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CMS Administrator Brooks-LaSure Letter to Payors Regarding Coverage of COVID-19 Vaccines Post Commercialization

Briggs Healthcare

We also wanted to send these reminders from the Centers for Medicare & Medicaid Services (CMS) about COVID-19 vaccine coverage and encourage you to start planning now for the fall vaccination campaign. By law, any Food and Drug Administration (FDA)-approved or authorized COVID-19 vaccine is covered under Medicare Part B.

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340B Court Cases

Healthcare ECONOMIST

The Public Health Service Act ( PHSA ) in 1992, created a program to allow hospitals providing care for underserved communities to be able to access discounted drugs. Becerra v Empire Health Foundation. This case examines how Medicare calculates disproportionate share hospital (DSH) payments to hospitals.

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NASHP Model Act to Limit Out-of-Network Provider Rates

NASHP

This model legislation limits out-of-network rates for inpatient and outpatient hospital services to the lesser of (a) the state’s median in-network commercial rate for the same service; or (b) [X]% of the Medicare rate for the same service in the same geographic area.

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HHS Issues Proposed Rule to Provide Clarity on Rights of Conscience in Healthcare

Sheppard Health Law

The provisions also prohibit entities that receive federal funds from denying admission or discriminating against any applicant for training or study based on their reluctance or willingness to counsel, recommend, perform, or assist in certain health services or research activities because of their religious beliefs or moral convictions.

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Public Health Modernization Toolkit: About This Toolkit and Our Framework

NASHP

Third, the growing recognition of the role of social determinants of health in driving health outcomes and health care costs has led to increased health care delivery system investment in upstream prevention activities and community investment traditionally in the realm of public health.

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Medicare moving to reference pricing?

Healthcare ECONOMIST

“CMS will exclude a drug or biological product that is designated as a drug for only one rare disease or condition under section 526 of the FD&C Act and that is approved for only an indication (or indications) for such disease or condition” Low-spending Medicare drugs. Note that this figure is not inflation indexed.

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Major Questions about Vaccine Mandates, the Supreme Court, and the Major Questions Doctrine

Bill Of Health

This Friday, the Supreme Court will hear arguments about two federal vaccine mandates: the Centers for Medicare and Medicaid Services’ (CMS) mandate for health care workers, and the Occupational Safety and Health Administration’s (OSHA) vaccine-or-test mandate for employers with over 100 workers.