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What We're Reading: CMS Ends Kymriah Payment Plan; High Court Pick Sets Up Abortion Fight; Medicaid Expansion in Maine
July 10, 2018 – AJMC Staff
Pause in Risk Adjustment Payments Announced, CMS Blames District Court's Decision
July 08, 2018 – Surabhi Dangi-Garimella, PhD
This Week in Managed Care: July 6, 2018
July 06, 2018
What We're Reading: Trade War Impact on Opioid Fight; Ark. Medicaid Enrollees' Deadline; EPA Sits on Health Report
July 06, 2018 – Allison Inserro
What We're Reading: Combining Antibiotics Proves Potent; Kentucky Dentists See Chaos; Declining US Fertility Rate
July 05, 2018 – Allison Inserro
Kentucky Cuts Medicaid Vision, Dental Benefits Following Block to Work Requirements
July 02, 2018 – Jaime Rosenberg
Federal Judge Blocks Kentucky's Medicaid Work Requirements
June 29, 2018 – Allison Inserro
CMS Will Waive MIPS for Doctors Who Agree to More Medicare Advantage Risk
June 29, 2018 – Allison Inserro
This Week in Managed Care: June 29, 2018
June 29, 2018

What We're Reading: CMS Ends Kymriah Payment Plan; High Court Pick Sets Up Abortion Fight; Medicaid Expansion in Maine

AJMC Staff
CMS quietly ended a pay-for-performance plan for Novartis' Kymriah—a half-million-dollar cancer treatment; President Donald Trump’s nomination of Judge Brett M. Kavanaugh to the Supreme Court sets up an intense partisan fight over health care; lawmakers in Maine's state House failed to override Republican Governor Paul LePage's veto of a bill that would fund the first year of Medicaid expansion.

CMS Ends Pay-for-Performance Plan for Novartis' Kymriah

CMS quietly killed a pay-for-performance plan for a chimeric antigen receptor (CAR) T-cell therapy—Novartis' Kymriah, which is a half-million-dollar cancer treatment, Politico reported. The deal drew internal HHS scrutiny and is the target of current congressional investigations. CMS refused to comment on the story, but Politico said emails showed that administration lawyers were uncomfortable with how much Novartis was influencing the arrangement, including counseling CMS on the payment criteria for the breakthrough drug.

 

Trump's SCOTUS Pick Sets Up Abortion, Affordable Care Act Battles

President Donald Trump’s nomination of Judge Brett M. Kavanaugh to the Supreme Court sets up an intense partisan fight over reproductive health care and possibly the Affordable Care Act (ACA). NPR reported that abortion and the ACA are top of mind for a large number of Senate Democrats in their fight to persuade moderate Republicans and moderates in their own party to oppose Kavanaugh. Senate Majority Leader Mitch McConnell, R-Kentucky, leads the slimmest of majorities and had expressed misgivings about Kavanaugh's path to confirmation, but said he was a “superb choice.”

 

Maine Lawmakers Fail to Override Governor's Veto of Bill to Fund Medicaid Expansion

Lawmakers in Maine's state House failed to override Republican Governor Paul LePage's veto of a bill that would fund the first year of Medicaid expansion, The Hill reported. The 85-58 vote of the $60 million bill fell short of the two-thirds majority needed to pass. Maine voters approved Medicaid expansion last year, but LePage has blocked its implementation. His administration has asked the Maine Supreme Judicial Court to delay the expansion until the state legislature passes a bill funding its share of the costs. 

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With Approval of CAR T-Cell Therapy Comes the Next Challenge: Payer Coverage
 
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