In the July/August 2013 RPM Report, I co-wrote an article with Avalere's Scott Gottlieb and Lauren Barnes discussing the potential to use the new technology add-on payments (NTAPs), a novel pathway created by Congress in 2001, as a foundation for new policies that support innovation and address public health goals.
At March's MedPAC meeting, staff discussed improving Medicare spending value by linking Fee-for-Service (FFS) payment to the comparative clinical effectiveness of healthcare therapies.
New Avalere analysis finds that exchange enrollment is on track to reach 5.4 million by the end of March when open enrollment is set to end. That number falls short of current Congressional Budget Office (CBO) estimates that six million people will enroll in exchanges in 2014.
MedPAC's latest public meeting was March 6 and 7 and covered topics such as equalizing payments across post-acute settings of care, improving quality measurement, exploring alternative methods to pay for Part B drugs, enhancing delivery of primary care services through payment incentives, and ways to improve payments and care delivery across Medicare fee-for-service (FFS), Medicare Advantage (MA) and Accountable Care Organization (ACOs).
The American Medical Association's (AMA) Current Procedural Terminology (CPT®) Editorial Panel (Panel) announced on March 5 its acceptance of a set of codes that will be used to report testing for large-scale, multianalyte genomic sequencing procedures typically performed using Next Generation Sequencing (NGS) technology.
On March 5, CMS released the HHS Notice of Benefit and Payment Parameters for 2015 final rule.
On Feb. 24, CMS released an advance notice of proposed rulemaking and request for comments on two potential methodology changes to adjust Medicare fee schedule payment amounts or other Medicare payment amounts for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS).
FDA will hold a public hearing on April 1 to receive feedback from key stakeholders on 1) demographic subgroup representation in clinical trials, 2) analysis of demographic subgroup data, and 3) communication of demographic subgroup information to the public.
The financial alignment demonstrations (FAD), designed to coordinate care for dual eligible beneficiaries, are gaining momentum as states begin implementation and final planning.
On March 4, President Obama released his budget for the 2015 Fiscal Year (FY). While Congress is unlikely to engage in a serious budget process this year, the president's budget expresses the administration's priorities and stands as a marker of potential healthcare offsets or "savers" for other legislative initiatives, including a repeal of the Sustainable Growth Rate (SGR).
On Feb. 28, Washington State's Health Care Authority (HCA), which administers the state's Health Technology Assessment (HTA) Program, recommended five technologies to undergo initial review and coverage decisions, and recommended one topic for re-review, beginning in 2015.
A new analysis from Avalere Health estimates that from October 2013 through January 2014, between 2.4 million and 3.5 million people have newly enrolled in Medicaid as a result of the Affordable Care Act (ACA).
On Feb. 24, FDA issued draft guidance on exclusivity determinations for certain fixed-combination drug products (FCDs).
On Feb. 19, OIG released a claims analysis of 2011 hospital inpatient Medicare cases, finding that Medicare and its beneficiaries could achieve substantial cost savings by expanding the inpatient hospital Medicare Severity Diagnosis Related Group (DRG) window.
FDA has now confirmed that the first widespread generic-drug equivalency testing program was initiated last September (without public notice).
On Feb. 21, CMS enhanced the Physician Compare website to include the addition of quality measures to indicate the performance achieved on a set number of specific metrics.
On Feb. 18, FDA released guidance outlining how an applicant can obtain FDA feedback on a potential or planned medical device submission reviewed by the Center for Devices and Radiological Health (CDRH) and the Center for Biologics Evaluation and Research (CBER), including the Pre-Submission (formerly pre-Investigational Device Exemption (pre-IDE)) program.
Last week, CMS awarded First Coast Service Options, Inc. (First Coast) the contract for the administration of Medicare Part A and Part B fee-for-service claims in Jurisdiction N, which encompasses Florida, Puerto Rico, and the U.S. Virgin Islands.
A new Avalere Health analysis finds that enrollment in Medicare Advantage (MA) plans grew substantially in 2014 versus 2013.
An Avalere Health study commissioned by the American Diabetes Association, YMCA of the USA (YMCA), in collaboration with the American Medical Association (AMA) focusing on HR 962/S 452, The Medicare Diabetes Prevention Act (MDPA), found that if enacted, the bill would save the Federal Government $1.3 billion over 10 years, and would also dramatically reduce diabetes among Medicare beneficiaries.
