Billy Wynne

HHS, Labor, and Treasury Release Updated Guidance on No Surprises Act Implementation: Federal IDR Process The Departments of Labor, Health and Human Services (HHS), and the Treasury, along with the Office of Personnel Management (OPM), released guidance documents explaining changes to the implementation of the No Surprises Act (NSA), in light of district court decisions…

Commissioners Discuss Potential Reforms to Physician Fee Schedule Updates The Medicare Payment Advisory Commission (MedPAC) convened a session to discuss long-term considerations for payment under the Medicare Physician Fee Schedule (PFS). This work is separate from the Commission’s annual payment adequacy work which will begin in December. MedPAC staff, including Principal Policy Analyst Geoff Gernhardt…

Commission Discusses How to Evaluate Site Neutral Payment for Nonqualifying Conditions at IRFs and SNFs  The Medicare Payment Advisory Commission (MedPAC) held a meeting to discuss its research on an alternative method to establish Medicare payments for conditions treated in inpatient rehabilitation facilities (IRFs). Following MedPAC’s chapter on an aligned post-acute care (PAC) payment system…

Agencies Extend COVID-19 Telemedicine Flexibilities Through December 31, 2024 The Drug Enforcement Agency (DEA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) jointly issued a second temporary rule that extends the full set of COVID-19 telemedicine flexibilities for prescription of controlled medications through December 31, 2024. What is it. The agencies note that…

Generic Drug Work Plan Discussed; Commissioners Suggest Exploring Specialty Generics and Vertical Integration The Medicare Payment Advisory Commission (MedPAC) convened a session to discuss the Commission’s workplan to analyze generic drug prices in Medicare Part D. MedPAC staff detailed that the Commission is currently examining generic drug prescription drug event (PDE) data, as well as…

AHRQ Issues Supplemental Evidence and Data Request on Mental Health and Occupational Stress in the Emergency Medical Service and 911 Workforce The Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Centers (EPC) Program issued a request for supplemental evidence and data submissions (SEADs) to inform its review on Mental Health and Occupational Stress in…

Agency Suggests That CMS Explore Policies to Reduce Prices of Biosimilars and Part B Biologics The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) released a report showing that biosimilar competition has led to lower costs for the Medicare Part B program and enrollees. Part B drugs are usually large, complex…

Senate HELP Ranking Member Cassidy Seeks Stakeholder Input on NIH Reform; Due Oct. 27 On Friday, Senate Health, Education, Labor, and Pensions (HELP) Committee Ranking Member Bill Cassidy (R-OA) announced a request for stakeholder input to inform potential reforms to the National Institutes of Health (NIH) in areas such as increasing the pace of science, organizing NIH…

Agency Estimates CMMI Increased Federal Spending by $5.4 Billion From 2011 through 2020; Agency Expected to Increase Spending by $1.3 Billion from 2021 to 2030 The Congressional Budget Office (CBO) released an updated estimate that indicates the Center for Medicare and Medicaid Innovation (CMMI), established under the Affordable Care Act (ACA) to explore innovative health…

Agency Releases New Medicaid Information and Questions for Public Comment on Mental Health Parity, Due December 4th Today, the Centers for Medicare and Medicaid Services (CMS) released multiple pieces of information for states and stakeholders. The release, described in full below, includes a letter reinforcing the continuous eligibility requirement for individuals 19 and under; additional…