ACHP Media Monitoring Report: November 22, 2016

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Note: The Media Monitoring Report will not be published Wednesday, November 23 through Friday, November 25. We will resume publication Monday, November 28.

ACHP in the News: ACHP President and CEO Ceci Connolly advocated for restoration of Medicare Advantage quality incentive payments in The Hill Extra (subscriber’s content).

Risk corridor data released
The Centers for Medicare and Medicaid Services (CMS) has released risk corridor data for 2015. The CMS memo states 2015 payments to insurers will be used to offset the program’s 2014 deficit, which now exceeds $8 billion for 2014 and 2015 combined. The risk corridor program was implemented to help stabilize exchanges by transferring funds from insurers with from insurers with lower than expected costs to those with higher than expected costs. Brian Blase at Forbes reports.

CMS plans to cut Medicaid pass-through payments
The Centers for Medicare and Medicaid Services (CMS) wants to end pass-through payments, which are supplemental funding for Medicaid providers. CMS provides pass-through payments to Medicaid managed care plans that treat a large number of individuals with complex health issues who are on Medicaid or uninsured. Critics believe ending the payments would undermine recent shifts toward outcome-based care instead of a fee-for-service model, explains Virgil Dickinson of Modern Healthcare. 

Democratic leaders ask for proposed drug price regulation to be scrapped
Leading congressional Democrats are asking the Obama administration to refrain from implementing a new model for prescription drug reimbursement. The overhaul proposed by the Centers for Medicare and Medicaid Services earlier this year would adjust payments under Medicare Part B, which pays for drugs given by doctors, according to Andrew Siddons of Congressional Quarterly. Congressional Democrats are worried the new rules could have an adverse effect on smaller practices (subscriber’s content).

High premiums have Americans seeking alternatives
Due to expensive premiums, many Americans are considering forgoing purchasing standard health insurance. Some individuals plan to accept the federal tax penalty and rely on alternative health care safety nets. Jayne O’Donnell of USA Today describes some of the options Americans are considering, including health sharing plans, community health centers and catastrophic insurance plans. The Centers for Medicare and Medicaid Services says coverage is affordable for most Americans with the federal subsidy, and ACA-funded navigators usually find solutions for consumers seeking coverage. 

House looks to delay ACA court case
The House of Representatives is seeking the delay of a court case regarding the Affordable Care Act (ACA) subsidy program as President-elect Donald Trump has stated he will repeal and replace the health law. A district court previously ruled that payment of subsidies requires an appropriation, which Congress did not provide; the Obama administration has appealed the decision, questioning both the ruling and challenging whether a chamber of Congress can bring a legal challenge. The Associated Press has the story.

Mylan will not testify in EpiPen settlement
Executives at Mylan refused Sen. Chuck Grassley’s (R-IA) request to appear at a Senate Judiciary Committee hearing for the possible settlement of a Medicaid pricing debate. An investigation began when it was reported Mylan was overpaid millions of dollars for EpiPens because the company incorrectly classified the device. Sarah Ferris of The Hill shares despite Mylan’s refusal to attend the hearing, Grassley will continue to seek answers.

Paul Ryan proposes alternative to ACA
If Republicans successfully repeal the Affordable Care Act, Speaker of the House Paul Ryan has a blueprint for its replacement. Released last June, Ryan’s A Better Way plan would remove the individual mandate, expand the use of health savings accounts and limit tax breaks for employer-sponsored insurance. The blueprint includes some ACA provisions, including protecting those with preexisting conditions from being denied insurance and offering tax credits to help individuals afford coverage. Alison Kodjak of NPR reports.