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BioWorld - Saturday, December 13, 2025
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MedPAC anticipates doubling of Medicare spending by 2032

Aug. 21, 2025
By Mark McCarty
The Medicare Payment Advisory Commission said in a recent report that Medicare spending in the U.S. is poised to nearly double to $1.9 trillion over the coming eight years, a figure that is likely to apply ever-increasing price pressures on makers of devices, diagnostics and pharmaceuticals.
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US-health-flag-medicare.png

MedPAC anticipates doubling of Medicare spending by 2032

Aug. 20, 2025
By Mark McCarty
The Medicare Payment Advisory Commission said in a recent report that Medicare spending in the U.S. is poised to nearly double to $1.9 trillion over the coming eight years, a figure that is likely to apply ever-increasing price pressures on makers of devices and diagnostics.
Read More
Medicare puzzle

Congress questions Medicare’s WISeR proposal

Aug. 14, 2025
By Mark McCarty
The U.S. Centers for Medicare & Medicaid Services proposed to use AI to cut down on abuse of the Medicare program, but several members of Congress have concerns about the notion, given that private payers have used AI to illegitimately deny services to their beneficiaries.
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Medicare puzzle

Congress questions Medicare’s WISeR proposal

Aug. 13, 2025
By Mark McCarty
The U.S. Centers for Medicare & Medicaid Services proposed to use AI to cut down on abuse of the Medicare program, but several members of Congress have concerns about the notion, given that private payers have used AI to illegitimately deny services to their beneficiaries.
Read More
Medicare puzzle

TEAM proposal beefed up in Medicare inpatient final for FY 2026

Aug. 5, 2025
By Mark McCarty
The U.S. Centers for Medicare & Medicaid Services adopted several significant policy changes in the Medicare inpatient final rule for fiscal 2026, which includes a larger rate bump for hospitals than seen in the draft.
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Adopt MFN pricing or else, drug companies told

July 31, 2025
By Mari Serebrov
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President Donald Trump sent letters July 31 to the CEOs of 17 major drug manufacturers doing business in the U.S., giving them 60 days to comply with his May 12 executive order (EO) on most-favored-nation (MFN) pricing. The EO appealed to drug companies to undertake MFN pricing voluntarily to end the freeloading in which other developed countries pay, on average, three times less than Americans are charged for the same medicines.
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Boston Scientific - Watchman FLX

Cardiologists blast Medicare LAA closure draft

July 29, 2025
By Mark McCarty
The ink is barely dry on the draft Medicare physician fee schedule for 2026, but three cardiology societies blasted the draft for cutting rates for left atrial appendage closure procedures – a move they said needlessly endangers patients.
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CMS logo and website

CMS revisits coverage criteria for Parkinson’s, essential tremor

July 28, 2025
By Mark McCarty
An advisory committee for the U.S. Centers for Medicare & Medicaid Services endorsed a series of patient- and clinician-reported outcomes that might not be reflected in the evidentiary bases for currently available technologies. This development suggests some manufacturers will have to conduct new studies of their devices in order to sustain Medicare coverage.
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Gears with regulatory words

Palmetto wary of Prelude’s, Exact Sciences’ test for DCIS

July 21, 2025
By Mark McCarty
Palmetto GBA of Columbia, S.C., issued a draft local coverage determination that provides coverage for biomarker testing to stratify a patient’s risk associated with ductal carcinoma in situ.
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Heart and Optimizer Mini

Impulse Dynamics inches closer to Medicare coverage for CCM

July 17, 2025
By Mark McCarty
The U.S. Centers for Medicare & Medicaid Services (CMS) has issued a draft coverage memo for cardiac contractility modulation (CCM), which offers coverage with evidence development for the company’s Optimizer line of devices. CMS said it will issue the final coverage memo by Oct. 8, 2025, which will mark the achievement of an objective the company set for itself more than two decades ago.
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