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ML Strategies Health Care Update, May 19, 2014 (PDF)

"It is likely that CMS will continue to develop initiatives that include pricing transparency through alternative payment models like bundled payments and/or stand-alone initiatives like the physician and hospital data releases. Stakeholders, especially those in the medical technology and biopharmaceutical spaces from laboratories to drug manufacturers, have also been the subject of recent scrutiny. This indicates that future CMS efforts could further apply transparency initiatives as policymakers and commercial payers alike focus on innovative but very expensive therapies, devices, and diagnostics."

ML Strategies Health Care Update, April 28, 2014: Health Care Narrative Shifting to Delivery & Payment Reform (PDF)

"With open enrollment behind us, policymakers have begun to shift their focus on the rising cost of health care in a significant way.... For ACA supporters, recent actions are a sign of how important other factors are to blame for the high cost of health care. The starkest example of this was the recent letter sent by high ranking House Democrats to the manufacturer of Sovaldi, asking them to justify the [$1,000 per pill] price of its Hepatitis C drug, causing Gilead's stock to take a significant dive on fears that policymakers or other stakeholders would intervene to limit the price of the costly drug."

ML Strategies Health Care Update, March 17, 2014 (PDF)

Topics include: [1] SGR fix advances in the House, action planned in Senate; [2] Senate presses HHS for details on budget following House testimony; and [3] House lawmakers warn against Medicare Advantage cut.

ML Strategies Health Care Update, January 27, 2014 (PDF)

"Citing recent high profile data breaches at Target and others, Majority Leader Eric Cantor (R-VA) outlined in a January memo similar concerns over security of health care data. House Republicans have made exchange data security a priority for some time, already holding four hearings this Congress on the issue."

ML Strategies Health Care Update, December 23, 2013 (PDF)

"The CMS Innovation Center released a Request for Information ... asking for input on the next version of Pioneer Accountable Care Organizations (ACOs). The Pioneer ACO program was the first ACO program launched by CMS. Using Innovation Center authority it is also more aggressive, with greater risk and reward, designed for providers with greater experience delivering coordinated care."

ML Strategies Health Care Reform Update, December 16, 2013 (PDF)

Topics include: Policymakers Focused on Long Term Care Hospital Reform; NIH Looking to Shift Funding to Individual High-Risk Research: Implementation of the Affordable Care Act; and Other HHS and Federal Regulatory Initiatives.

ML Strategies Health Care Reform Update, December 9, 2013 (PDF)

"[On December 6, the CBO] released an updated score for replacing the Sustainable Growth Rate (SGR) formula. The score reduces the cost of doing away with the SGR by over $20 billion, revising it from $139.1 billion to $116.5 billion. This latest decrease adds to the growing possibility of passing a permanent SGR replacement bill as early as Q1 2014.... On November 27th, CMS published the Medicare Physician Payment Rule. The rule significantly scales back cuts outlined in the proposed version to independent labs that would have decreased reimbursement by 26 percent."

ML Strategies Health Care Reform Memo, November 18, 2013 (PDF)

Items include: Cancellation Plan Fix; Will cholesterol-fighting medicines become even more widely prescribed; Initial Enrollment Numbers Released; Oversight Hearing on Website Rollout; Request for QHP Comments; and Hearings and Mark-Ups Scheduled.

ML Strategies Health Care Reform Update, November 11, 2013 (PDF)

Update on developments in federal and state health care reform legislation and regulations, including summaries of recent announcements and regulatory activity by HHS, CCIIO, IRS and CMS.

ML Strategies Health Care Reform Update, November 4, 2013 (PDF)

"[HHS] clarified that health coverage obtained through the exchanges were not considered 'federal health care programs' with respect to the Anti-Kickback Statute.... Members of the Senate Finance Committee and the House Ways and Means Committee released a bipartisan discussion draft proposal ... [that] would permanently repeal the SGR update mechanism, reform the fee for service payment system, encourage participation in alternative payment models, and provide performance-based incentive payments to physicians and other health care professionals."