Midweek Update

The federal judge in the health insurer mergers anti-trust case pending here in DC federal district court will be holding a status call tomorrow morning. The government prefers a trial next February while the defendants prefer separate trials later this year.  The judge’s preference will rule the day.  

Yesterday, CMS finalized its Medicare Part A prospective payment system rule for inpatient hospital services, and Modern Healthcare’s lede suggests that it’s not good news for hospitals.

In a final rule released Tuesday, the CMS said it will keep a controversial 1.5% cut to hospital reimbursement. Industry stakeholders had rallied against the move which aims to recoup a total of $11 billion in overpayments.  Hospitals expected the cut to remain at 0.8%​—as it has been ever year since 2014, two years after Congress mandated the CMS to recover funds allegedly lost as a result of incorrect coding on inpatient hospital stays.

The rule takes effect on October 1, 2016.  Robert Moffitt from the Heritage Foundation offer his expert views on the next 50 years of the Medicare Program here.  The FEHBlog predicts more Medicare cost shifting to FEHBP and other employer sponsored and for that matter ACA marketplace plans in the near term.

The Drug Channels blog offers seven takeaways from his review of the initial (subject to change) 2017 formulary lists released by CVS Caremark and Express Scripts. It’s interesting to see how the two companies’ strategies stack up.