Oz Dodges Medicaid Cuts But Signals Openness On MA Reductions
Dr. Mehmet Oz, nominee to be administrator of the Centers for Medicare and Medicaid Services (CMS), seems well placed to be confirmed. In a hearing, he dodged most questions on Medicaid cuts but signaled that he might favor reductions to Medicare Advantage (MA) overpayments. I have been saying this for some time now.
Oz said he is in favor of work requirements for Medicaid and removing undocumented individuals. He did not defend the Affordable Care Act (ACA) enhanced premium tax credits set to expire in 2025.
Oz appeared to agree with Sen. Elizabeth Warren, D-MA, and others at several points in the hearing that the MA program needs better reform and oversight, especially on payments. Even Sen. HELP Chairman Bill Cassidy, R-LA, appeared to agree and also raised denial of care by plans, on which Oz concurred.
Oz also said he would defend the Medicare drug price negotiation law in court, is open to international reference pricing for drugs, says pharmacy benefit manager (PBM) reform is needed, and that he has concerns on private equity’s role in healthcare.
Additional articles: https://insidehealthpolicy.com/daily-news/oz-vows-defend-medicare-price-negotiations-court-challenges-open-reference-pricing and https://www.medpagetoday.com/publichealthpolicy/medicare/114668 and https://www.beckershospitalreview.com/hospital-management-administration/dr-oz-vague-on-medicaid-cuts-in-nomination-hearing-6-notes.html and https://thehill.com/homenews/ap/ap-politics/ap-mehmet-oz-senate-hearing-cms/?tbref=hp and https://www.modernhealthcare.com/politics-policy/mehmet-oz-confirmation-hearing-cms and https://www.healthcaredive.com/news/dr-oz-cms-nominee-support-medicaid-work-requirements/742605/
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#oz #cms #healthcare #coverage #healthcarereform #medicare #medicareadvantage #medicaid #workrequirements #fwa #overpayments #priorauthorization #exchanges #obamacare #pbms #ira #drugpricing #branddrugmakers #privateequity
All 15 Brand Drug Makers Will Negotiate In Second Round
The Centers for Medicare and Medicaid Services (CMS) announced that all 12 brand drug manufacturers will participate on Medicare drug price negotiations in the second round. There is some dispute about the fact that there are more than 15 drugs included. This could be the subject of a court fight.
#ira #cms #drugpricing #branddrugmakers
Government Shutdown Averted
Senate Democrats supplied enough votes to allow a procedural vote to pass with 60 votes to clear the way for a final vote on the continuing resolution (CR). The CR passed on a vote of 54 to 46, with two Democrats supporting and one Republican opposing. The procedural votes passed 62-38, with ten Democrats voting yes and one Republican voting no.
Democrats changed their views due to worries that a shutdown would hurt them politically. But Democrats were very split on passing the GOP measure.
A few critical healthcare extensions are in the bill, but no Medicare physician rate fix – temporary or permanent.
Additional articles: https://www.fiercehealthcare.com/regulatory/schumer-indicates-democrats-are-divided-government-spending-bill and https://thehill.com/homenews/senate/5195254-gop-funding-bill-democrats-advance-senate/ and https://thehill.com/homenews/administration/trumps-first-100-days/5194625-live-updates-trump-senate-government-shutdown/
#governmentshutdown #cr #trump #congress #ffy2025budget
https://thehill.com/homenews/senate/5196169-senate-passes-funding-bill-shutdown
Bipartisan December Healthcare Package Stalled
Senate Democrats attempted to pass a bipartisan healthcare deal that failed to make a final funding package in December, but Sen. Rick Scott objected to passing the bill with unanimous consent. This likely dooms the bill for now.
The bill included a patch for the Medicare physician rate cut, extended telehealth flexibilities for two years, and reformed pharmacy benefit managers (PBMs), among other reforms.
Additional article: https://insidehealthpolicy.com/daily-news/sen-rick-scott-blocks-dems-bid-pass-december-health-deal
(Some articles may require aa subscription.)
#pbms #telehealth #physicians #rates #medicare
https://thehill.com/policy/healthcare/5196027-wyden-sanders-health-package-pbm-blocked
CA Medicaid Costs Burgeoning
California’s Medicaid program has borrowed $3.4 billion from the state’s general fund to cover ballooning health expenses for 15 million residents. The program will likely need more dollars.
Spending unexpectedly grew due to higher-than-expected enrollment of seniors, fewer Californians losing coverage than anticipated, increased pharmaceutical spending, and expanding coverage of undocumented immigrants.
#medicaid #ca #healthcare #coverage
— Marc S. Ryan
