This Weekly’s Hot Topics
- DMHC proposed regulations for payors’ average contracted rate. (California News)
- Harnessing the Power of Immunotherapy, March 3, Huntington Beach (MOASC News)
- What’s New with Physician Compare webinar TOMORROW & Thursday (CMS News)
The California Department of Managed Health Care (DMHC) has issued proposed regulations for calculating payors’ “average contracted rate” under California’s new out-of-network billing and payment law. The law (AB 72), which took effect July 1, 2017, requires fully insured commercial payors to make “interim payments” to non-contracted physicians for covered, non-emergent services performed at in-network health facilities. For more information click here and go to California News.
The Institute for Clinical and Economic Review (ICER) has released an evidence report assessing the comparative clinical effectiveness and value of approved CAR-T therapies. The report found that both therapies (Yescarta and Kymriah) provided improvements in response rates and survival for patients who have exhausted most other treatment options, and that the drugs are priced in alignment with their clinical value. For more information click here and go to National News.
As anticipated, the President’s 2019 budget includes changes to the 340B program. Specifically, the budget notes that it will propose to modify payments for Part B drugs purchased through the 340B program to reward “hospitals that provide charity care and reducing payments to hospitals that provide little to no charity care.” For more information click here and go to National News.
You still have time to register for the “What’s New with Physician Compare” webinars. The Centers for Medicare & Medicaid Services (CMS) will be hosting two 90-minute Physician Compare webinars to talk about the recent Physician Quality Reporting System (PQRS) and non-PQRS PY 2016 measures release on Physician Compare. For more information click here and go to CMS News.
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February 20, 2018