Medicare Advantage Plans have not raised concerns about patients' health and are an important part of overall Medicare program benefits. Allowing insurers to offer these types of plans to Medicare beneficiaries will expand choices in the market, and will ensure that those who want Medicare Advantage coverage will have that option.” In her conclusion, CMS Administrator Seema Verma wrote that the final rule is “an important step forward to ensure Medicare remains competitive in the face of the private sector and promotes high-quality care and cost savings.” The Centers for Medicare & Medicaid Services (CMS) announced yesterday that it would allow the Health and Human Services Office of Inspector General to review its new rule authorizing access to experimental drugs and devices. CMS said that after the OIG “initiates its review of the policies under the Protecting Access to Medicare Act of 2017,” it “intends to propose a second policy in October 2018 to facilitate the use of drugs or devices in the treatment of conditions that are life-threatening or immediately life-threatening if left untreated.” The announcement was made in the Federal Register and as part of the CMS statement, OIG said in a release that it was aware of the proposed rule, and that the proposed rule “gives OIG more time to study the law's intent and effects. We look forward to providing the Acting Inspector General [Steve Linick] and CMS a detailed OIG report on this new flexibility, as well as any potential implications, upon the OIG’s completion of our work.” In its statement, CMS Administrator Seema Verma said: “Under the Protecting Access to Medicare Act, people suffering from serious, life-threatening conditions will now have access to promising treatments while clinical trials are completed. The current law does not provide access to drugs or devices while clinical trials are ongoing. The new policy gives people and their doctors more time to determine the safety and efficacy of these treatments. By having an alternative for patients, the new rule may improve the quality of life for many individuals and help the U.S. health care system meet the demand for new treatments as they emerge from research into the disease." "The process of adopting these new policies for Medicare is never easy, but we continue to work with OIG to get new policies right and work toward the common goal of providing high-quality care for our nation's seniors." Earlier this week, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule that includes major changes in the way Medicare covers drugs for beneficiaries. The changes would apply to drugs covered under the Medicare Part D prescription drug program (commonly referred to as Medicare Part D). This proposed rule comes from the Protecting Access to Medicare Act (PAMA) legislation signed into law by President Trump on April 13, 2017. The proposed rule gives Health Care Providers time to establish patient populations to help them gain experience with different approaches to using new technologies. By giving new treatments a chance to demonstrate whether they help patients, CMS hopes to decrease costs and increase access to innovative treatments. Medicare has a program known as “Medicare Advantage” in which private insurance companies come in and provide benefits to Medicare beneficiaries instead of the federal government. The Department of Health & Human Services has a similar program known as “Medicare Part C” in which private insurance companies come in and provide benefits to Medicare beneficiaries instead of the federal government. A new analysis released by the Centers for Medicare & Medicaid Services (CMS) finds that most Medicare Advantage plans and Medicare Part C private plans are offering lower prices for Part D prescription drugs than are available to people on the general Medicare population. The report comes as the Centers for Medicare & Medicaid Services is seeking comment on the potential of changing the structure of the Part D program to benefit people who get their insurance through Medicare Advantage or Medicare Part C. In its report, CMS said: “Medicare beneficiaries in Part C or Medicare Advantage private health plans paid on average 32 percent more in 2018 premiums and premiums that vary by area than people with Original Medicare coverage. However, they received 22 percent fewer benefits in 2018 than those with Original Medicare coverage.” To read more, click here. To view the whole report, click here. CMS Administrator Seema Verma, HHS Secretary Alex Azar, and CMS officials gave the following remarks during a press conference to discuss the proposed rule regarding an interim final rule that would expand access to certain types of drugs: “Today’s proposed rule will begin the process of making new treatments available to people with cancer, HIV, Hepatitis C and Parkinson’s disease and other serious diseases. Expanding access to promising new treatments could speed the development of new therapies, and at the same time make patients’ lives better. Today’s proposed rule will authorize access to three new types of drugs: sofosbuvir and velpatasvir combination products for the treatment of Hepatitis C; sofosbuvir-velpatasvir-voxilaprevir combination products for the treatment of HIV-HCV coinfection; and an investigational new drug for patients with Parkinson’s disease. Today’s proposed rule also makes several additional interim final modifications to the policies regarding additional drugs for HIV, Parkinson’s disease, HCV, and melanoma. While this administration is actively working to combat drug abuse, today’s action today would expand access to promising new treatments for a number of serious, chronic diseases. These treatments may one day lead to higher quality of life for millions of Americans.” “It is especially important that, as a general rule, people with serious, chronic conditions should not be able to abuse prescription drugs. For these drugs to work, people must take them as prescribed. However, the American people are not aware that their prescription drugs are becoming cheaper in other countries.” “Since I took office, the list of pharmaceuticals whose price has risen by more than 100 percent includes more than 30 drugs. That is why I have directed the FDA to take action against those companies to end this unfair practice. The Secretary of Health and Human Services is working with the Commissioner of Food and Drugs to consider changes to the laws that will ensure foreign governments honor our request and protect consumers.” At a hearing before the Senate Finance Committee today, CMS Administrator Seema Verma, HHS Secretary Alex Azar, and CMS officials will discuss the Protecting Access to Medicare Act of 2017. The proposal would provide Medicaid beneficiaries with access to experimental drugs and devices by authorizing states to pay for experimental drugs and devices covered under the Medicare Part B program. At a hearing today before the Senate Finance Committee, Senator Joe Donnelly (D-IN) and several other members of Congress emphasized that the Affordable Care Act (ACA) has saved millions of Americans from “catastrophic drug costs” and argued that the ACA needs to be maintained in order to continue protecting Americans. Drug prices in America have been “skyrocketing,” said Donnelly, adding: “Our constituents rely on Medicare to cover the high cost of prescription drugs. In 2015, there was a 20 percent increase in the price of these drugs.” Donnelly suggested that the ACA, and specifically the “innovative Medicaid drug coverage for our constituents who rely on it to access the medicines they need” are “critical” to providing coverage for Americans. When people with Medicare get sick and don’t have access to drugs, they seek out drugs elsewhere, and some of them turn to the black market. “This is also a problem for all Americans. Many Americans use their own savings to pay for their prescriptions, rather than seeking the higher cost of health insurance. As a result, we’re seeing families forced into bankruptcy by this growing problem. Congress has a responsibility to protect Americans, including seniors, from the mounting cost of drugs.” Donnelly added: “Now, it’s time we pass legislation that continues to hold down the cost of prescription drugs for our seniors and Americans with chronic health conditions. The bill before us today will protect seniors by ensuring that Medicare can continue to provide needed drugs. I commend our Chairman Alexander and Ranking Member Enzi for their continued work on this bill.” Sens. Rob Portman (R-OH) and Patty Murray (D-WA) introduced the bill at the hearing. Today, CMS Administrator Seema Verma released a statement about a proposed rule regarding the Medicaid Drug Rebate Program, which she says “would improve patients’ access to life-saving drugs by ensuring they are paying the lowest possible prices for their medications.” “There are a number of problems with the way we pay for prescription drugs, which affects both Medicare beneficiaries and the American people. We are working with Congress on legislation to change the way we do that.” At a hearing today, Senators Patty Murray (D-WA), Lamar Alexander (R-TN), Joe Manchin (D-WV), and Susan Collins (R-ME) introduced legislation to protect people with long term-care disabilities from “outrageous” costs that are forcing them to become homeless or risk losing their homes to foreclosure.