could leave enrollees vulnerable if one should decide to abandon the state — which has happened before. (Source: bizjournals.com Health Care News Headlines)
Source: bizjournals.com Health Care News Headlines - January 21, 2021 Category: Health Management Authors: Chris Larson Source Type: news

Wichita native receives one of Trump's final-hours pardons
A Wichita native who was convicted of fraud as a Tampa, Fla., health-care executive was pardoned by President Trump early Wednesday morning. Todd Farha, who was President and CEO of WellCare Health Plans, was one of five company executives who were convicted of health-care fraud in 2013. Farha is the son of Jim Farha, a longtime Wichita physician who died a year ago. Farha was sentenced to three years in prison for two counts of defra uding Florida's Medicaid program, though he stayed out while… (Source: bizjournals.com Health Care:Physician Practices headlines)
Source: bizjournals.com Health Care:Physician Practices headlines - January 20, 2021 Category: American Health Authors: Kirk Seminoff Source Type: news

Trump pardons former WellCare executives in final round of pardons
As part of a flurry of last-minute pardons and commutations, President Donald Trump granted pardons to five former executives of WellCare Health Plans who were convicted in a case involving allegations of defrauding Florida ’s Medicaid program. Trump pardoned former WellCare CEO and President Todd Farha, former General Counsel Thaddeus Bereday, former Chief Financial Officer Paul Behrens, former Vice President William Kale and former Vice President Peter Clay. FBI agents raided WellCare's Tampa… (Source: bizjournals.com Health Care News Headlines)
Source: bizjournals.com Health Care News Headlines - January 20, 2021 Category: Health Management Authors: Jim Saunders Source Type: news

Trump pardons former WellCare executives in final round of pardons
As part of a flurry of last-minute pardons and commutations, President Donald Trump granted pardons to five former executives of WellCare Health Plans who were convicted in a case involving allegations of defrauding Florida ’s Medicaid program. Trump pardoned former WellCare CEO and President Todd Farha, former General Counsel Thaddeus Bereday, former Chief Financial Officer Paul Behrens, former Vice President William Kale and former Vice President Peter Clay. FBI agents raided WellCare's Tampa… (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - January 20, 2021 Category: Biotechnology Authors: Jim Saunders Source Type: news

CMS unveils final rule to speed up coverage of advanced tech
The U.S. Centers for Medicare and Medicaid Services (CMS) has issued a final...Read more on AuntMinnie.comRelated Reading: MSN touts new CMS clinical data registry measures ACR urges Congress to stop Medicare cuts CMS grants pass-through status for Detectnet CMS finalizes major cut in radiology reimbursement CMS issues final rule modernizing Stark law (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - January 19, 2021 Category: Radiology Source Type: news

CMS: Medicare and Medicaid Programs; Contract Year 2022 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicaid Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly
Notice of final rule from the Centers for Medicare and Medicaid Services (CMS) revising regulations for Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), and the Medicare Cost Plan program, and Programs of All-Inclusive Care for the Elderly (PACE), among other things. This rule is effective March 22, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - January 19, 2021 Category: Rural Health Source Type: news

CMS: Medicaid Program; Medicaid Fiscal Accountability Regulation
Notice from the Centers for Medicare and Medicaid Services (CMS) withdrawing theNovember 18, 2019 proposed rule, which would have created new reporting requirements for states to address the financing of supplemental and base Medicaid payments through the non-federal share. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - January 19, 2021 Category: Rural Health Source Type: news

CMS: Medicare Program; CY 2021 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Medicaid Promoting Interoperability Program Requirements for Eligible Professionals; Quality Payment Program; Coverage of Opioid Use Disorder Services Furnished by Opioid Treatment Programs; Medicare Enrollment of Opioid Treatment Programs; Electronic Prescribing for Controlled Substances for a Covered Part D Drug; Payment for Office/Outpatient Evaluation and Management Services; Hospital IQR Program; Establish New Code Categories; Medicare Diabetes Prevention Program (MDPP) Expanded Model Emergency Policy; Coding and Payment for Virtual Check-In Services Interim Final Rule Policy; Coding and Payment for Personal Protective Equipment (PPE) Interim Final Rule Policy; Regulatory Revisions in Response to the Public Health Emergency (PHE) for COVID-19; and Finalization of Certain Provisions From the March 31st, May 8th and September 2nd Interim Final Rules in Response to the PHE for COVID-19; Correction
Notice from the Centers for Medicare and Medicaid Services making technical corrections to theDecember 28, 2020 final rule. This correction is effective January 19, 2021, and is applicable January 1, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - January 19, 2021 Category: Rural Health Source Type: news

New Innovation to Address System Overload by Systemizing the Field Triage and Treatment of Non-Emergent Patients
Introductory Note from JEMS Editor Emeritus A.J. Heightman, MPA, EMT-P JEMS has prided itself on introducing countless groundbreaking concepts and innovations to the EMS community since its inception in 1980. As an example, in May 1980, JEMS introduced Jack Stout’s Public Utility Model and System Status management which changed the way many EMS Systems operated. His concepts introduced new ways to maximize resources and revenue through changes in the deployment of crews and resources. In Feb. of 1981, Dr. Jeff Clawson’s dispatch priority training and the Medical Priority Dispatch System (MPDS); the impact...
Source: JEMS Patient Care - January 18, 2021 Category: Emergency Medicine Authors: Marc Eckstein, MD, MPH Tags: Administration and Leadership Communications & Dispatch Exclusives California EMS Prehospital Telemedicine Source Type: news

New Innovation to Address System Overload by Systemizing the Field Triage and Treatment of Non-Emergent Patients
Introductory Note from JEMS Editor Emeritus A.J. Heightman, MPA, EMT-P JEMS has prided itself on introducing countless groundbreaking concepts and innovations to the EMS community since its inception in 1980. As an example, in May 1980, JEMS introduced Jack Stout’s Public Utility Model and System Status management which changed the way many EMS Systems operated. His concepts introduced new ways to maximize resources and revenue through changes in the deployment of crews and resources. In Feb. of 1981, Dr. Jeff Clawson’s dispatch priority training and the Medical Priority Dispatch System (MPDS); the impact...
Source: JEMS Administration and Leadership - January 18, 2021 Category: Emergency Medicine Authors: Marc Eckstein, MD, MPH Tags: Administration and Leadership Communications & Dispatch Exclusives California EMS Prehospital Telemedicine Source Type: news

New Innovation to Address System Overload by Systemizing the Field Triage and Treatment of Non-Emergent Patients
Introductory Note from JEMS Editor Emeritus A.J. Heightman, MPA, EMT-P JEMS has prided itself on introducing countless groundbreaking concepts and innovations to the EMS community since its inception in 1980. As an example, in May 1980, JEMS introduced Jack Stout’s Public Utility Model and System Status management which changed the way many EMS Systems operated. His concepts introduced new ways to maximize resources and revenue through changes in the deployment of crews and resources. In Feb. of 1981, Dr. Jeff Clawson’s dispatch priority training and the Medical Priority Dispatch System (MPDS); the impact...
Source: JEMS Latest News - January 18, 2021 Category: Emergency Medicine Authors: Marc Eckstein, MD, MPH Tags: Administration and Leadership Communications & Dispatch Exclusives California EMS Prehospital Telemedicine Source Type: news

New Innovation to Address System Overload by Systemizing the Field Triage and Treatment of Non-Emergent Patients
Introductory Note from JEMS Editor Emeritus A.J. Heightman, MPA, EMT-P JEMS has prided itself on introducing countless groundbreaking concepts and innovations to the EMS community since its inception in 1980. As an example, in May 1980, JEMS introduced Jack Stout’s Public Utility Model and System Status management which changed the way many EMS Systems operated. His concepts introduced new ways to maximize resources and revenue through changes in the deployment of crews and resources. In Feb. of 1981, Dr. Jeff Clawson’s dispatch priority training and the Medical Priority Dispatch System (MPDS); the impact...
Source: JEMS: Journal of Emergency Medical Services News - January 18, 2021 Category: Emergency Medicine Authors: Marc Eckstein, MD, MPH Tags: Administration and Leadership Communications & Dispatch Exclusives California EMS Prehospital Telemedicine Source Type: news

New Innovation to Address System Overload by Systemizing the Field Triage and Treatment of Non-Emergent Patients
Introductory Note from JEMS Editor Emeritus A.J. Heightman, MPA, EMT-P JEMS has prided itself on introducing countless groundbreaking concepts and innovations to the EMS community since its inception in 1980. As an example, in May 1980, JEMS introduced Jack Stout’s Public Utility Model and System Status management which changed the way many EMS Systems operated. His concepts introduced new ways to maximize resources and revenue through changes in the deployment of crews and resources. In Feb. of 1981, Dr. Jeff Clawson’s dispatch priority training and the Medical Priority Dispatch System (MPDS); the impact...
Source: JEMS Operations - January 18, 2021 Category: Emergency Medicine Authors: Marc Eckstein, MD, MPH Tags: Administration and Leadership Communications & Dispatch Exclusives California EMS Prehospital Telemedicine Source Type: news

New Innovation to Address System Overload by Systemizing the Field Triage and Treatment of Non-Emergent Patients
Introductory Note from JEMS Editor Emeritus A.J. Heightman, MPA, EMT-P JEMS has prided itself on introducing countless groundbreaking concepts and innovations to the EMS community since its inception in 1980. As an example, in May 1980, JEMS introduced Jack Stout’s Public Utility Model and System Status management which changed the way many EMS Systems operated. His concepts introduced new ways to maximize resources and revenue through changes in the deployment of crews and resources. In Feb. of 1981, Dr. Jeff Clawson’s dispatch priority training and the Medical Priority Dispatch System (MPDS); the impact...
Source: JEMS Special Topics - January 18, 2021 Category: Emergency Medicine Authors: Marc Eckstein, MD, MPH Tags: Administration and Leadership Communications & Dispatch Exclusives California EMS Prehospital Telemedicine Source Type: news

DARZALEX FASPRO ® (daratumumab and hyaluronidase-fihj) Becomes the First FDA-Approved Treatment for Patients with Newly Diagnosed Light Chain (AL) Amyloidosis
January 15, 2021 (HORSHAM, Pa.) – The Janssen Pharmaceutical Companies of Johnson & Johnson announced today the U.S. Food and Drug Administration (FDA) approval of DARZALEX FASPRO® (daratumumab and hyaluronidase-fihj), a subcutaneous formulation of daratumumab, in combination with bortezomib, cyclophosphamide and dexamethasone (D-VCd) for the treatment of adult patients with newly diagnosed light chain (AL) amyloidosis.[1] DARZALEX FASPRO® is the first and only FDA-approved treatment for patients with this blood cell disorder that is associated with the production of an abnormal protein, which leads to th...
Source: Johnson and Johnson - January 16, 2021 Category: Pharmaceuticals Tags: Our Company Source Type: news

CMS streamlines prior authorizations in final rule
The U.S. Centers for Medicare and Medicaid Services (CMS) has issued a final...Read more on AuntMinnie.comRelated Reading: MSN touts new CMS clinical data registry measures ACR urges Congress to stop Medicare cuts CMS grants pass-through status for Detectnet CMS finalizes major cut in radiology reimbursement CMS issues final rule modernizing Stark law (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - January 15, 2021 Category: Radiology Source Type: news

Public Inspection: CMS: Medicaid Program: Medicaid Fiscal Accountability Regulation
Pre-publication notice from the Centers for Medicare and Medicaid Services (CMS) withdrawing the November 18, 2019 proposed rule, which would have created new reporting requirements for states to address the financing of supplemental and base Medicaid payments through the non-federal share. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - January 15, 2021 Category: Rural Health Source Type: news

Public Inspection: CMS: CY 2021 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Medicaid Promoting Interoperability Program Requirements for Eligible Professionals; Quality Payment Program; Coverage of Opioid Use Disorder Services Furnished by Opioid Treatment Programs; Medicare Enrollment of Opioid Treatment Programs; Electronic Prescribing for Controlled Substances for a Covered Part D Drug; Payment for Office/Outpatient Evaluation and Management Services; Hospital IQR Program; Establish New Code Categories; Medicare Diabetes Prevention Program (MDPP) Expanded Model Emergency Policy; Coding and Payment for Virtual Check-in Services Interim Final Rule Policy; Coding and Payment for Personal Protective Equipment (PPE) Interim Final Rule Policy; Regulatory Revisions in Response to the Public Health Emergency (PHE) for COVID-19; and Finalization of Certain Provisions from the March 31st, May 8th and September 2nd Interim Final Rules in Response to the PHE for COVID-19; Correction
Pre-publication notice from the Centers for Medicare and Medicaid Services making technical corrections to theDecember 28, 2020 final rule. This correction is effective upon publication of this notice, which is scheduled for January 19, 2021, and is applicable January 1, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - January 14, 2021 Category: Rural Health Source Type: news

Thyroid cancer screening hits the right note
Researchers from France discovered a thyroid cancer screening technique that...Read more on AuntMinnie.comRelated Reading: Ultrasound: The 60-year-old modality of the future Expanded Medicaid tied to more thyroid cancer diagnoses Doctors order thyroid ultrasounds without good reasons Laryngeal ultrasound helps detect vocal cord polyps Is thyroid cancer overdiagnosed for 9/11 first responders? (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - January 13, 2021 Category: Radiology Source Type: news

New data show retail medicine prices fell in 2019
In 2019, retail prescription medicine prices declined by 0.4%, on average, according to National Health Expenditures (NHE)data from the Centers for Medicare& Medicaid Services (CMS) published recently inHealth Affairs. While retail prescription medicine spending grew 5.7% that same year,this increase was due to more patients getting the medicines they need, not higher prices. (Source: The Catalyst)
Source: The Catalyst - January 13, 2021 Category: Pharmaceuticals Authors: Katie Koziara Tags: Let's Talk About Cost Source Type: news

OR Medicaid expansion helped more women access insurance coverage for abortion services
(Oregon State University) A recent study from Oregon State University found that after Oregon expanded Medicaid in 2014, more women were able to receive insurance coverage for abortion services, rather than paying out of pocket. (Source: EurekAlert! - Medicine and Health)
Source: EurekAlert! - Medicine and Health - January 13, 2021 Category: International Medicine & Public Health Source Type: news

Medicaid Work Requirements at the U.S. Supreme Court: A Potentially Devastating Blow to Health Coverage for Millions
In spring 2021, the U.S. Supreme Court is scheduled to hear a case on the legality of imposing work requirements in the Medicaid program. (Source: The Guttmacher Institute)
Source: The Guttmacher Institute - January 13, 2021 Category: International Medicine & Public Health Authors: Guttmacher Source Type: news

Few Ob-Gyns Can Prescribe Buprenorphine for Opioid Use
TUESDAY, Jan. 12, 2021 -- Fewer than 2 percent of obstetrician-gynecologists who accept Medicaid are able to prescribe buprenorphine, according to a study published online Dec. 11 in JAMA Network Open. Max Jordan Nguemeni Tiako, from the Yale... (Source: Drugs.com - Pharma News)
Source: Drugs.com - Pharma News - January 12, 2021 Category: Pharmaceuticals Source Type: news

Nationwide Study Shows Continued Rise in Opioid Affected Births
Provides overview of study conducted by researchers at the U.S. Department of Health and Human Services (HHS) that found the rates of pregnant women diagnosed with opioid use disorder and of babies born with withdrawal symptoms increased from 2010-2017. Identifies rural, white, and Medicaid populations with the highest rates of maternal opioid-related diagnoses and neonatal abstinence syndrome. (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - January 12, 2021 Category: Rural Health Source Type: news

North Carolina simplifies medicaid enrollment, improves coverage for pregnant women
(American Academy of Family Physicians) North Carolina did not expand Medicaid eligibility under the ACA, which continued to put many low-income women at risk for losing health care coverage post partum. The state did comply with ACA standards for simplifying Medicaid enrollment. By automating the process and removing a stringent and often cumbersome financial assessment process, more low-income women qualified for full Medicaid and reduced the number of women who instead qualified for more limited benefits under the state's Medicaid for Pregnant Women program. (Source: EurekAlert! - Medicine and Health)
Source: EurekAlert! - Medicine and Health - January 12, 2021 Category: International Medicine & Public Health Source Type: news

Transforming U.S. Mental Health System Is Possible; Broad Changes Will Be Needed to Improve Access and Quality
Conditions are ripe for transforming the U.S. mental health care system, with scientific advances, the growth of Medicaid, and political consensus on the importance of improving mental health creating the possibility that goals once thought out of reach may be possible. (Source: RAND)
Source: RAND - January 11, 2021 Category: Health Management Authors: RAND Corporation Source Type: news

An 11th-Hour Approval for Major Changes to Medicaid in Tennessee
The Trump administration ’s move, which Biden could eventually reverse, would loosen program rules and cap the state’s funding as part of a block grant. (Source: NYT)
Source: NYT - January 9, 2021 Category: American Health Authors: Margot Sanger-Katz Tags: Medicaid Tennessee Health and Human Services Department Verma, Seema Source Type: news

Tennessee is 1st to be approved for Medicaid block grant
Gov. Bill Lee says Tennessee has become the first state in the nation to be approved to receive funding in a lump sum for its Medicaid program through a block grant program (Source: ABC News: Health)
Source: ABC News: Health - January 8, 2021 Category: Consumer Health News Tags: Health Source Type: news

Affordable Care Act Reduced Income Inequality in United States
FRIDAY, Jan. 8, 2021 -- The Affordable Care Act (ACA) has reduced income inequality, with a larger decrease in states that expanded Medicaid, according to a study published in the January issue of Health Affairs. Matthew Buettgens, Ph.D., from the... (Source: Drugs.com - Pharma News)
Source: Drugs.com - Pharma News - January 8, 2021 Category: Pharmaceuticals Source Type: news

With New Majority, Here ’s What Democrats Can (and Can’t) Do on Health Care
Senate control opens up new possibilities, but the party will still need to contend with arcane rules and the challenges of a narrow majority. (Source: NYT)
Source: NYT - January 7, 2021 Category: American Health Authors: Sarah Kliff and Margot Sanger-Katz Tags: Patient Protection and Affordable Care Act (2010) Law and Legislation Health Insurance and Managed Care Medicare Medicaid United States Politics and Government Source Type: news

CMS Issues New Roadmap for States to Address the Social Determinants of Health to Improve Outcomes, Lower Costs, Support State Value-Based Care Strategies
The Centers for Medicare and Medicaid Services (CMS) issued guidance to state health officials describing how to adopt strategies that address the social determinants of health (SDOH) in Medicaid and the Children's Health Insurance Program (CHIP). Discusses how SDOH exacerbate health disparities among a variety of populations, including rural communities, and the guidance aims to help states improve population health and reduce costs. (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - January 7, 2021 Category: Rural Health Source Type: news

Price Transparency: A Gift To Americans In The New Year
On January 1, a new rule from the Centers for Medicare and Medicaid Services went into effect requiring hospitals to publish the prices they negotiate with insurers for various medical procedures. This rule will inject some sorely needed transparency into the U.S. healthcare system. (Source: Forbes.com Healthcare News)
Source: Forbes.com Healthcare News - January 4, 2021 Category: Pharmaceuticals Authors: Sally Pipes, Contributor Tags: Policy /policy Business /business Innovation /innovation Healthcare /healthcare sallypipesblog Source Type: news

CMS: Agency Information Collection Activities: Submission for OMB Review; Comment Request
The Centers for Medicare and Medicaid Services is seeking comment two information collections: 1) Solicitation for Applications for Medicare Prescription Drug Plan 2022 Contracts and 2) CMS Plan Benefit Package (PBP) and Formulary CY 2022 to collect plan bids to establish Medicare Advantage and Prescription Drug plan benefit package options for the next contract year. Comments are due by February 3, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - January 4, 2021 Category: Rural Health Source Type: news

GAO: Request for Medicaid and CHIP Payment and Access Commission (MACPAC) Nominations
The Government Accountability Office (GAO) is accepting nominations for appointment to the Medicaid CHIP Payment and Access Commission (MACPAC). Appointments are effective May 2021. Letters of nomination and resumes are due by January 26, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - January 4, 2021 Category: Rural Health Source Type: news

IHS: Reimbursement Rates for Calendar Year 2021
Notice from the Indian Health Service (IHS) announcing the calendar year 2021 reimbursement rates for inpatient and outpatient care provided to Medicare, Medicaid, and other federal program beneficiaries by IHS facilities. The updated rates apply to all qualifying services provided on or after January 1, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - December 31, 2020 Category: Rural Health Source Type: news

CMS: Medicare Program; Secure Electronic Prior Authorization For Medicare Part D
Notice of final rule from the Centers for Medicare and Medicaid Services (CMS) adopting a new standard for the Medicare Prescription Drug Benefit program's (Part D) e-prescribing program as required by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT for Patients and Communities Act). This rule amends regulations to require Part D plan sponsors to support a National Council for Prescription Drug Programs (NCPDP) SCRIPT standard for use in certain electronic prior authorization transactions. This rule is effective February 1, 2021. (Source: Federal R...
Source: Federal Register updates via the Rural Assistance Center - December 31, 2020 Category: Rural Health Source Type: news

CMS: Medicaid Program: Establishing Minimum Standards in Medicaid State Drug Utilization Review and Supporting Value-Based Purchasing for Drugs Covered in Medicaid, Revising Medicaid Drug Rebate and Third Party Liability Requirements
Notice of final rule from the Centers for Medicare and Medicaid Services (CMS) regarding regulatory changes to support state flexibility to enter into value-based purchasing arrangements (VBPs) with manufacturers. This rule also implements provisions of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act designed to reduce opioid-related fraud, misuse, and abuse through the Medicaid Drug Utilization Review (DUR) program. This rule is effective March 1, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - December 31, 2020 Category: Rural Health Source Type: news

Medicaid to Cover Routine Costs for Patients in Trials Medicaid to Cover Routine Costs for Patients in Trials
A federal COVID relief/annual spending package mandates that all state Medicaid programs cover routine expenses related to clinical trials. The order comes during an expansion of Medicaid's population.Medscape Medical News (Source: Medscape Hematology-Oncology Headlines)
Source: Medscape Hematology-Oncology Headlines - December 30, 2020 Category: Cancer & Oncology Tags: Hematology-Oncology News Source Type: news

CMS: Agency Information Collection Activities: Proposed Collection; Comment Request
The Centers for Medicare and Medicaid Services (CMS) is seeking comments on the following information requests: 1) State Permissions for Enrollment in Qualified Health Plans in the Federally-Facilitated Exchange& Non-Exchange Entities and 2) Transparency in Coverage. Comments are due by March 1, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - December 30, 2020 Category: Rural Health Source Type: news

Public Inspection: CMS: Medicare Program; Secure Electronic Prior Authorization For Medicare Part D
Pre-publication notice of final rule from the Centers for Medicare and Medicaid Services (CMS) adopting a new standard for the Medicare Prescription Drug Benefit program's (Part D) e-prescribing program as required by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT for Patients and Communities Act). This rule amends regulations to require Part D plan sponsors to support a National Council for Prescription Drug Programs (NCPDP) SCRIPT standard for use in certain electronic prior authorization transactions. This rule is effective 60 days after public...
Source: Federal Register updates via the Rural Assistance Center - December 30, 2020 Category: Rural Health Source Type: news

CHART Model Community Transformation Track Application Deadline Extension
The Centers for Medicare and Medicaid Services (CMS) extended the Community Health Access and Rural Transformation (CHART) Model Community Transformation Track application deadline to March 16, 2021. The Community Transformation Track will provide funding to up to 15 rural communities to design systems of care that improve access to high quality care that is sustainable and value-based. (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - December 30, 2020 Category: Rural Health Source Type: news

Obamacare, in Its First Big Test as Safety Net, Is Holding Up So Far
Job losses and the loss of insurance have typically gone hand in hand. This year, more Americans are staying covered. (Source: NYT)
Source: NYT - December 29, 2020 Category: American Health Authors: Margot Sanger-Katz, Sarah Kliff and Quoctrung Bui Tags: Health Insurance and Managed Care Patient Protection and Affordable Care Act (2010) Recession and Depression Layoffs and Job Reductions Medicaid Source Type: news

Spotlight on Policy: Will the Election Change PALTC Practices?
With 2020 now over — thank goodness — the thinking now shifts to what the rest of the COVID-19 pandemic and the post-pandemic world will look like. In the midst of unpredictable change due to the pandemic, there also will be a changeover in the White House and the federal agencies. That means there will be a new s ecretary for the Department of Health& Human Services (HHS) as well as a new administrator for the Centers for Medicare& Medicaid Services (CMS). (Source: Caring for the Ages)
Source: Caring for the Ages - December 29, 2020 Category: Health Management Tags: News From the Society Source Type: news

To Prescribe or Deprescribe Statins, That Is the Question
The treatment of elevated cholesterol, particularly with β-hydroxy β-methylglutaryl-CoA (HMG-CoA) reductase inhibitors, commonly known as statins, is measured by the Centers for Medicare& Medicaid Services in various different ways. Statin Use in Persons With Diabetes (SUPD), a new Medicare Part D star measure in 2019, was listed as measure D14 in 2020; it calculates the percentage of patients between 40 and 75 years old who received at least two diabetes medication fills and also received a statin medication during the measurement period. (Source: Caring for the Ages)
Source: Caring for the Ages - December 29, 2020 Category: Health Management Authors: Jeanne Manzi Source Type: news

CMS Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; New Categories for Hospital Outpatient Department Prior Authorization Process; Clinical Laboratory Fee Schedule: Laboratory Date of Service Policy; Overall Hospital Quality Star Rating Methodology; Physician-owned Hospitals; Notice of Closure of Two Teaching Hospitals and Opportunity To Apply for Available Slots, Radiation Oncology Model; and Reporting Requirements for Hospitals and Critical Access Hospitals (CAHs) to Report COVID-19 Therapeutic Inventory and Usage and to Report Acute Respiratory Illness During the Public Health Emergency (PHE) for Coronavirus Disease 2019 (COVID-19)
Notice of final rule with comment period and interim final rule with comment period from the Centers for Medicare and Medicaid Services (CMS). The final rule revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2021, updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program, and establishes and updates the Overall Hospital Quality Star Rating beginning with the 2021 calendar year, among other things. The interim final rule modifies the Radi...
Source: Federal Register updates via the Rural Assistance Center - December 29, 2020 Category: Rural Health Source Type: news

Mediation has failed in Kentucky's Medicaid contract lawsuit
The tangled dispute over who gets to administer the state's more than $8 billion Medicaid program is back before a Franklin Circuit Court judge. (Source: bizjournals.com Health Care:Physician Practices headlines)
Source: bizjournals.com Health Care:Physician Practices headlines - December 28, 2020 Category: American Health Authors: Chris Larson Source Type: news

Public Inspection: CMS: Medicaid Program: Establishing Minimum Standards in Medicaid State Drug Utilization Review and Supporting Value-Based Purchasing for Drugs Covered in Medicaid, Revising Medicaid Drug Rebate and Third Party Liability Requirements
Pre-publication notice of final rule from the Centers for Medicare and Medicaid Services (CMS) regarding regulatory changes to support state flexibility to enter into value-based purchasing arrangements (VBPs) with manufacturers. This rule also implements provisions of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act designed to reduce opioid-related fraud, misuse, and abuse through the Medicaid Drug Utilization Review (DUR) program. This rule is effective 60 days publication of this notice in the Federal Register, which is scheduled for December 3...
Source: Federal Register updates via the Rural Assistance Center - December 28, 2020 Category: Rural Health Source Type: news

CMS: Medicare Program; CY 2021 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Medicaid Promoting Interoperability Program Requirements for Eligible Professionals; Quality Payment Program; Coverage of Opioid Use Disorder Services Furnished by Opioid Treatment Programs; Medicare Enrollment of Opioid Treatment Programs; Electronic Prescribing for Controlled Substances for a Covered Part D Drug; Payment for Office/Outpatient Evaluation and Management Services; Hospital IQR Program; Establish New Code Categories; Medicare Diabetes Prevention Program (MDPP) Expanded Model Emergency Policy; Coding and Payment for Virtual Check-in Services Interim Final Rule Policy; Coding and Payment for Personal Protective Equipment (PPE) Interim Final Rule Policy; Regulatory Revisions in Response to the Public Health Emergency (PHE) for COVID-19; and Finalization of Certain Provisions from the March 31st, May 8th and September 2nd Interim Final Rules in Response to the PHE for COVID-19
Notice of final rule and interim final rule from the Centers for Medicare and Medicaid Services. The final rule includes changes to Medicare Part B payment policies to ensure that payment systems are updated to reflect changes in medical practice, relative value of services, and changes in the statute; Medicare Shared Savings Program requirements; Medicaid Promoting Interoperability Program requirements for Eligible Professionals; updates to the Quality Payment Program; Medicare coverage of opioid use disorder services furnished by opioid treatment programs; Medicare enrollment of Opioid Treatment Programs; payment for off...
Source: Federal Register updates via the Rural Assistance Center - December 28, 2020 Category: Rural Health Source Type: news

CMS: Agency Information Collection Activities: Submission for OMB Review; Comment Request
The Centers for Medicare and Medicaid Services is seeking comment on the following information collections: 1) Application for Enrollment in Medicare the Medical Insurance Program; 2) Request for Retirement Benefit Information; 3) Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP); 4) Fast Track Appeals for Notice of Medicare Non-Coverage and Detailed Explanation of Non-Coverage and how to file the appeals request. Comments are due by January 22, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - December 23, 2020 Category: Rural Health Source Type: news