The Daily Scan

June 27, 2018

Last Updated: 1:40 PM EST

Legislation

  • HHS Secretary Alex Azar testified yesterday before the Senate Finance Committee on "Prescription Drug Affordability and Innovation: Addressing Challenges in Today’s Market". Azar stated: "From Day One of his administration, President Trump has directed HHS to make drug pricing a top priority. Too many of our family members, neighbors, and friends have worked hard their entire lives only to see their savings wiped out just to afford drugs they need to live." (Finance.Senate.gov)

Litigation

  • In the case of National Institute of Family and Life Advocates, et al. v. Becerra, Attorney General of California, et al., the U.S. Supreme Court ruled yesterday that the California Reproductive Freedom, Accountability, Comprehensive Care, and Transparency Act (FACT Act), that was enacted to regulate crisis pregnancy centers, violates First Amendment rights, and that pro-life centers are not required to recommend services that violate their religious beliefs. The FACT Act previously required all licensed clinics that primarily serve pregnant women to notify women that California provides free or low-cost services, including abortions. (SupremeCourt.gov)

Medicaid

  • The U.S. Government Accountability Office (GAO) released a new study today on "Actions Needed to Mitigate Billions in Improper Payments and Program Integrity Risks" in the Medicaid program. The study identified three broad areas of risk in Medicaid that also contribute to overall growth in program spending, including improper payments, supplemental payments, and demonstrations. (GAO.gov)

 

Regulation

  • The Centers for Medicare and Medicaid Services (CMS) announced new and enhanced initiatives designed to improve Medicaid program integrity through greater transparency and accountability, strengthened data, and innovative and robust analytic tools. CMS Administrator Seema Verma has set forth three pillars to guide CMS’ work in the Medicaid program: Flexibility, Accountability, and Integrity. In a prepared statement, she expanded on the role of CMS saying, “As we give states the flexibility they need to make Medicaid work best in their communities, integrity and oversight must be at the forefront of our role. (CMS.gov)

 

  • HHS OIG released a new study yesterday as part of the annual reporting mandate from the Patient Protection and Affordable Care Act (ACA). The study revealed that Medicare Part D plans generally include drugs commonly used by dual eligibles. For this report, OIG determined whether the 386 unique formularies used by the 3,476 Part D plans operating in 2018 cover the 200 drugs most commonly used by dual eligibles. OIG also determined the extent to which plan formularies applied utilization management tools to those commonly used drugs. (OIG.HHS.gov)

Private Sector

  • Mayo Clinic and Blue Cross and Blue Shield of Minnesota (Blue Cross) have announced a new agreement that will keep all Mayo locations across Minnesota in the Blue Cross provider network through 2023. The agreement, which takes effect on Jan. 1, 2019, is structured to offer comprehensive clinical strategies that support the health of the population in southern Minnesota and maintain ongoing support of complex specialty care provided by Mayo Clinic. By ensuring access to Mayo Clinic’s clinical and diagnostic expertise for patients with complex medical conditions and needs, this agreement will help Blue Cross members with commercial or government coverage reduce avoidable costs caused by misdiagnoses or unnecessary treatment plans. (MayoClinic.org)

 

 

 

 

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