ABL HEALTHCARE ONLINE
ABL Healthcare Member News & Industry Trendletter * December 4, 2018
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HEALTHCARE MEMBER NEWS
WELCOME BACK!

>>> David Soffa, MD, has served as Chief Medical officer and then Senior VP of Medical Affairs at AIM Specialty Health for the past 19 years, and has been involved in creation and execution of imaging management and other utilization management programs for 20+ years. His special interests are in physician communication, education, behavior change, and the science of medical decision-making. AIM Specialty Health has developed technology-based, proven management programs to assist health plans in promoting the most appropriate use of outpatient diagnostic imaging services, specialty pharmaceuticals, and genetic testing. Its programs also help manage oncology, cardiology and musculosketetal services for over 40 million people on behalf of 30+ health insurers in 50 states, using HIPAA-compliant information systems. David's background includes active clinical practice in diagnostic radiology, and 20+ years in full-time administrative medicine, managed care policy, and clinically related business. He was a Co-Founder, Senior VP and Chief Clinical Officer of National Imaging Associates; Co-Founder and Chief Medical Officer of Interactive Diagnostic Systems; President of F&K Diagnostic Imaging; and VP of West Bay IPA. He was President of the San Francisco Medical Society, and subsequently Board Member of The San Francisco Health Care Foundation and Vice Chair of the governing body of the San Francisco Health Plan. David has re-joined the Bay Area Round Table.

UPCOMING ABL HEALTHCARE
ROUND TABLES & EVENTS
  • 12/05 - 19th Innovations in Healthcare ABBY Awards, in Long Beach
  • 12/12 - 20th Innovations in Healthcare ABBY Awards, in San Francisco

  • 2019
  • 1/09 - Orange County Round Table*
  • 1/10 - East Bay Round Table
  • 1/15 - Silicon Valley Round Table*
  • 1/16 - San Francisco Round Table*
  • 1/18 - Los Angeles Round Table
  • *Round Table dates moved from usual days, due to a conflicting Holiday or JP Morgan Conference
ARTICLES
HEALTHCARE MEMBER NEWS
Last Call to Reserve Your Seat for Innovations in HealthcareTM ABBY Awards - on Dec. 5 & 12, in Southern & Northern California

Ten of healthcare's most innovative companies are Finalists to present their health IT, digital health, diagnostic, and med device solutions, as well as innovative approaches for reducing the cost of quality care at ABL Organization's 19th and 20th Innovations in HealthcareTM ABBY Awards Dual Events, to be held on December 5th, in Long Beach, and December 12th, in San Francisco.

AND THE FINALISTS ARE: For the Southern California Event: Advanced Pathways; Amenity Health, Inc.; Catasys, Inc.; healthPiper, LLC; and ImpediMed, Inc. For the Northern California Event: Care3, Inc.; Help-Full; Modio Health, Inc.; NEOFECT; and California Schools VEBA. At each of the events - Dec. 5th and 12th, following live presentations made by the leaders of the Finalist companies, each audience member will cast their secret ballots to determine one ABBY Awardee in Southern California and one Awardee in Northern California.

Also, at the SoCal event on Dec. 5th, a keynote presentation will be made by Robert Maloney, MD, Director of Maloney Vision Institute, and Clinical Professor of Ophthalmology at David Geffen School of Medicine at UCLA. Dr. Maloney has worked at the forefront of innovative vision-correction surgery for 20 years - personally performing 60,000+ vision correction procedures. He's also a brilliant medical edu-tainer and will share with attendees the inspiring backstory of one of the greatest Innovations in Healthcare of all time, and how it's played out in history and art, as well as in today's routine medical practice.

And at the NorCal event on Dec. 12th, an "ABBY Update" presentation will be made by Dave Sayen, currently a Senior VP at Gorman Health Group, and previously a CMS Regional Administrator for Region IX (CA, AZ, NV, HI, and Pacific Territories). Several years ago, Dave took home an ABBY Award on behalf of CMS's Center for Medicare & Medicaid Innovation - for its "Bold Experiment in Government Payment Innovation." Here, Dave will share what's happened since, lessons learned, tweaks made, and the legacy of the Innovation Center. Email laura@abl.org for information on attending either event!

Alvaka Networks to Host Software Patching Webinar in December & January

Alvaka Networks will present a live webinar - Software Patching: The First and Most Important Step in Securing Your System - on several dates in December 2018 and January 2019, including Dec. 7, 14, 21 and 28. The webinar will run from 10-11 a.m. each time. Says Alvaka: "The majority of security threats you face today; viruses, worms, spyware and other malware utilize some unchecked vulnerability in your software to compromise your system. Patches fix the 'holes' in the code. A recent study found 98.8% of breaches can be stopped by good patching practices." (Oli Thordarson, Orange County)

Care3 Shares Top 5 Things Learned at National PACE Association Conference

David Williams, CEO of Care3, shares The Top 5 Things I Learned at the National PACE Association Annual Conference, after his company attended and sponsored the recent PACE (Program of All-Inclusive Care for the Elderly) event, which is dedicated to helping seniors live in their homes while receiving outstanding medical care. In his blog post, David discusses: 1. Communications between staff, participants, and family mean everything. 2. PACE is "radical." 3. Gifts don't always come wrapped with a bow. 4. PACE has a "blind spot." And 5. New PACE programs are coming. (David Williams, Los Angeles)

Center for Elders' Independence to Present on Managing a High-Risk Population

On the evening of December 5, Linda Trowbridge and the leadership team from the Center for Elders' Independence (CEI), one of the nation's largest and oldest PACE providers, will discuss what it takes to manage a high-risk population and how each team supports the interdisciplinary care model, how new technologies and innovations are leveraged to improve care, and how the community and start-ups can collaborate. This panel discussion will take place at the Aging 2.0 San Francisco event, which is a free event. (Linda Trowbridge, Bay Area)

Ceresti Team Co-Authors AJMC Paper on Dementia & Comorbid Conditions

Ceresti CEO Dirk Soenksen and Chief Commercial Officer Chris Selecky co-authored an article in the American Journal of Managed Care - Impact of Dementia on Costs of Modifiable Comorbid Conditions. The writers conclude that Alzheimer's disease and other dementias have a substantial impact on the prevalence and costs of certain comorbid conditions that may be modifiable by care management. (Dirk Soenksen & Chris Selecky, both Orange County)

Choice in Aging Debuts Videos Highlighting its Programs

Choice in Aging has created a 30-second video advertisement that is playing before every movie at two theaters in Concord, California - the Veranda LUXE Cinema and Brenden Theatres, for an entire year. Also, Choice in Aging has unveiled a two-minute video that showcases its Young at Heart Intergenerational Program. (Debbie Toth, Bay Area)

Cigna Offers Several New Digital Health Solutions

Cigna is collaborating with Annum Health to offer an innovative, digital health support solution to help people reduce alcohol consumption. Program participants will use a digital app and have a personal support team comprised of health coaches, physicians, and licensed therapists to help each individual meet their goals. Also, Cigna is adding Happify Health's Happify and Prevail Health's iPrevail evidence-based digital platforms to help customers build greater resilience, as well as cope with stress, anxiety, and depression. They will be available as part of the Cigna Total Behavioral Health program. And, Cigna has launched its new Cigna Healthy Pregnancy app to better connect individual customers to Cigna's suite of health benefits, including the Cigna Healthy Pregnancies, Healthy Babies maternity health engagement program. (Chris De Rosa, Orange County)

GeBBS Chosen by Chicago's Saint Anthony Hospital

Saint Anthony Hospital is implementing GeBBS Healthcare Solutions' Healthcare Information Management Compliance Audit & Coding Solutions. The acute care, community hospital, which serves residents of Chicago's west and southwest sides, selected GeBBS because of the depth of their coding and compliance audit expertise in addition to their robust processes and proprietary technology. (Nitin Thakor, Los Angeles)

Good Samaritan's Comprehensive Stroke Center Treats Severe Strokes with Thrombectomies, Most US Hospitals Can't

As a Comprehensive Stroke Center, Good Samaritan Hospital in Los Angeles, has already performed 65 of these advanced procedures, called a thrombectomy, so far this year. This procedure, which is transforming stroke care in America, can be used to treat the most severe stroke patients - but timing is critical. Various studies show that severe stroke patients fare better if taken directly to a thrombectomy hospital instead of waiting for a transfer to one. In many severe stroke cases, a patient who waits more than an hour for a thrombectomy has lower chances of a full recovery. Since most hospitals don't do thrombectomies, transfer sometimes is necessary. If so, faster is better. (Read Article: Wall Street Journal, 11/28/18, supplemented by Good Sam's Shauna Pearce) (Andy Leeka, Los Angeles)

Gorman Health Group on Star Ratings, "Patients Over Paperwork," & MA 2020

On December 13, Gorman Health Group will present a webinar - 2019 Star Ratings Performance Trends and Landscape Evolution, from 10-11 a.m. Pacific, providing an in-depth look at the trends of the recently released 2019 Star Ratings and their implications. Meanwhile, in Dave Sayen's recent blog post - Patients Over Paperwork is Real, he shares that this particular government campaign is primarily about cutting red tape and reducing administrative burdens, with a particular focus on improving the beneficiary experience and maximizing the time patients and providers spend together. And, in Medicare Advantage 2020 Proposed Rule, Dave discusses telehealth, Star Ratings, and using extrapolation in the Risk Adjustment Data Validation audits. (Dave Sayen, Bay Area)

HumanGood Communities Named Best Nursing Homes by U.S. News

U.S. News & World Report identified the best nursing homes for the upcoming year, and HumanGood earned high recognition for several skilled nursing centers across its communities of Redwood Terrace, Terraces at San Joaquin Gardens, Terraces at Los Altos, Piedmont Gardens, Valle Verde, and Judson Park. Researchers evaluated 15,000+ nursing homes around the country, and 2,975 earned the U.S. News Best Nursing Home designation. Also, HumanGood was listed as the nation's seventh largest senior housing provider for 2018 as part of LeadingAge Ziegler's 15th annual ranking of the top 200 providers. (Tara McGuinness, Bay Area)

Kaiser Permanente Tops California's Healthcare Quality Report Card

Kaiser Permanente Northern and Southern California health plans are the only plans in the state to receive 5 stars - the highest possible rating - for overall quality of medical care in the annual Healthcare Quality Report Card from California's Office of the Patient Advocate (OPA). In addition, KP Northern California is the only health plan in the state to earn 5 stars for overall clinical effectiveness in behavioral and mental health care. The 2018-2019 report card provides California consumers with side-by-side comparisons of the 16 largest HMOs and PPOs in the state. It rates them on national standard-of-care measures that involve treatment and prevention of a range of conditions that have significant implications for personal health. (Walt Meyers, Bay Area)

Kindred's RehabTracker App is Helping Improve Patient Outcomes

Kindred Rehabilitation Services (KRS), a division of Kindred Healthcare, announced that initial data from healthcare locations where RehabTracker is being utilized shows the application is improving outcomes for patients. RehabTracker is a mobile app developed by KRS, with which patients work with their therapy team to set personal goals and input them into the app; use their cell phones or tablets to see and track their progress in real time; share that progress with invited family and friends; and receive messages of support from loved ones. Patients at KRS-served locations using RehabTracker as of June 2018 have experienced increases in: Functional Independence Measure, discharge to community, and Program Evaluation Model score. (Adam Darvish, Los Angeles)

King & Spalding to Address Service Animals, Robots & Immigrants Within Healthcare Settings

On December 18, King & Spalding (K&S) will present a webinar - Service Animals, Robots and Immigrants in Healthcare Settings - Diverse, Emerging Issues and How to Operationalize, from 10-11 a.m. Pacific, where they will provide tips for developing policies and procedures to address emerging issues such as relevant requirements for accommodating service animals; how robots can be used in the non-surgical ambulatory care setting; and what obligations apply to providing non-emergency care to illegal immigrants. (Marcia Augsburger, Sacramento, & Travis Jackson)

MYnd Analytics Wins HHS Subcontract to Support Suicide Prevention

MYnd Analytics has been awarded a subcontract to incorporate its Psychiatric EEG Evaluation Registry (PEER) report within a project to develop a suicide prevention toolkit for the U.S. Department of Health and Human Services. By combining artificial intelligence, machine learning, and data analytics, MYnd Analytics can analyze EEG data to recognize patterns, predict outcomes, and personalize medicine; multiple studies have shown a relationship between EEG findings, medication response, and suicidality. Meanwhile, the company's PEER was featured on CBS New York by medical correspondent Dr. Max Gomez. (George Carpenter, Orange County)

Nelson Hardiman Becomes Largest Healthcare Firm in Los Angeles

Nelson Hardiman was awarded a Tier 1 ranking in Healthcare Law and Administrative/ Regulatory Law by U.S. News & World Report and, with the recent addition of three experienced healthcare attorneys, has become the largest healthcare law practice in Los Angeles. As such, the firm was featured in a recent article in the Los Angeles & San Francisco Daily Journal. Meanwhile, Harry Nelson was interviewed on KTLA5 concerning the 20th year of the opioid crisis and to discuss his latest book, The United States of Opioids: A Prescription for Liberating a Nation in Pain. (Harry Nelson, Los Angeles)

NorthBay Primary, Specialty Care Earn Top Honors

NorthBay Medical Group has earned a 5-star rating in overall patient experience - the highest rating possible - in annual survey results announced by the California Office of the Patient Advocate. The rating is the result of Patient Assessment Surveys of patients who received care in 2017, and covers six categories: care provided, communication with patients, coordination of patient care, health promotion, helpfulness of office staff, and timeliness of care and services provided. This top patient experience rating comes on the heels of an Integrated Healthcare Association award in October that honored NorthBay Medical Group as one of the top performing and most improved physician organizations in California. (Elnora Cameron, Bay Area)

Select Data Reports: PPS Final Rule Increases HHA's Payments for 2019

In PPS Final Rule Increases HHA's Payments for 2019, Select Data reports that CMS has finalized a plan to launch a budget-neutral payment model for home health that utilizes 30-day periods of care and stops using the number of therapy visits to determine payment, according to Decision Health. The Patient-Driven Groupings Model (PDGM) will launch "on or after" Jan. 1, 2020, according to the final rule. And, in CoP Interpretive Guidelines: Are You Compliant?, Select Data notes that the Home Health Agency Condition of participation (CoP) went into effect January 13, 2018, but that some agencies are still struggling with it. According to the CoP Interpretive Guidelines, to be compliant, home health agencies must have established standards of practice issued by a nationally recognized organization with expertise in the field. If your organization fails to meet these minimum standards when audited, you may be assessed a monetary fine or lose your Medicare certification. (Ed Buckley, Orange County, & Ted Schulte, Los Angeles)

Shriners Hospitals for Children - NorCal Receives $198,000 Gift

Shriners Hospitals for Children - Northern California has received a gift of $198,000 to benefit its pediatric hand program. The gift was made at the direction of anonymous donors, who have a personalized charitable fund at Placer Community Foundation. This Shriners Hospital is a leading provider of pediatric hand and upper extremity care in Northern California. (Maggie Bryan, Bay Area)

VivaLNK Launches Wearable Patch for Continuous Stress & Recovery Monitoring

VivaLNK has announced the availability of Vital Scout, the only reusable, wearable patch for the continuous monitoring of stress and recovery levels. Designed to be worn 24 hours a day over a period of two to three days at-a-time, Vital Scout offers a comprehensive picture of stress and recovery levels by analyzing the user's heart rhythm throughout waking and sleeping hours. Vital Scout uses medical grade electrocardiography sensors, and established heart rate variability algorithms to accurately measure the body's response to the physiological impacts of daily activities. (Jiang Li, Silicon Valley)

ZEISS Gets Another FDA Clearance

Having received the first FDA clearance for OCT Angiography technology in September 2015, the Medical Technology business group of ZEISS has now received the first FDA clearance for Swept-Source OCT imaging technology for posterior ocular structures with ZEISS PLEX Elite 9000. This powerful, cutting-edge Swept-Source OCT and OCT Angiography platform was designed for advanced retina research and is at the core of the Advanced Retina Imaging Network. (Angelo Rago, Bay Area)

TECH MEMBERS' HEALTHCARE NEWS
Catasys Signs Agreement with Capital Blue Cross

Catasys, Inc., a leading AI and technology-enabled healthcare company, has entered into an agreement with Capital BlueCross, a community-based health insurer serving members in 21 counties in Central Pennsylvania and the Lehigh Valley. Beginning the first quarter of 2019, eligible Capital BlueCross commercial members will be able to take advantage of Catasys' OnTrak solution, an integrated 52-week program that identifies, engages and treats members with untreated behavioral health conditions that exacerbate chronic medical disease and result in unnecessarily higher medical costs. (Rick Anderson, West Los Angeles Technology)

Sidebench & WITH to Present Universal Design Symposium

In 2018, Sidebench has teamed with the WITH Foundation, a non-profit foundation dedicated to promoting comprehensive healthcare, deep empathy, and design that focuses on the needs of adults with developmental disabilities, to create a workshop that teaches tech product designers how to design for a more accessible world. In November, Sidebench and WITH hosted a second round of Universal Design Events comprised of a Universal Design Symposium on Nov. 27, and a Beta Day on Nov. 28. More information. Meanwhile, Sidebench and WITH have been selected to share their message with a larger audience in an Equitable Design for Persons with Disabilities session at SXSW 2019, in March. (Kevin Yamazaki, West Los Angeles Technology)

Tanner Research CEO to Present Dinner & Movie Night

On the evening of December 7th, John Tanner, Ph.D., CEO of Tanner Research, will present a Nutrition Science event - Dinner and Movie Night: Eating You Alive, where he will screen a movie that takes a scientific look at the reasons we're so sick, who's responsible for feeding us the wrong information, and how we can use whole-food, plant-based nutrition to take control of our health. Attendees will also enjoy a healthy, plant-based dinner buffet in an informal setting, with free parking. (John Tanner, Monrovia Technology)

HEALTHCARE INDUSTRY TRENDS
85.4% of All Telehealth Users Had Mental Health Diagnosis: CMS

The Telebehavioral Health Institute has extracted key telebehavioral health and mental health information from a recent CMS Congressional report. Analysis indicates that telehealth is being used primarily to treat beneficiaries with mental health diagnoses. In 2016, 85.4% of all telehealth users (74,547 beneficiaries) had a mental health diagnosis. The overwhelming majority of Medicare telehealth users in all years studied were diagnosed with one of eight common mental health and substance use conditions. Approximately 37% of Medicare beneficiaries who received telehealth services in 2016 had diagnoses of a recurring major depressive disorder, bipolar disorder, and schizoaffective disorders. An additional 7,032 individuals (7.9%) were treated for schizophrenia and 4,554 (5.1%) for an episode of depression. HOWEVER, treatment for physical chronic conditions, such as diabetes and heart failure, are not among the most common diagnoses and there were fewer than 1,000 Medicare beneficiaries treated by telehealth for these conditions. (Read Article: Telebehavioral Health Institute, 11/26/18) IN FACT, when it comes to telemedicine, comprehensive reimbursement and coverage state mandates and a dearth of local psychiatrists were key factors in adoption, according to a research letter about the trends in telemedicine published in JAMA yesterday. The letter, which examines trends of telemedicine uptake in a large commercially-insured population between 2005 and 2017, found that while telemedicine was steadily growing during the time period, the majority of patients were still opting for in-person visits with their provider. (Read Article: MobiHealth News, 11/29/18)

In 2017, Number of Uninsured Kids Rose for First Time this Decade

After years of steady decline, the number of U.S. children without health insurance rose by 276,000 in 2017, according to a Georgetown University report. While not a big jump statistically - the share of uninsured kids rose to 5% in 2017 from 4.7% a year earlier - it is still striking. The uninsured rate typically remains stable or drops during times of economic growth. In September, the U.S. unemployment rate hit its lowest level since 1969. (Read Article: California Healthline, 11/29/18)

Suicide, at 50-Year Peak, Pushes Down US Life Expectancy

Suicides and drug overdoses pushed up U.S. deaths last year, and drove a continuing decline in how long Americans are expected to live (a baby born last year in the U.S. is expected to live about 78 years and 7 months, on average. An American born in 2015 or 2016 was expected to live about a month longer, and one born in 2014 about two months longer than that). Overall, there were 2.8+ million U.S. deaths in 2017, or nearly 70,000 more than the previous year, the CDC said. It was the most deaths in a single year since the government began counting more than a century ago. The increase partly reflects the nation's growing and aging population. But it's deaths in younger age groups - particularly middle-aged people - that have had the largest impact on calculations of life expectancy, experts said. (Read Article: New York Times, 11/29/18)

"Probiotics Might Not Do Much; Focus on Fiber Instead"

According to a recent study, the effectiveness of probiotics can depend on an individual's resident microbiome. In participants with a "resistant" gut microbiome - about half of the group studied - the bacteria from probiotics wound up in the toilet bowl. In fact, increasing evidence suggests that instead of eating new bugs, we should focus on feeding the ones we already have. These good bugs thrive on certain types of dietary fiber, dubbed prebiotics, found in fruits, vegetables, nuts, seeds, and whole grains. (Read Article sent by Andy Leeka from: Outside Online, 11/29/18)

CVS Health and Aetna Close $70 Billion Merger

Nearly one year after agreeing to merge in a bid to reinvent healthcare for Americans, CVS Health and Aetna have sealed the deal, bringing together one of the nation's largest pharmacy chains and one of the largest health insurers. Aetna will be a stand-alone unit within CVS and led by members of its current management team. Mark Bertolini will resign as Aetna CEO but will have a seat on CVS' board of directors. (Read Article: Modern Healthcare, 11/28/18)

Amazon to Sell EHR-Mining Software

In a move that expands its budding presence in the healthcare space, Amazon is selling software that mines patient health records for information that helps physicians improve treatments and hospitals cut costs, The Wall Street Journal reports. The software, dubbed Amazon Comprehend Medical, will use natural language processing and machine learning to highlight key data points - such as medical condition, medication dosage and clinical trial reports - from EHRs and unstructured clinical notes that physicians can use to inform a patient's care. Amazon said the insights can help healthcare organizations with clinical decision support, revenue cycle management and population health. The software may also free employees of clerical work, such as manually rifling through notes. (Read Article: Becker's Health IT & CIO Report, 11/27/18)

Apple Watch ECG Will Go Live by Year's End - Report

Apple made big waves at its last September special event by announcing - concurrent with FDA's announcement of its clearance - an ECG reader built into the Apple Watch Series 4. Now, according to a leaked training document obtained by MacRumors, that feature is set to go live in the next WatchOS update, version 5.1.2, due out before the year's end. (Read Article: MobiHealth News, 11/29/18)

From Gene Editing to AI, How Will Technology Transform Humanity?

"A geneticist, an oncologist, a roboticist, a novelist and an A.I. researcher walk into a bar." That could be the setup for a very bad joke - or a tremendously fascinating conversation. Fortunately for us, it was the latter. On a blustery evening in late September, in a private room at a bar near Times Square, the magazine gathered five brilliant scientists and thinkers around a table for a three-hour dinner. In the (edited) transcript, you can see what they had to say about the future of medicine, health care and humanity. (Read Article: The New York Times Magazine Tech and Design Issue, 11/16/18)

HEALTHCARE & GOVERNMENT
CMS Hospital Value-Based Purchasing Program Results for Fiscal Year 2019

The Hospital Value-Based Purchasing Program adjusts what Medicare pays hospitals under the Inpatient Prospective Payment System based on the quality of inpatient care the hospitals provide to patients. For fiscal year 2019, the law requires that CMS reduce a portion of the base operating Diagnosis-Related Group payment amounts otherwise applicable to a participating hospital for each discharge by 2%, and that the estimated sum total of these reductions be the amount redistributed to participating hospitals based on their performance on a previously-announced set of quality and cost measures. CMS estimates that the total amount available for value-based incentive payments in FY 2019 will be approximately $1.9 billion. (Read: CMS Fact Sheet, 12/3/18)

Dem Single-Payer Fight Shifting to Battle Over Medicare Buy-In

Momentum is building among House Democrats for a more moderate alternative to single-payer healthcare legislation. The legislation, which would allow people aged 50 to 65 to buy Medicare, is being championed by Rep. Brian Higgins (D-NY), who supported House Minority Nancy Pelosi (D-Calif) for Speaker in exchange for a commitment to work on his bill when Democrats take control of the House early next year. (Read Article: The Hill, 11/29/18)

PHARMA & GOVERNMENT:
Flashpoint: Tying U.S. Drug Prices to What Other Countries Pay

A patient advocate and a pharmaceutical industry representative went head to head recently on a proposal to peg U.S. drug prices to how much they cost in other countries - sparring over whether it is an idea whose time has come or the death knell for innovation. Health secretary Alex Azar recently proposed a controversial change to the way Medicare pays for drugs administered in doctors' offices that would tie some U.S. prices to the cost in other countries. The government would aim to pay about 30% less for certain drugs, with the price reduction for individual drugs related in some way to the average price of those drugs in certain other countries. (Read Article: STAT, 11/29/18)

CMS Takes Action to Lower Rx Costs by Modernizing Medicare

CMS has proposed polices for 2020 to strengthen and modernize the Medicare Part C and D programs. The proposal would ensure that Medicare Advantage and Part D plans have more tools to negotiate lower drug prices, and the agency is also considering a policy that would require pharmacy rebates to be passed on to seniors to lower their drug costs at the pharmacy counter. (Read Article: CMS.gov/newsroom, 11/26/18)

Democrats Taking Key Leadership Jobs Have Pocketed Millions from Pharma

Three of the lawmakers who will lead the House next year as Congress focuses on skyrocketing drug costs are among the biggest recipients of campaign contributions from the pharmaceutical industry, a new Kaiser Health News analysis shows. House Democrats recently selected Rep. Steny Hoyer of Maryland to serve as the next majority leader and Rep. James Clyburn of South Carolina as majority whip, making them the No. 2 and No. 3 most powerful Democrats as their party regains control of the House in January. Both lawmakers have received more than $1 million from pharmaceutical company political action committees in the past decade. Adding Rep. Nancy Pelosi, the California Democrat expected to be the next speaker, the three-person House Democratic leadership team has collected more than $2.3 million total in campaign contributions from drugmakers since the 2007-08 election cycle, according to KHN. (Read Article: Kaiser Health News, 11/29/18) Meanwhile, a new KHN database tracks campaign donations from drugmakers over the past 10 years. (View Database)

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