Medicare is proposing across-the-board cuts to what Trump administration officials believe are overpriced medical procedures, scans, and tests — a consequential decision designed to even the score between highly paid specialists and primary care doctors. “People used to talk about the primary care physician being sort of the quarterback of the team,” Abrams said. “But what team do you know where the quarterback is the lowest-paid member?”
Medicare also criticized the way these services are currently priced — through surveys of physician practices that have unreliably low response rates — and wants to exclude that input going forward. Read more from STAT’s Bob Herman and Tara Bannow about the details of the proposal — and why it got slammed by the American Medical Association.
neuroscience
International consortium uncovers protein changes linked to neurodegenerative disease
More than 57 million people across the world live with neurodegenerative diseases, a figure set to double every 20 years. Current treatment options for these incurable conditions are limited, but scientists are betting that studying protein-level changes could help identify new drug targets and biomarkers to guide diagnosis, prognosis, and treatment decisions.
In a series of studies published
The data come from the Global Neurodegeneration Proteomics Consortium, a public-private partnership funded in part by Gates Ventures, the private office of Bill Gates. In an accompanying letter, the Microsoft co-founder praised the consortium’s progress — and noted that many of the samples in its database come from federally funded research.
“I cannot wait to see what other discoveries are made in the years to come, especially now that the GNPC dataset is available to the public,” Gates wrote. “We are on the cusp of turning the tide against dementia — which makes this an especially bad time to pull back on research.” — Jonathan Wosen
- Even grave errors at rehab hospitals go unpenalized and undisclosed, KFF Health News
Indian generic drugmaker fails another FDA inspection
Sun Pharma, the world’s largest generic drugmaker, failed another FDA inspection of one of its facilities, after it’s been repeatedly cited for serious quality control issues.
The problems cited at the plant involved a raft of practices that raised questions about the ability of the Indian drugmaker to properly ensure sterility, environmental conditions, and cleanliness, according to an FDA report.
The failed inspection comes amid rising anxiety over the viability of the supply of generic medicines from India. Manufacturers in the country supply about 40% of the generic medicines taken by Americans.
Read more from STAT’s Ed Silverman.
from Politico:
HOSPITAL PAY CUT — The Trump administration is proposing cutting $280 million in payments to certain hospital clinics for administering drugs to patients, POLITICO’s Robert King reports.
The Centers for Medicare and Medicaid Services said the cut would ensure that Medicare beneficiaries aren’t charged more for the same service at a hospital than at an independent clinic. The proposed rule is likely to generate fierce pushback from the hospital industry, which has successfully fought similar congressional efforts.
The rule also outlines 2026 Medicare payment rates for hospital outpatient services and ambulatory surgical centers and includes new changes to boost price transparency.
“These reforms expand options and enforce the transparency Americans deserve to ensure they receive high-quality care without hidden costs,” CMS Administrator Mehmet Oz said in a statement.
Background: The first Trump administration adopted a policy in 2019 to lower payments for outpatient hospital clinics to align them with those of independent clinics. Now, CMS wants to expand that policy to include services for storing or administering pharmaceuticals to patients.
The agency estimates the change will reduce Medicare spending by $280 million, with $210 million allocated to Medicare and $70 million to Medicare beneficiaries thanks to lower co-insurance rates, according to a fact sheet on the rule.
Key context: Site-neutral payments — when Medicare pays the same amount for the same service regardless of where it’s provided — have gotten bipartisan support on Capitol Hill. But packages have never made it across the finish line partly due to fervent lobbying from the hospital industry, which argues the payment cuts would imperil the finances of vulnerable hospitals.
What’s next: The rule has a 60-day comment period before final approval.
