Providers ramp up their lobbying game to avert Medicare cuts

Hospitals and doctors scrambling to stem impending cuts

Provider groups, along with allies in Congress, are escalating lobbying efforts to stem pay cuts for doctors and hospitals.

Blitz is Aim for a few cuts We plan to start next year, as well as the extension of expiring clauses.Doctors almost rush to avoid 4.5% cut Doctors and hospitals are once again about to waive maximum, flat mandatory cuts, but Medicare reimbursements 4 percent for Medicare payments.

Doctors and hospital groups are used to lobbying behind efforts to avoid pay cuts, but they often get their way. Congressional aides and lobbyists say negotiations are ongoing, conversations about this are very fluid, and the leadership has yet to reach agreement on a top-line spending deal for the year-end package.

Against this backdrop, group- and health-provider-friendly lawmakers are rushing to ensure that potential year-end spending negotiations can stave off imminent cuts.

• of American Medical Associationpresidents headed to the Capitol this week for a three-day meeting. Provider group urged members Call and email congressional representatives.
• Two cohorts of lawmakers have collected signatures on a letter obtained by The Health 202 and will send it to parliamentary leadership next week.
• Two senators plan to introduce legislation next week that would extend expired financial incentives for doctors to participate in certain Medicare payment models.

Many provider groups and some legislators have big questions. They try to avoid overall cuts by claiming that their practices are tackling high inflation and rising costs. But it could be a tall order amid tense negotiations over the health care portion of a potential year-end spending deal.

“I’m not here to negotiate.” Jack Lesneck The AMA president said of his visit to Capitol Hill this week.

manager. Susan Wilde (D-Pa.) and Marianette Miller-Meeks (Republican-Iowa) is asking other lawmakers to sign a bipartisan letter containing a similar message. The letter, obtained by The Health 202, states, “Physicians, in particular, who have not received inflation updates in the Medicare program, call for Congressional intervention to prevent these cuts altogether.”

Meanwhile, the Republican Doctors’ Caucus is preparing its annual letter to seek leadership support in the short term while promising to work on long-term solutions, fending off cuts at the Capitol. has become a lobbying activity for

But not all experts believe Congress needs to swoop in. Around Bob Herman of Stat, of Medicare Payments Advisory Board Said Congress earlier this year It is reasonable to set payments to physicians “at amounts in accordance with current law” and doing so does not affect access to care or the ability of clinicians to provide it.

For years, the health care system has attempted to shift to paying for quality care rather than the sheer volume of services provided. Created incentives for providers to participate in new methods.ability to qualify 5 percent Bonus payments are set to expire at the end of the year unless Congress acts.

groups like National ACO Association, of National Rural Health Association and other medical procedures months of push for expansion. sense. John Barasso (R-Wyo.) and sheldon white house (DR.I.) plans to introduce legislation next week to address the cliffs, Barrasso’s office confirmed to The Health 202.

CMS is open to reassessment of Alzheimer’s drug coverage

President Bidenof Medicare directors say their agents are want to re-evaluate Limited coverage of Alzheimer’s drugs after new therapies shows more promise.

detail: Pharmaceutical companies Biogen and Eisai Data for a new treatment, lecanemab, were presented. provide more profit to the patient than its controversial predecessor Aduhelm, statisticsof Bob Herman report.

• “I can’t talk about the details, but I can only say that our doors are really open.” Chiquita Brooks Rashuathe head of Medicare and Medicaid Service Centersaid at the Milken Institute Future of Health Summit. “When new data comes along, we’ll look at it.”

Backstory: In April, Medicare limited Aduhelm payments to patients enrolled in clinical trials.This is due to doubts about the benefits of this drug and concerns that this drug has a high rate of brain swelling and bleeding. Final Compensation Policy It also applies to future anti-amyloid drugs, including lecanemab.

That decision was “based on the information available at the time,” Brooks-Lashua said, and may be reassessed “as new products come to market.”

#1 on The Health 202: A bipartisan group of senators is urging the Secretary of Health and Human Services Xavier Becerra Brooks-LaSure revisits a 2013 CMS decision that limited Medicare coverage for certain brain scans to once in a lifetime when a patient is enrolled in a clinical trial.

MPs argue that successor research indicate Amyloid PET imaging, which scans the brain for clumps of a protein called amyloid-beta that characterizes Alzheimer’s disease, is effective in diagnosing the disease. and that it could cost thousands of dollars.

Sen. Edward Markey (D Massachusetts), Co-Chair Bipartisan Congressional Task Force on Alzheimer’s Diseaseand Sens. sherry moore capito (RW.Va.) and Martin Heinrich (DN.M.) led 11 other MPs in writing.

Texas judge dismisses lawsuit against doctor who violated state’s abortion ban

san antonio judge dismissed the lawsuit sued yesterday Alan Bladetexas doctor openly rebelled against Controversial abortion laws enforced by civilians, texas tribune report.

Known as Senate Bill 8 (SB 8), the law allows anyone to sue someone for “facilitating” an abortion after fetal heart activity is detected at about six weeks’ gestation.But a district court judge Aaron Haas Plaintiffs were found ineligible to bring such a lawsuit if they were not related to or harmed by a prohibited abortion.

Important reasons: Yesterday’s ruling ends what appears to be the only positive challenge under the law. It sets an important precedent but does not overturn the law. Mark HyaronSenior Advisor Reproductive Rights Center, represented a blade. Hearron said he expects the decision to be appealed.

Main context: SB 8’s unique civil enforcement mechanism made it difficult to challenge in court without a test case.braids written in Washington Post op-ed Shortly after the law went into effect in September 2021, he deliberately performed an abortion to file a private lawsuit. I wanted to keep it from escaping,” he wrote.

National Abortion Federation:

FDA updates coronavirus vaccinations for young children

of Food and Drug Administration Approved modified coronavirus shot from Pfizer – BioNTech When Moderna Our colleague says that for a 6 month old child Laurie McGinley report.

Children who receive the Moderna vaccine are eligible to receive a booster two months after their second dose.

But Pfizer’s Omicron-targeted vaccine is not considered a booster. The company has a three-dose regimen, with a bivalent vaccine replacing the last dose. A child who has already received her three doses of Pfizer immunizations is not eligible for another dose at this time, as it is not considered a booster.

of Centers for Disease Control and Prevention We will approve the updated shots soon.

But the government’s latest efforts to strengthen protections face an unfortunate reality.: public interest in shots was gloomy. Less than 5 percent Percentage of children under the age of 4 Completed the first series According to the CDC, a new coronavirus vaccine has been confirmed to be effective and may be eligible for the latest shot.Less than 10 percent Even received the first shot.

FDA Commissioner Robert Calif said:

• House Minority Leader Kevin McCarthy (Republican-California) Congressman Mike Gallagher (R-Wis.) serve as new president House Select Committee on China The next Congress is expected to investigate, among other investigations, the origins of the coronavirus pandemic.
• Congressman passed overwhelmingly Yesterday, the $858 billion defense policy bill It will cancel the coronavirus vaccine mandate for military personnel in the Biden administration and give the daring Republicans their first post-midterm victory. Caron Demirzian report.
• Risk of mpox infection among unvaccinated people was almost 10 times higher than individuals who received two doses of Jinneos vaccine and 7.4 times higher than those who received only one dose, according to Investigation CDC announced yesterday.

Hospital financial decisions impact critical shortage of pediatric beds for RSV patients (via Liz Szabo l Kaiser Health News)

More States Consider Extending Postpartum Medicaid Coverage Beyond Two Months (By Matt Volz | Kaiser Health News)

Hidden Victims of the Covid Pandemic: Pregnant Women (Apoorva Mandavilli | The New York Times)

thank you for reading! see you on monday.