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CMS Issues Proposed Rule to Establish National Medicare Coverage Pathway for Medical Devices with Breakthrough Designation and Modifies Definition of “Reasonable and Necessary”

Today, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to establish a Medicare coverage pathway for medical devices designated as breakthrough by the Food and Drug Administration (FDA). The new proposed Medicare Coverage of Innovative Technology (MCIT) pathway would significantly accelerate Medicare coverage of new breakthrough devices by beginning national coverage [...] Read More

Congress Reaches a Deal on the Next COVID-19 Package

Senate leaders have recently announced that Congress has reached a deal on an additional COVID-19-driven funding package, the Paycheck Protection Program and Health Care Enhancement Act. This recent funding package replenishes a loan program for small businesses impacted by the coronavirus outbreak, but also includes funding related to COVID-19 testing. Dubbed CARES 3.5, this deal [...] Read More

MACPAC Reviews Medicaid Formularies; Reviews Successful Programs for Integrated Care for Dual-Eligibles in September 2019 Meeting

Applied Policy in the News x Meet the Team x Philanthropy x On September 26 and 27, 2019, MACPAC held the first meeting of their new 2019-2020 term. This meeting covered several sessions on topics of importance to the Medicaid program, including discussion on integrated care for dual-eligibles, Medicaid formularies, and oversight of directed payments. [...] Read More

President Trump Hints at Possible Drug Pricing Executive Order

Tweet President Trump announced on July 5 that he is planning to release an Executive Order that would enact a “most favored nation” requirement for prescription drug manufacturers. It was not immediately clear how this Executive Order would differ from the International Pricing Index proposal for Medicare that is currently under review with the Office [...] Read More

Challenges Facing Congress in Rural Health Care Reform

The Centers for Disease Control (CDC) website includes a photograph that shows what can only be described as an idealized version of rural America: a beckoning country lane leading past well-fed, grazing cattle to a large, beautifully maintained and attractively landscaped house and barn. But the statistics superimposed over this bucolic scene reveal a very [...] Read More

Veteran’s Administration Releases Two New Final Rules, Aims to Enable Greater Access to Services and Reduce Wait-Times

Overview On Wednesday June 5, 2019 The Veteran’s Health Administrated released two final rules: the Veterans Community Care Program (VCCP) and Urgent Care. These final rules enable eligible veterans to receive hospital care, medical services, and urgent care services from eligible providers when certain criteria are met. The rule becomes effective June 6, 2019. Veterans [...] Read More

Verma Announces Plan to Foster Innovation for Transformative Medical Technologies

On May 2, CMS Administrator Seema Verma announced the Trump Administration’s “comprehensive strategy” to foster innovation for and improve patient’s access to transformative medical technologies. The strategy, detailed by Administrator Verma in a speech at the Medical Device Manufacturers Association (MDMA) Annual Meeting, is based on two specific changes related to coding. CMS says that [...] Read More