Medicaid Advisers Want To Make Sure Beneficiaries Are Safeguarded From Proposal To Ban Rebates To PBMs
Although the rule is geared toward changing how Medicare handles rebates to middlemen, members of the Medicaid and CHIP Payment and Access Commission want to make sure Medicaid beneficiaries are protected from any downstream ramifications. Meanwhile, Medicare advisers talk about a unified payment system for post-acute care facilities.
Modern Healthcare:
MACPAC Wants Part D Rule To Protect Medicaid Supplemental Rebates
Congressional Medicaid advisers on Friday questioned whether the Trump administration should include Medicaid in its major proposal to ban middleman rebates from Medicare Part D. Medicaid has been an overlooked component of the proposed rule, whose chief goal is to lower out-of-pocket costs for people with Medicare prescription drug plans. Medicaid is a different animal: people with Medicaid insurance pay only a nominal amount at the drug counter whereas Medicare beneficiaries can be on the hook for high copays. (3/8)
Modern Healthcare:
MedPAC Opposes Episode-Based Payments For Post-Acute Care Facilities
A panel of Medicare advisors decided that a future unified payment system for post-acute care facilities should be based on each individual patient stay and not for the entire episode of care. The Medicare Payment Advisory Commission on Friday discussed how to proceed on creating a unified prospective payment system to improve the accuracy of Medicare fee-for-service payments for post-acute care settings. While commission members were encouraged about an episode-based system, the idea was scuttled after concerns about whether post-acute care facilities would discharge patients too soon under the system. (King, 3/8)
And in other Medicare news —
Modern Healthcare:
Providers Hope For Stark Overhaul To Boost Value-Based Payment
The 1989 Stark Law penalizing physicians and hospitals for making medical decisions for patients based on their financial self-interest has few remaining fans. Even its author, former California Democratic Rep. Pete Stark, has called for repealing the law, which has metastasized in complexity over 30 years. Now the Trump administration, backed by provider groups, is poised to make what CMS Administrator Seema Verma called “the most significant changes to the Stark law since its inception.” (Meyer, 3/9)
