Private Physician Practice Takes Another Blow From A New 2,400-Page Government Rule

Just before former House Speaker John Boehner handed the gavel to Paul Ryan, he shepherded legislation that eliminated a despised Medicare payment formula under which physicians faced a 21.2% pay reduction. Congress could not allow the pay cut to take place and take the risk that physicians would turn away their Medicare patients. But...

MACRA: The Burden of Proof

MACRA:  The Burden of Proof by Carol Monaco The Centers for Medicare and Medicaid Services has released a 2,398-page final rule implementing what is likely the most complex clinician payment program in Medicare’s history, known as the Quality Payment Program, born out of the Medicare Access & CHIP Reauthorization Act of 2015 or MACRA. As...

Far-Reaching Medicare Part B Changes Violate Separation Of Powers — And With CBO’s Blessing

Members of Congress expressed outrage at the Congressional Budget Office during a recent House hearing for assuming that sweeping, untested changes to Medicare will save $34 billion “even before you know what the project is,” Rep. Scott Garrett (R-NJ) said. “There is no cost-benefit analysis, there is no testing done, you don’t even know...

Competition in Medicare Advantage, Part D, and “Extra Help”/ Working together for seniors and taxpayers

Seniors are beginning to get fliers in the mail alerting them to the upcoming open season for enrollment in Medicare Advantage and Medicare Part D prescription drug plans.  Both programs rely on competition and consumer choice to increase options and hold down costs for seniors.  Open season begins October 15 for those planning to...

CMS Rule On Biosimilar Payment Could Have Serious Side Effects

The Obama administration and leading members of Congress are clashing over a new Medicare payment rule that could compromise patient care, impede development of a fledgling part of the biologics industry, and make it more difficult to track patient safety issues. At issue is government payment policy for a new class of drugs called...