November 1, 2018 Legislation
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CMS has issued a proposed rule to require drug companies to include list prices when they advertise on TV. The price would be for a 30 day supply or a typical course of therapy. The drugs would have to be ones that are available for fed med reimbursement. The drug companies believe the rule is unfair since most do not pay list prices but much less due to contracts.
China has fined vaccine maker Changsheng Bio-technology $1.32 Billion for falsifying data for a rabies vaccine. Also many executives were banned from ever working in the drug sector again.
The OIG has said that an insurer providing incentive payments to physicians in its network to boost preventative health screening would not violate the anti-kickback rules. In this case a Medicaid managed care plan would pay $1 per existing enrollee for increasing early screening and 10% year over year screening. If any provider got over 20% year over year increase they would get $2.
President Trump announced a new policy to be phased in over five years to reduce how much Medicare pays for drugs on Part B. Presently they pay based on the average sales price of drugs. The new way which will affect half the country on a trial basis will be based on the average sales price around the world with similarly based economies. Now we are paying about 80% more than the average price in other countries. Secretary Azar said this could save $8 Billion per year. The administration is also proposing the creation of a new group of middlemen to negotiate bulk prices for these drugs. This will hurt the bottom line of the oncologists and rheumatologists. Top
The Wall Street Journal had an oped blasting the upcoming Question in the next Massachusetts election. The nurses union wants strict ratios in the state for how many patients a nurse can care for. This follows California's law which has been shown to not affect patient care at all. The new law would be worse than California's since there would be no waivers for rural hospitals. If it passes the hospitals say it could cause bigger bills or less patient beds since they would need a tremendous amount of nurses by 1/1/2019 or face a huge penalty. There is no phase in. Top
DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the
time of publication. Nothing in this article constitutes legal advice. Readers
should consult with their own legal counsel before acting on any of the
information presented.