CMS Guide Foresees Increased Use Of CED, Even In Local Coverage Calls

CMS Guide Foresees Increased Use Of CED, Even In Local Coverage Calls-insidehealthpolicy: CMS signals plans to increasingly rely on coverage with evidence development (CED) in a final guidance that backs away from an earlier expectation that the agency would only use the policy infrequently as new technologies were presented for coverage early in the development process.

Health Jobs Keeping Growing

Health Jobs Keeping Growing-politicopro: The economy is expected to add all sorts of health care workers in the future, and that includes nonclinical workers like patient representatives, community health workers or medical records technicians, says a report from the College for America at Southern New Hampshire University. These types of jobs comprise 42 percent of the health care workforce, and demand for them is expected to keep growing as care becomes more team-based and patient-centered, the report says.

Obama Would Veto Corporate Tax Cut Bill

Obama Would Veto Corporate Tax Cut Bill-rollcall: President Barack Obama would veto an emerging $450 billion tax cut deal coming together in the Senate, according to the White House.

House Lawsuit Goes After ACA Cost Sharing

House lawsuit goes after ACA cost sharing-politicopro: The complaint contends the health care law requires cost-sharing payments from the insurers — presumably with the understanding that the government would repay them — but doesn’t make those payments contingent on the government and Congress appropriating the funding.

Upton Pushes For 'Cures' Bill To Be On House Floor By Memorial Day

Upton Pushes For 'Cures' Bill To Be On House Floor By Memorial Day: Rep. Fred Upton (R-MI) told patient and pharmaceutical groups Friday (Nov. 21) that he is pressing for the long-anticipated 21st Century Cures bill to be on the House floor before Memorial Day and on the president's desk by the end of 2015.

Jason Chaffetz Promises Less Personal Oversight

Jason Chaffetz Promises Less Personal Oversight-politicopro: Chaffetz said in an interview on Wednesday that he would focus on how to fix the Secret Service, embassy security and mundane tasks like U.S. Postal Service reform.

HHS Acknowledges Error In Enrollment Numbers, Says 6.7M Effectuated

HHS Acknowledges Error In Enrollment Numbers, Says 6.7M Effectuated-insidehealthpolicy: HHS on Thursday (Nov. 20) acknowledged that it overstated enrollment by nearly half a million people because it had included both dental and medical health plans in recent numbers, and affirmed that there were 6.7 million people enrolled in health plans as of Oct. 15, or 400,000 less than previously asserted.

W&M Health Chair Floats Major CMS Hospital Reforms, Including Short-Stay Pay Plan

W&M Health Chair Floats Major CMS Hospital Reforms, Including Short-Stay Pay Plan-insidehealthpolicy: House Ways & Means health subcommittee Chair Kevin Brady (R-TX) late Wednesday floated a broad-based legislative plan to dramatically overhaul CMS' payment and oversight of hospitals.

Few Employers Dropping Health Benefits, Surveys Find

Few Employers Dropping Health Benefits, Surveys Find-washingtonpost: Two major surveys released Wednesday found that the Affordable Care Act has not thus far caused many employers to drop health benefits for their workers, as critics of the law had predicted.  

Pallone Takes Energy & Commerce Ranking Slot In Full Caucus Vote

Pallone Takes Energy & Commerce Ranking Slot In Full Caucus Vote-insidehealthpolicy: New Jersey Rep. Frank Pallone eked out a surprise 100-90 victory in battle against Rep. Anna Eshoo (CA) for the ranking Democratic slot on the influential Energy & Commerce Committee, in a blow to House Minority Leader Nancy Pelosi (D-CA) who supported Eshoo but has also been the focus of Democratic grumbling following the party's crushing election defeats.

CMS Creates New Office For Data Analytics, Names New Chief Data Officer

CMS Creates New Office For Data Analytics, Names New Chief Data Officer-insidehealthpolicy: CMS announced Wednesday (Nov. 19) that it has created an Office of Enterprise Data and Analytics (OEDA) that will be tasked with overseeing improvements in data collection and dissemination

As California Expands Medicaid To New Beneficiaries, Many Others Are Dropped

As California Expands Medicaid To New Beneficiaries, Many Others Are Dropped-kaiserhealthnews: California expanded Medicaid under the ACA, and has enrolled 2.7 million low-income residents in Medi-Cal in 2014, but the state may also drop an abnormally high number of beneficiaries from its Medicaid program by the end of the year.

Paul Ryan Selected to Chair Ways and Means Committee

Paul Ryan Selected to Chair Ways and Means Committee-AP: The Wisconsin Republican will take over the chamber's tax-writing panel—a post that could boost his national profile ahead of a possible presidential bid.

Chaffetz Wins Four-Way Showdown for Oversight Gavel

Chaffetz Wins Four-Way Showdown for Oversight Gavel-rollcall: There were hardly any surprises among the Republican Steering Committee’s picks for chairmen in the 114th Congress, but the one major question decided on Tuesday was who would lead the Oversight and Government Reform Committee. And the answer is Rep. Jason Chaffetz, R-Utah.

Eshoo, Pallone Go To Full Dem Caucus For Vote On E&C Ranking Dem Slot

Eshoo, Pallone Go To Full Dem Caucus For Vote On E&C Ranking Dem Slot-insidehealthpolicy: In a fight that could be an early test of House Minority Leader Nancy Pelosi's sway following a tumultuous election, Reps. Anna Eshoo (D-CA) and Frank Pallone (D-NJ) will go to the full Democratic caucus Thursday morning for a vote on who will become the ranking member of the powerful Energy and Commerce Committee that will steer key health policy issues in the House for the next congressional session.

How The Supreme Court Can Kill Obamacare Without Overturning It

How The Supreme Court Can Kill Obamacare Without Overturning It-nationaljournal: The legal challenge over the law's insurance subsidies could tear apart several sections of the Affordable Care Act, setting off an insurance "death spiral" that could make the law unworkable in more than half the country. That's because the subsidies are part of a complex, interwoven set of policies that aim to balance out each state's insurance market.

CMS Releases Rates Dataset, But Comparisons Difficult

CMS Releases Rates Dataset, But Comparisons Difficult-politicopro:  Leading up to the first exchange open enrollment period last October, HHS published a report on weighted average premiums for the so-called 2014 benchmark plan — the silver plan. HHS and CMS did not release comparable figures for 2015 premiums on Friday.

Advocates Of State 'Right To Try' Laws Eye Texas As Next Battleground

Advocates Of State 'Right To Try' Laws Eye Texas As Next Battleground-insidehealthpolicy:  A key advocate of state "right to try" laws views Texas as the next battleground for legislation, already passed by five states, that would let seriously ill patients access experimental drugs, outside the FDA approval process, following phase I trials.

Sander Levin wants to stay as top Democrat on Ways and Means

Sander Levin wants to stay as top Democrat on Ways and Means-politicopro:  Rep. Sandy Levin has officially declared he’ll seek another term as the top Democrat on the influential House Ways and Means Committee.  In a letter to colleagues on Wednesday, Levin told Democrats he would push ardently for tax policies that reform corporate tax inversions and trade negotiations.

States slow to recoup money for botched Obamacare sites

States slow to recoup money for botched Obamacare sites-politicopro: Some of the states that built Obamacare exchanges wasted tens of millions of dollars paying contractors to build websites that ultimately didn’t work. Some are still trying to get the money back but not very aggressively.  And like most issues that concern the health law, state efforts to recover money from the botched exchanges are clouded by political accusations. With the second enrollment season getting underway this weekend, only a handful of states have recovered payments over last fall’s fiasco. Most are seeking quiet settlements rather than going to court. Some haven’t made much of an effort at all, leading critics of the Affordable Care Act to charge that Democratic officials are covering up their own culpability.

Mitch McConnell Unanimously Elected Majority Leader by GOP

Mitch McConnell Unanimously Elected Majority Leader by GOP-rollcall: Senate Republicans have unanimously elected Mitch McConnell to be majority leader

Pitching Obamacare the 2015 way

Pitching Obamacare the 2015 way-politicopro: At this point last year, President Barack Obama had talked up Obamacare on “Leno.” He tweeted about it with Katy Perry, asked ministers to pitch it to their flocks and dispatched top officials and celebrities to spread the Obamacare word.  This year? Silence. That’s about to change.

Ted Cruz is out on a limb on Obamacare repeal

Ted Cruz is out on a limb on Obamacare repeal-politicopro: Interviews with a wide range of key figures in the Senate and within the conservative movement show that while the party may be united rhetorically on repealing Obamacare, Republicans are surprisingly squishy on exactly how to do it.

Battle for Darrell Issa’s gavel heats up

Battle for Darrell Issa’s gavel heats up-politico:  Everyone watching the behind-the-scenes battle for the House Oversight and Government Reform Committee gavel has one question in mind: Who does John Boehner want?  Utah Rep. Jason Chaffetz, who is trying to leapfrog five more-senior members, and Ohio Rep. Mike Turner, who is No. 3 in seniority, have spent months furiously lobbying the members of the House Republican Steering Committee, which will meet next week to consider their cases.

Lame Duck Provides An Opportunity To Pass SGR Deal, Lawmakers Say

Lame Duck Provides An Opportunity To Pass SGR Deal, Lawmakers Say-insidehealthpolicy:  The GOP Doctors Caucus and more than 110 lawmakers are urging House leadership to resume negotiations on the stalled Medicare physician payment reform deal when Congress resumes following the elections, and one Democratic Ways & Means staffer said the lame duck session is a prime opportunity for Congress to pass a deal to replace the Sustainable Growth Rate before new committee leaders take over. The staffer also said that Rep. Sander Levin (MI), the ranking Democrat on Ways & Means, would like to pass the SGR deal without offsetting the entire package, though lobbyists say it is unlikely that Republicans would allow that to happen.

VA Set to Undergo Major Restructuring

VA restructuring includes customer service branch, advisory councils-militarytimes: Veterans Affairs Secretary Robert McDonald announced plans to create a chief customer service officer, simplify the agency's structure, and create a national network of veterans advisory councils.

CMS Axed Sunshine CME Exclusion, But Most Payments Still Won't Be Reported

CMS Axed Sunshine CME Exclusion, But Most Payments Still Won't Be Reported-insidehealthpolicy: Even though CMS recently scrapped a provision that had exempted continuing medical education (CME) payments from the Open Payments Program (Sunshine Law), many CME payments still won't have to be reported thanks to a clarification the agency tucked into the final 2015 physician payment rule.

AdvaMed Officially Opens Office In China, Eyes Partnerships

AdvaMed Officially Opens Office In China, Eyes Partnerships-insidehealthpolicy: The Advanced Medical Technology Association Monday (Nov. 10) officially opened its office in Shanghai, China, the medical device lobby group said, with goals of setting up partnerships with regulators and Chinese stakeholders and harmonizing ethical business practices.

Last fall’s HealthCare.gov ghosts could haunt 2015 sign-up

Last fall’s HealthCare.gov ghosts could haunt 2015 sign-up-politicopro: The second year of Obamacare’s open enrollment begins Saturday, and unresolved problems from the first season are complicating the already daunting task of enrolling millions of uninsured and re-enrolling millions more.

House, Senate at odds over extending tax breaks

House, Senate at odds over extending tax breaks-politicopro: Many rank-and-file conservatives are pushing House leaders to postpone any action on the breaks until next year when Republicans will take complete control of Congress.

Top Republicans: Get ready to make deals

Top Republicans: Get ready to make deals-politicopro: Emboldened by sweeping midterm election victories, Republican leaders are vowing not to repeat the errors of past years, when messy fiscal fights eroded public confidence in Washington and became the hallmark of the GOP-controlled House.

Federal Legislation Mulled As Fifth State Advances 'Right To Try' Initiative

Federal Legislation Mulled As Fifth State Advances 'Right To Try' Initiative-insidehealthpolicy: Arizona became the fifth state in recent months to give terminally ill patients the right to try investigational medicines that are in the early stages of clinical trials, with state voters passing a "Right to Try" ballot measure on Nov. 4.

FDA Loses Key Funding Advocate As Pryor Falls In GOP Senate Takeover

FDA Loses Key Funding Advocate As Pryor Falls In GOP Senate Takeover insidehealthpolicy: Sen. Mark Pryor (D-AR), chair of the appropriations subcommittee with jurisdiction over FDA, lost his re-election Tuesday (Nov. 4) in a move that could complicate food safety advocates' efforts to increase funding for implementation of the food safety law. Pryor's race was closely watched by FDA funding advocates because the lawmaker has been receptive to FDA funding issues.

FDA Will Face Reforms, Oversight In Republican Congress, Analysts Say

FDA Will Face Reforms, Oversight In Republican Congress, Analysts Say-thegraysheet: At least eight seats in the Senate were considered toss-ups, and candidates ran many tight races in the 2014 election. But by day’s end Nov. 4 the Republican party had captured Senate chairs up for grabs in Arkansas, Colorado, Iowa, Montana, North Carolina, South Dakota and West Virginia, adding up to 52 seats they will command in the 2015-16 congressional session. Also, the GOP captured an additional 10 House seats, solidifying their control of that chamber.

Post-Election Picture Of House Energy And Commerce Committee

Post-Election Picture Of House Energy And Commerce Committee-thegraysheet:  Ten current members of the House Energy and Commerce Committee will not be returning in January, but most of the turnover is the result of retirements and members (successfully or unsuccessfully) seeking other office. The most senior member to lose his seat in the election is Rep. Ralph Hall from Texas, who lost the Republican primary earlier this year. Rep. John Barrow, D-Ga., is the only committee member to have lost his House seat in the Nov. 4 general election, to Republican Rick Allen.

Industry Looking To New GOP Congress To Repeal Device Tax

Industry Looking To New GOP Congress To Repeal Device Tax-thegraysheet: A new report from the Congressional Research Service says companies have overestimated the negative impact of the device excise tax. But that has not stopped Republicans from citing repeal of the tax as a top priority in the next session on Congress, when they will have control of both the House and Senate.

Senate survey: It’s the GOP’s to lose

Senate survey: It’s the GOP’s to lose-politico: In the waning days of Election 2014, key Senate races that had been razor-close affairs for months have moved toward Republicans — from the open seats of Iowa and Georgia to challenges to incumbents in Arkansas and Alaska. Kentucky appeared to move off the map with Mitch McConnell — poised to replace Harry Reid as majority leader next year — opening a decisive lead.

Knowns and unknowns in the race for the House

Knowns and unknowns in the race for the House-politico: As the 2014 House election enters its final hours, this much is certain: Republicans will retain control of the chamber, and perhaps win their largest majority since the 1940s. After that, there are all sorts of wild cards. Will this election season — which already saw House Majority Leader Eric Cantor lose his primary — produce any more upsets? Will Republicans succeed in adding diversity to their ranks? Will a GOP-friendly environment enable the party to make inroads in the Northeast?

Final Doctor Pay Rule Delays Pay-Transparency Measure; Assigns First Care-Management Code Pay Rates; Finishes ACO Quality Measures

Final Doctor Pay Rule Delays Pay-Transparency Measure; Assigns First Care-Management Code Pay Rates; Finishes ACO Quality Measures-insidehealthpolicy: The final 2015 pay rule for physician services puts off pay-transparency measures until 2017; assigns the first pay rates for new care-management codes; implements Obamacare's value-based pay modifier; finishes changes to several quality reporting initiatives, including for accountable care organizations; and combines pay for sedation and colonoscopy to avoid surprising seniors with copays for screening that is supposed to be free.