Government News of the Week
Medicare Compliance, HIPAA, Medicare Advantage and Part D,
Health Care Reform, and Other Federal and State Government Developments
Government News of the Week is a weekly email newsletter with timely news stories from Washington, D.C., and the 50 state capitals. Articles are selected for their impact on hospitals, health plans, medical group practices, physicians and other health care providers. Subscribe now to get an issue delivered to your inbox every Monday!

November 23, 2015

Note: Government News of the Week will not be published next week. The next issue will be sent on Dec. 7.

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(1) While CMS does not intend to introduce any new star measures for 2017, it plans to move one Part D measure and introduce another to the display measure page .... (more)

(2) California regulators and consumer groups are charging Blue Shield of California with failing to fulfill its pledge to donate $140 million, which they say was part of the deal to allow the carrier to purchase Medicaid insurer Care1st Health Plan .... (more)

  From the AIS Blogs
  Insurers and pharmaceutical producers always have had somewhat of an uneasy relationship, but the two sectors were able to put aside their differences when the ACA was adopted since each saw the potential for gaining millions of new customers. Any thoughts that this alliance could endure, however, seem to have disappeared in recent months as drug prices have soared and insurers have gotten bitter that they are subject to strict rate-hike and medical loss ratio curbs while the pharmaceutical producers aren’t. Where is this burgeoning dispute heading? Join the conversation at the AIS Blogs.

(3) CMS is pressing hepatitis C drugmakers for information on value-based deals with payers, including state Medicaid agencies .... (more)

(4) During the first week of the open-enrollment period, more than 540,000 people purchased insurance coverage through — up 20% from the first week of enrollment a year ago, HHS Sec. Sylvia Burwell wrote in a Nov. 12 blog titled, “A Solid Start.” She noted that more than 9 million people are currently enrolled in an exchange-based plan, and said renewals are expected to make up a larger share of enrollment this year compared to a year ago. People new to exchanges accounted for about one-third of enrollment during the first week of November. While exchanges and health plans have emphasized the importance of enrolling young and uninsured Latinos this fall, HHS reported that just 52,000 people contacted a Spanish-speaking representative during the opening week — about half the number who called during the same period a year ago. Thirty-eight states use .... (From Inside Health Insurance Exchanges' E-Alert)

  From Congress and the Federal Agencies

(5) On the heels of the decision in Shands Jacksonville Medical Center, Inc. et al. v. Sebelius, issued by the U.S. District Court for the District of Columbia in September, six Ohio hospitals filed a similar action in the U.S. District Court for the Southern District of Ohio .... (more)

(6) CMS shifted the start date for the Comprehensive Care for Joint Replacement (CJR) model from Jan. 1 to April 1, 2016, in a final rule to be published in the Federal Register on Nov. 24 .... (more)

(7) HCA Holdings Inc. agreed to pay $2 million to settle false claims allegations that it billed for medically unnecessary lab tests and double billed for fetal testing .... (more)

(8) The Boeing Co. received final approval of its class-action settlement with employees who alleged the company did not include health coverage of their autistic dependents .... (more)

(9) Hospice of Citrus County in Lecanto, Fla., agreed to pay $3 million to settle false claims allegations it billed Medicare for medically unnecessary hospice care to some patients .... (more)


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