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International Reference Pricing for Medicare Drugs: New Lease on Life or Least Likely to Succeed?

On Sunday, September 13, 2020, President Donald Trump issued a long-anticipated Executive Order on international reference drug pricing (the “EO”), signaling that rulemaking on the prices that the Medicare program pays for drugs may be underway again. The EO introduces some new concepts for international reference drug pricing, including, significantly, application to Medicare Part D as well as Part B, and an even lower international reference price. However, like its predecessor pronouncements, the EO provides no specifics for implementation, leaving it unlikely that any changes to the Medicare program contemplated by the EO will go into effect, if ever, before the 2020 election, by the end of the year, or soon thereafter.

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Governor Baker Announces Major Investment in COVID-19 Provider Reimbursement and Testing Capacity


Time to Read: 2 minutes Practices: Health Care

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Coronavirus Landing Site

On April 7, 2020, Governor Charlie Baker announced that his administration will invest an additional $800 million into the State’s Medicaid program known as MassHealth to support a variety of providers hard-hit by the pandemic. The majority of the money will come from MassHealth savings from the cancellation of costly elective procedures, as well as increased federal reimbursement for COVID-19 treatment.

  • Hospitals will receive $400 million of the funding. The Baker administration has identified 28 safety-net and high-Medicaid hospitals to receive the majority of this funding “to address lost revenue and increased costs for hospitals at the front lines of treating patients.”1 The funding will also be used to support a rate increase of 20 percent for COVID-19 care and 7.5 percent for all other hospital care.
  • Nursing Facilities will receive $80 million of funding, $50 million of which will be distributed to all nursing facilities in Massachusetts. Facilities that are fully or partially dedicated to serving COVID-19 patients will be eligible for an additional $30 million to support the cost of providing care.
  • Community Health Centers will receive more than $50 million.
  • Personal Care Attendants will receive approximately $30 million.
  • Miscellaneous Providers, including ambulance providers, physicians, behavioral health providers, home health agencies, and certain long-term services and supports day programs, are eligible for the remainder of the $300 million. The Governor has not yet specified how these funds will be allocated among these providers. 

Governor Baker has also focused on increasing testing capacity. The Governor has launched a program to allow for rapid on-site testing of residents in long-term care facilities. The state Department of Health, in partnership with the Massachusetts National Guard, is administering the Nursing Home Mobile Testing Program. The National Guard had already completed more than 1,300 tests, and the Department of Public Health on April 7 expanded the program to allow on-site staff to collect specimens. The Governor also announced the launch of a CVS rapid testing site in Lowell, Massachusetts which allows up to 1,000 patients to be tested per day and receive results on-site. With the launch of this new site, CVS will be shuttering its Shrewsbury pilot testing site. 

The announcement of increased funding and testing resources will provide much-needed relief for providers struggling with the increased costs of care during the COVID-19 pandemic and other challenges associated with managing the virus outbreak. Providers will need to monitor releases from the Governor’s office and the Department of Public Health for updates on how to access these new funding streams.

  1. Press Release, Governor Charlie Baker and Lt. Governor Karyn Polito, Baker-Polito Administration Announces Increased Resources For Health Care Providers, Expanded Support For Long-Term Care Facilities, COVID-19 Testing Initiatives (Apr. 7, 2020), https://www.mass.gov/news/baker-polito-administration-announces-increased-resources-for-health-care-providers-expanded.
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