CMS ISSUES FINAL RULE ON MEDICARE BIDDING PROGRAM
The Centers for Medicare & Medicaid Services (CMS) has issued a final rule to implement a new competitive bidding program in Medicare. The bidding program aims to reduce beneficiary out-of-pocket costs, improve the accuracy of Medicare payments and ensure access to high quality medical equipment and supplies to ten of the largest metropolitan statistical areas across the country. The program is expected to be fully implemented in 2010 and is estimated to save Medicare and taxpayers $1 billion annually, lowering coinsurance for Medicare beneficiaries.
HEALTH PLANS SCRAMBLE TO MEET CMS CHANGES
Health plans were scrambling last month to incorporate more than 2,000 changes to the 2008 USP model formulary guidelines by an April 17 filing deadline set by the Centers for Medicare & Medicaid Services. CMS announced the changes for Medicare Part D participants, and health plan sponsors and pharmacy benefits managers had to work quickly to translate 2007 formularies to the new 2008 drug list. CMS had announced the changes on March 20. CMS required a revised submission file format and rules that include new levels of coding.
HEALTH MANAGEMENT FIRM ADDS STATE TO CLIENT LIST
SHPS, a leading provider of health advocacy and health benefit solutions announced that the state of Alabama has become its newest client. SHPS will serve the state of Alabama’s State Employees Insurance Board by providing integrated health advocacy services that will include disease management, utilization management, case management, and a 24-hour nurse line. Their services will assist all employees regarding issues, conditions and decisions that affect their personal health in order to maximize health benefits while minimizing health risks.
CMS PROPOSES REVISIONS TO CLINICAL TRIALS POLICY
Medicare officials have proposed revisions to the Clinical Trial Policy national coverage determination (NCD). Revisions to the Clinical Trial Policy, under which Medicare pays for certain items and services for Medicare beneficiaries involved in clinical trials, include renaming the policy as the Clinical Research Policy, requiring registration of all trials online, and requiring publishing of all clinical trial results.