Billy Wynne

Agencies Issue Final Merger Guidelines Aimed at Preserving Competition and Protecting Consumers The Department of Justice (DOJ) and the Federal Trade Commission (FTC) jointly released the 2023 Merger Guidelines, which outline and guide their review of mergers and acquisitions (M&A) to ensure compliance with federal antitrust laws (press release). The Merger Guidelines aim to better…

Agency Finds That Only 18% of Medicare Beneficiaries With Opioid Use Disorder Received Medication Treatment The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) released a report on the percentage of Medicare enrollees who receive medication to treat their opioid use disorder (OUD).OIG highlights that opioid-related overdose deaths remain at a…

Departments Finalize IDR Administrative Fee Amount and Methodology, Certified IDR Entity Fee Ranges The Departments of Treasury, Labor, and Health and Human Services (HHS) (the Departments) released a final rule to establish the independent dispute resolution (IDR) administrative fee amount and methodology, and the certified IDR entity fee ranges for single and batched determinations. The…

Commissioners Discuss MMPs and the Future of Integrated Plans for Dually Eligible Beneficiaries The Medicaid and CHIP Payment and Access Commission (MACPAC) convened a panel discussion to consider the transition from Medicare-Medicaid Plans (MMPs) to Dual Eligible Special Needs Plans (D-SNPs) and the future of integrated care for individuals who are dually eligible for Medicare…

Commission Staff Presents Data Update on Unwinding the Continuous Coverage Provisions The Medicaid Payment and Access Commission (MACPAC) held a meeting to review reporting requirements related to the unwinding of the continuous coverage requirements in Medicaid and an update on data to monitor state progress. Background: Principal Analyst and Research Advisor Martha Heberlein presented the…

Agency Releases Toolkit to Help MA Organizations Identify Diagnosis Codes That Are At High Risk of Being Miscoded The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) released a toolkit to help Medicare Advantage (MA) organizations identify and evaluate high-risk diagnosis codes to ensure proper payments and provide better care…

Committee Examines President Biden’s Executive Order on AI and Sector-Specific Expertise in AI with Administration Officials The House Energy and Commerce (E&C) Committee convened a hearing to examine how federal agencies can leverage sector-specific expertise to navigate the evolving landscape of artificial intelligence (AI). Members discussed with Administration officials AI’s diverse applications across the health…

Revised Medicare Prescription Drug Inflation Rebate Program Guidance Clarifies Identification of Rebatable Drugs and Rebates for Drugs in Shortages The Centers for Medicare and Medicaid Services (CMS) released revised guidance (Part B Guidance and Part D Guidance) for the Medicare Prescription Drug Inflation Rebate Program (press release, fact sheet). Overall, CMS provides clarity on the…

Innovation Center Announces Changes to the MA VBID Model for 2025 The Center for Medicare and Medicaid Innovation (CMMI or Innovation Center) recently released a blog post detailing several forthcoming changes to the Medicare Advantage Value-Based Insurance Design (VBID) Model for 2025.   The Innovation Center explains that the VBID model has grown exponentially since it began…

House Passes SUPPORT Act Reauthorization Hours After Senate HELP Committee Advances Bill to the Floor Today, the House of Representatives passed the Support for Patients and Communities Reauthorization Act by a vote of 387-37. The legislation features the reauthorization of many existing programs and the following new provisions: Requires future regulations addressing opioid use to…