Kaiser Daily Health Policy Report Highlights Recent CMS Developments
Summaries of recent coverage related to CMS appear below.
- Competitive bidding: Internist Laboratory, Sharp HealthCare and Scripps Health on Tuesday filed a lawsuit to block a Medicare pilot program that is testing competitive bidding for laboratory services, CQ HealthBeat reports. The providers allege that CMS should have filed a public notice for the program and received public comment before the pilot was launched, according to attorney Patric Hooper of Hooper, Lundy & Bookman. CMS spokesperson Peter Ashkenaz said that the pilot program "was mandated by Congress to determine whether competitive bidding can be used to provide laboratory services while maintaining value, quality and access to care" (CQ HealthBeat, 1/30).
- Erythropoiesis-stimulating agents: Nearly 91% of oncologists and hematologists surveyed said that their patients have experienced adverse consequences as a result of a CMS rule limiting Medicare coverage for ESAs used to treat anemia in chemotherapy patients, according to a study released on Wednesday by US Oncology, CongressDaily reports. The study found that more than 75% of 282 oncologists and 25 hematologists surveyed said a blood transfusion was required for about 17% of their patients because of the rule and that 30% had to reduce chemotherapy treatments for 19% of patients (Edney, CongressDaily, 1/31).
- Medicare Health Support: CMS on its Web site on Tuesday posted an announcement that MHS -- a pilot program intended to coordinate care for Medicare beneficiaries with diabetes and congestive heart failure in five states and Washington, D.C. -- is "not meeting the statutory requirements of improved clinical quality outcomes, improved beneficiary satisfaction and the achievement of financial savings targets," The Hill reports. Starting in July, about 68,000 beneficiaries will be dropped from care-coordination programs, according to The Hill. CMS said it will wait until it receives a report from outside auditors before deciding whether to launch the second phase of the program, but the "negative assessment this week does not bode well for the program's future prospects," The Hill reports (Young, The Hill, 1/30).
