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• Senate Finance Draft Extender Legislation Tweaks Low-Volume Hospital Program, Home-Health Rural Add-On
  A legislative discussion draft obtained by Inside Health Policy shows the Senate Finance Committee is considering extending a number of Medicare payment programs -- many of which historically were renewed alongside patches to the Sustainable Growth Rate -- for between two and five years, including: the Geographic Practice Expense Index (GPCI) Floor, ambulance add-on payments, low-volume hospital adjustments, the Medicare Dependent Hospital program, home health rural add-on, funding for quality measures, the Maternal, Infant and Early Childhood Home Visiting Program, and outreach and assistance funding for low-income programs. The discussion draft also includes provisions that would repeal the Medicare therapy caps and delay aspects of the Bipartisan Budget Act of 2013 related to Medicaid third-party liability.
• CMS, In Major Step, Proposes Handing States Authority On EHBs, Rate Review
  CMS on Friday (Oct. 27) took a major step toward administratively overhauling the Affordable Care Act's health insurance exchanges in line with key GOP health reforms that have stalled on Capitol Hill. The administration proposed to give states new flexibility to set essential health benefits, loosen requirements for small business exchanges, increase the threshold for rate review, eliminate standardized plan options and the "meaningful difference" standard, and more. The policies are laid out in a draft 2019 Notice of Benefit Payments and Parameters, on which CMS will take comments through Nov. 27.
• Endo Sues FDA Over 503B Compounding Policy
  Endo Pharmaceuticals and subsidiary Par Sterile Products are suing FDA to block the agency's current interim policy on compounding of bulk substances by outsourcers, which they argue ignores congressional intent under the Drug Quality and Security Act (DQSA) and violates drug law by allowing copies of FDA-approved drugs to be compounded in bulk while bypassing the FDA approval process.
• CMS Meets With Pharmaceutical, Insurance Companies On Value-Based Pay
  CMS officials on Thursday (Oct. 26) met with pharmaceutical and insurance company representatives to discuss movement toward value-based payment, including how to measure value and quality, CMS Administrator Seema Verma said. The meeting came after CMS requested advice on new Medicare and Medicaid drug payment models as part of a Request for Information on a new direction for CMS' innovation center, and as rumors of a drug price executive order resurface.