CMS Lets Drug Makers Access More Data Under Final Coverage Gap Discount Agreement

CMS responded to drug makers comments about the Coverage Gap Discount Program manufacturer agreement in an Aug. 3, 2010 memo, obtained by Inside Health Policy, and will allow drug makers greater access to prescription drug data, but not to the extent industry had asked for. CMS also said in the document that the sole exception [...]

CMS Actuaries: Trustees’ Report ‘Unduly Optimistic’ About Medicare’s Future

If Thursday’s report by the Medicare board of trustees on the program’s financial outlook seemed too optimistic, a presentation Friday by Centers for Medicare and Medicaid Services (CMS) Chief Actuary Richard Foster offered what may be a more realistic assessment.
The trustees said Thursday that about $575 billion over 10 years in Medicare savings generated by [...]

New Medicare Rules May Curb Use of Anemia Drugs for Dialysis

Yet more restrictions in the use of anemia drugs are on the way.
Medicare issued final rules Monday that are expected to sharply curtail the use of anemia drugs, particularly Amgen’s Epogen, in the treatment of patients undergoing kidney dialysis.
However, after getting lots of protest, Medicare decided to exempt certain [...]

New Health Official Faces Hostility in Senate

WASHINGTON — Unlike many other health policy experts, Dr. Donald M. Berwick, the new chief of Medicare and Medicaid, has extensive real world experience.
As co-founder of the Institute for Healthcare Improvement in Cambridge, Mass., he worked with doctors and nurses to upgrade care at hundreds of hospitals [...]

ESRD Rule Delays Bundling Oral Drugs; Keeps 5% Cut To Dialysis Centers

In a win for drug makers, CMS is waiting three years to bundle reimbursement of oral treatments for end stage renal disease that have have no injectible equivalents. Biopharmaceutical companies Amgen and Genzyme had lobbied for a delay, using a health reform law provision to bolster their argument. Big dialysis companies did not fair as [...]

Editorial: The public deserves a hearing for a Medicare appointee

“I CAN’T PLAY political games on these issues. I’ve got a government to run,” President Obama said in explaining his move to sidestep the Senate and use a recess appointment to install Donald Berwick to run Medicare and Medicaid. Mr. Obama’s hurry would have been more understandable had he not waited for more than a [...]

GOP spoiling for fight over Berwick appointment

On July 19, the White House sent to the Senate the nomination of Donald Berwick to be the top administrator of Medicare and Medicaid. The move seemed odd, given that President Obama had already nominated Berwick once, and then on July 7 used executive authority to bypass lawmakers and unilaterally appoint Berwick to the post [...]

Berwick’s Renomination Termed A ‘Technicality,’ Questions Remain

The White House hit the reset button Monday on Donald Berwick, renominating him for the post of CMS administrator after President Obama used a recess appointment to install the pediatrician as Medicare chief, with some observers speculating the move will help the controversial new CMS chief try to build a rapport with moderate Republicans as [...]

Pharmacists Seek Transition Period For Reform Law’s Dispensing Cycle Mandate

Pharmacy groups are urging CMS to be flexible as it implements the health reform law’s mandate for a shorter-cycle pharmaceutical dispensing technique aimed at alleviating waste, saying the new requirement will be costly for them to implement and dramatically change their business. Long-term care pharmacists say the requirement should only apply to expensive generic drugs, [...]

Senators Urge Medicare Officials to Focus on Anti-Fraud Efforts

Senators prodded Centers for Medicare and Medicaid Services officials in a hearing Thursday to do more to stop the Medicare program’s loss of tens of billions of dollars every year in fraud or improper payments.
“Sixty billion a year in fraud is simply unacceptable,” said Amy Klobuchar, D-Minn., referring to one estimate.
CMS officials are in the [...]

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