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D.C. Week: CMS Invites Work Requirements in Medicaid Waivers

D.C. Week: CMS Invites Work Requirements in Medicaid Waivers

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WASHINGTON — The head of the Centers for Medicare & Medicaid Services (CMS) spoke of a “new chapter” for Medicaid waivers — inviting proposals that require non-disabled adults to be employed, in school, or doing volunteer work as a condition of enrollment in the program.

Verma: States Can Impose Medicaid Work Requirements

CMS will allow “community engagement” — also known as work requirements — in state Medicaid waiver requests, according to CMS administrator Seema Verma.

“We will approve proposals that promote community engagement activities,” Verma said during a speech at the National Association of Medicaid Directors annual meeting on Tuesday. “For the future of our country, we need all Americans to be active participants in their communities.”

She argued that the resistance to work requirements for working-age, “able-bodied” individuals, reflects the “soft bigotry of low expectations” fostered under the Obama administration. Work requirements or community engagement includes holding a job, attending job training, volunteering, or going to school.

Relieving Paperwork Burden a Top Priority, Says Medicaid Director

The Trump administration is doing its best to relieve the administrative burden for Medicaid plans, Brian Neale, director of the Center for Medicaid and CHIP Services, said here Wednesday.

“Medicaid directors say they are devoting way too much time responding to CMS-required tasks,” Neale said at the annual meeting of the National Association of Medicaid Directors. “We’re going to help them free up those resources … At CMS, we’ve heard from states that our business processes at CMS can be administratively cumbersome. We are often told [that we] ask too many unnecessary questions and that our response times [are too long].”

“We’re addressing those concerns,” and with good reason, he said. “Relieving some of the day-to-day administrative burdens of states means spending less time checking boxes and more time developing approaches that improve health outcomes.”

Two information bulletins that CMS released this week — one on state Medicaid plan amendments and 1915 waivers, and the other on 1115 Medicaid demonstration projects — “outline the agency’s progress,” Neale continued.

Drug OK’d for Preventing CMV Infection in Bone Marrow Transplant

The FDA approved letermovir (Prevymis) as the first drug indicated for prevention of cytomegalovirus (CMV) infection in recipients of allogeneic hematopoietic stem cell transplant, the agency announced late Wednesday.

“Among the more than 27,000 allogeneic HSCTs performed each year worldwide (including approximately 8,500 transplants in the United States), an estimated 65%-80% of recipients have been previously exposed to CMV and are therefore at high risk for CMV infection,” the FDA said in a statement.

The drug was studied in a randomized controlled trial in which patients receiving letermovir showed lower rates of CMV infection compared with placebo. Letermovir is contraindicated in patients taking pimozide and ergot alkaloids and in patients receiving pitavastatin or simvastatin when co-administered with cyclosporine.

P-TAC Plea: More Resources to Get Advanced APMs Going

Physicians are experts in clinical care — not payment — and they need technical support to design new payment models, according to experts at a hearing of the House Energy and Commerce Health Subcommittee on Wednesday.

“There are still barriers that physicians face in transitioning to these new models,” said Elizabeth Mitchell, vice chair for the Physician-focused Payment Technical Advisory Committee (P-TAC), referring to the advanced alternative payment models (APMs).

“Most physicians, they have experience changing care delivery, but they have not been trained in the development of incentives, payment models, or risk management,” she stated.

Jeffrey Bailet, MD, committee chair and executive vice-president of health care quality and affordability at Blue Shield of California, stressed that the Medicare Access and CHIP Reauthorization Act (MACRA) is “silent” on whether its experts can provide technical assistance to those groups proposing new models.

Next Week

On Monday, the American Enterprise Institute will host a conversation with House Committee on Energy and Commerce chairman Greg Walden (R-Ore.)

On Tuesday, the Senate Health, Education, Labor, & Pensions (HELP) Committee will discuss gene editing technology and innovation.

On Wednesday, the Senate HELP committee will discuss “encouraging healthy communities, focusing on perspective from the Surgeon General.”

On Thursday, The Hill will host a discussion on the future of Alzheimer’s disease research.

Also on Thursday, the FDA’s Antimicrobial Drugs Advisory Committee will discuss an application for ciprofloxacin inhalation powder for the reduction of exacerbations in non-cystic fibrosis bronchiectasis in adult patients with respiratory bacterial pathogens.

2017-11-11T12:00:00-0500

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