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CMS updates Medicare Advantage Value-Based Insurance Design (VBID) Model for 2019

November 22, 2017

CMS updates Medicare Advantage Value-Based Insurance Design (VBID) Model for 2019
Expansion of model to 25 total states to provide Medicare beneficiaries with more choices and lower costs

The Centers for Medicare & Medicaid Services (CMS) today announced several updates to the Medicare Advantage Value-Based Insurance Design (VBID) Model for 2019 that encourages customized benefit designs and flexibilities that meet the health needs of beneficiaries in a total of 25 states.   

“This Administration is committed to making sure that our seniors have more choices and lower premiums in their Medicare Advantage plans,” said CMS Administrator Seema Verma. “CMS expects that this demonstration will provide insights into future innovations for the Medicare Advantage program.”

CMS recently announced in the Medicare Advantage and Part D proposed rule that it is providing new flexibility for customized benefit designs that address the specific health needs of certain beneficiaries under Medicare Advantage. This allows additional plan variety and options, reduced cost sharing for customized benefits and different cost-sharing for beneficiaries that meet specific medical criteria

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Public Health Provider Alert from BCHHS: Advice for Health Care Providers Treating Patients in or Recently Returned from Hurricane-Affected Areas, Including Puerto Rico and US Virgin Islands

October 25, 2017

CDC issued the attached Health Advisory on 10/24/17 to remind clinicians assessing patients currently in or recently returned from hurricane-affected areas to be vigilant in looking for certain infectious diseases, including leptospirosis, dengue, hepatitis A, typhoid fever, vibriosis, and influenza.

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MAHEC Prepares Western North Carolina for MACRA, Featured in New MACRA Toolkit

October 18, 2017

October 11, 2017– Last week was the deadline for physicians and other eligible professionals to begin collecting data to meet reporting requirements under the Medicare Access and CHIP Reauthorization Act (MACRA) or face a potential reduction in future Medicare reimbursement.

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From the AMA: An Update on Recent Actions by the Administration With Respect to the Affordable Care Act (ACA)

October 13, 2017

President Trump announced late last night that the Administration would no longer make the cost sharing reduction (CSR) payments to insurers offering plans in the ACA marketplace.

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Joint Statement on the Graham-Cassidy-Heller-Johnson legislation.

September 26, 2017

Over the weekend and earlier today, changes were made to the Graham-Cassidy-Heller-Johnson health system reform legislation.  These changes would primarily benefit a handful of states where Republican Senators have threatened to vote against the legislation on the floor.  In addition, changes were made that seem intended to address Senator Ted Cruz’s (R-TX) interest in providing still more flexibility to states under the proposed new block grant system.  Highlights of the recent changes include the following:

 

  • Directs more federal funding to key states, including Alaska, Arizona, Kentucky, and Maine:

 

  • Tightens language regarding pre-existing conditions:  states would have to describe how their health plans "shall maintain access to adequate and affordable health insurance coverage for individuals with pre-existing conditions." The original language said each state had to show how it "intends" to have adequate and affordable access to coverage.

 

  • States are given broad new authority to allow insurance companies to design new insurance rules for individuals and insurers that receive money through the block grant program.   Under the new version, states would no longer be required to apply for waivers from many of the ACA’s patient protections; instead, states could let insurers impose deductibles that are higher than the limits set by the ACA, or remove the health law’s limits on the costs that an individual family can incur in a year entirely. They could also offer coverage that lacks some of the ACA’s essential health benefits, such as maternity care, prescription drugs or mental health. Plus, states could let insurers widen the gap between how much older people and young people are charged. And states could remove requirements that insurers cover preventive-health treatments and immunizations. This could result in insurers offering bare-bones insurance policies that feature cheaper premiums but higher out-of-pocket costs, thereby pricing out individuals with pre-existing conditions.

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AMA Letter to Senate Leadership on Cassidy-Graham Amendment

September 19, 2017

The attached letter was sent to the Senate leadership today, expressing the AMA’s opposition to the Cassidy-Graham-Heller-Johnson Amendment to H.R. 1628, the “American Health Care Act of 2017.”  The legislation does not meet the principles for health system reform that the AMA shared with Congress on the first day of the 2017 legislative session.  In particular, it would result in millions of Americans losing health insurance coverage, further destabilize the health insurance marketplace, undermine the health care safety net provided by Medicaid, and jeopardize important insurance reforms such as guaranteed issue and the ban on pre-existing condition exclusions and benefit caps.

To take advantage of the preferred procedural rules provided for budget reconciliation bills that would allow passage by the Senate with a simple majority, the legislation must be passed by September 30.  House passage could be delayed until after that deadline, but no changes could be made.  A Congressional Budget Office estimate of the amendment’s impact is expected early next week; due to time constraints, it is not expected to include estimated impacts on coverage or other important details.

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From the APHA: Administration Shows Disregard for Research, Preference for Anti-Evidence Policy

August 28, 2017

In the first half of this week, the Trump administration has shown a disregard for science and evidence when it comes to the environment and safeguarding health.

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AMA Statement on Senate Debate on Health System Reform

July 26, 2017

During consideration of proposals related to the Affordable Care Act, the American Medical Association urges Senators to consider the impact their votes will have on the health of all Americans.

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News Alert: NCMS Takes Firm Stand on Federal Health Care Legislation

July 20, 2017

As the debate over the future of the Affordable Care Act (ACA) aka Obamacare continues to unfold in Washington, DC, you can be assured that your medical society has been working diligently on Capitol Hill and with local and national stakeholder groups to make sure any legislation protects — and enhances— your patients’ access to affordable, high quality care.

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2018 Medicare Physician Fee Schedule Proposed Rule Summary

July 17, 2017

An initial summary of the Medicare physician fee schedule proposed rule is below for your information. 

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CDC: Opioid prescriptions remain high despite recent decline

July 12, 2017

NBC Nightly News (7/6, story 7, 1:50, Guthrie) reported, “As this country battles the opioid drug crisis, the CDC reported today that far too many people are still being prescribed those highly addictive” pain medications “and for too long.

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A Burnout Epidemic: 25 Notes on Physician Burnout in the US

July 12, 2017

Here are 25 things to know about physician burnout.

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The AMA Strongly Opposes the Senate’s Health-reform Proposal

June 27, 2017

A lot of big numbers have been tossed around in the days since Senate leaders unveiled a “discussion draft” of legislation—dubbed the Better Care Reconciliation Act of 2017 (BCRA)—that would dramatically reshape how our country’s health system is financed.

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From National Rural Health Association: Senate Releases Health Care Reform Bill

June 22, 2017

The Senate released their version of the House passed American Health Care Act entitled the Better Care Reconciliation Act of 2017.

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Cyber-alert from the AMA

May 15, 2017

The United States Computer Emergency Readiness Team (US-CERT) has received multiple reports of ‘WannaCry’ (also known as ‘WannaCrypt’) ransomware infections in several countries around the world and in the United States.  Some of these infections are impacting patient access to care. 

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