Oct 2, 2019 | Drugs, Medicare, Part D
House Democrats introduced a bill to stem high and rising drug prices, as well as redesign the Part D benefit. This follows a range of proposals from the Trump Administration and a bipartisan proposal by the Senate Finance Committee. The House bill draws on both and adds a government negotiation for high-priced drugs. Click to read more.
Sep 27, 2019 | BRG Publications
In the second year of BRG Healthcare Transactions and Strategy’s annual Investment Index, we have continued to update the index by retrospectively tallying the number and type of deals we are aware of over the past eighteen months and prospectively surveying 133 investors from 85 organizations in August 2019 about areas of interest over the next year. These two sets of information provide a sense of trends in private equity healthcare investment. Click here to read the full report.
Sep 26, 2019 | Medicaid, Medicare
Starting November 5, 2019, CMS will require Medicare, Medicaid and CHIP providers to disclose any current or previous affiliation with fraudulent entities and individuals. Click to read more.
Sep 24, 2019 | Legislation/ Budgets/ Macro
The number of Americans lacking health insurance ticked up slightly last year, marking the first annual increase in the uninsured rate in nearly a decade, the US Census Bureau reported last Tuesday. The uninsured rate rose from 7.9% in 2017 to 8.5% last year, amounting to nearly 2 million more uninsured people. Click to read more.
Sep 23, 2019 | MedPAC, Post-Acute Care
Based on a Congressional mandate, MedPAC continues to explore a uniform value incentive program across post-acute sectors, where quality incentives tied to reimbursement have lagged other provider types. MedPAC’s model could form the basis for future changes, but not likely in the near term. Click to read more.
Sep 19, 2019 | Medicare, Substance Abuse
CMS has proposed adding substance use disorder (SUD) services to the Medicare fee schedule, including medication assisted therapies (MAT) for opioid treatment disorder (OUD) and expanded management and counseling services. Click to read more.
Sep 18, 2019 | Medicaid, Substance Abuse
According to an Urban Institute study, Medicaid-covered prescriptions for buprenorphine, which is used to treat opioid addiction, increased dramatically in states that expanded Medicaid. Click to read more.
Sep 17, 2019 | Hospice, Medicare, Part D
A recent OIG report found that Part D plans continue to incorrectly pay for drugs that should have been paid for by hospices under the Medicare Part A hospice benefit. Based on a sample of 2016 records, the OIG estimated that Part D plans made $160.8 million in incorrect payments, with the potential for even more. Click to read more.
Sep 12, 2019 | Inpatient Rehab (IRF), Medicare
CMS has finalized payment policies for Inpatient Rehab Facilities (IRFs) for FY2020, with limited technical adjustments from the proposed rulemaking. Click to read more.
Sep 10, 2019 | Medicaid, Skilled Nursing Facilities (SNF)
Effective October 1, 2019, the Patient Driven Payment Model (PDPM) will replace the RUG-III and RUG-IV case-mix methodologies under the Medicare SNF Prospective Payment System (PPS). These changes are likely to have implications for state Medicaid programs that use the current Medicare case mix adjustment tool for setting Medicaid nursing facility rates. Click to read more.
