The Centers for Medicare & Medicaid Services (CMS) finalized changes to outdated federal regulations that have burdened health care providers with added administrative costs and impeded the health care system’s move toward value-based reimbursement. The Physician Self-Referral Law, also known as the “Stark Law,” generally prohibits a physician from sending a patient for many types of services to a provider that the physician owns, is employed by, or otherwise receives payment from—regardless of what that payment is for.  The old federal regulations that interpret and implement this law were designed for a health care system that reimburses providers on a fee-for-service basis, where the financial incentives are to deliver more services. However, the 21st century American health care system is increasingly moving toward financial arrangements that reward providers who are successful at keeping patients healthy and out of the hospital, where payment is tied to value rather than volume.

Full press release

The Trump Administration has taken enormous steps towards lowering the cost of prescription drug prices in America, reflecting the historic commitments by both President Trump and Secretary Azar to put American patients first. In three different actions, the Administration has worked towards implementing President Trump’s July 24, 2020 Executive Order on “Lowering Prices for Patients by Eliminating Kickbacks to Middlemen;” cutting down on foreign freeriding through the Most Favored Nation Model; and announced the end of the Food and Drug Administration’s Unapproved Drugs Initiative (UDI), a program that drug companies had used to jack up prices on older drugs.

The Trump Administration finalized a rule to bring drug discounts directly to seniors at the pharmacy counter and eliminate the current system of drug rebates to middlemen.

• HHS Finalizes Rule to Bring Drug Discounts Directly to Seniors at the Pharmacy Counter
• Fact Sheet: Trump Administration Finalizes Proposal to Lower Drug Costs by Targeting Backdoor Rebates and Encouraging Direct Discounts to Patients
• Secretary Azar Confirmation In Response to Executive Order on Lowering Prices for Patients by Eliminating Kickbacks to Middlemen

The Trump Administration also announced the Most Favored Nation Model, a prescription drug payment model to put American patients first.

• Trump Administration Announces Prescription Drug Payment Model to Put American Patients First
• FACT SHEET: Most Favored Nation Model for Medicare Part B Drugs and Biologicals Interim Final Rule with Comment Period

Additionally, HHS announced a notice published in the Federal Register announced the withdrawal of guidance documents issued as part of the Unapproved Drugs Initiative.

• Statement from HHS Chief of Staff Brian Harrison on Unapproved Drugs Initiative
• Read the Frequently Asked Questions Regarding the Department of Health and Human Services’ Announcement on the Unapproved Drugs Initiative – PDF*

Here is a fact sheet on all of the actions the Administration has taken to lower prescription drug prices.

CMS will retire the original Compare Tools on December 1. Use Medicare.gov’s Care Compare to find and compare health care providers.

In early September, the Centers for Medicare & Medicaid Services (CMS) released Care Compare on Medicare.gov, which streamlines our eight original health care compare tools.  Since then, you’ve had the opportunity to use and familiarize yourself with Care Compare while having the option to use the original compare tools, too.  You’ve also been able to share feedback from a survey directly on Care Compare and we’ve received lots of great feedback so far.

The eight original compare tools – like Nursing Home Compare, Hospital Compare, Physician Compare – will be retired on December 1^st, ending this transition period. If you haven’t been using Care Compare, we urge you to:

• Use Care Compare on Medicare.gov and encourage people with Medicare and their caregivers to start using it, too. Go to Medicare.gov and choose “Find care”.
• Update any links to the eight original care tools on your public-facing websites so they’ll direct your audiences to Care Compare.

Care Compare offers a new design that makes it easier to find the same information that’s on the original compare tools. It gives you, patients, and caregivers one user-friendly place to find cost, quality of care, service volume, and other CMS quality data to help make informed health care decisions.

Now, instead of having to search through many compare tools, with just one click on Care Compare, you’ll find easy-to-understand information about nursing homes, hospitals, doctors, and other health care providers.

Please remember that when we retire the 8 original compare tools, you will still be able to find information about health care providers and CMS quality data on Care Compare, as well as download CMS publicly reported data from the Provider Data Catalog on CMS.gov.  Fully transitioning to these tools does not change how CMS measures quality. In addition, we’ll continue to make improvements to Care Compare and the Provider Data Catalog based on stakeholder and consumer feedback now and in the future.

Direct links to the tools & additional resources:

• Care Compare on Medicare.gov – https://www.medicare.gov/care-compare/
• Provider Data Catalog on CMS.gov – https://data.cms.gov/provider-data/
• Care Compare resources for consumers and partners – Medicare blog, Promotional video, Conference card

Full Press Release: https://www.cms.gov/newsroom/press-releases/cms-care-compare-empowers-patients-when-making-important-health-care-decisions

As part of its ongoing work to explore sustainable transportation options, the Pennsylvania Department of Transportation (PennDOT) is requesting public feedback for the PennDOT Pathways Program. Information is accessible at www.penndot.gov/funding and feedback will be accepted through December 17, 2020.

“A safe and reliable transportation network is critical to quality of life for those who travel throughout our state,” said PennDOT Secretary Yassmin Gramian. “We take our responsibility as stewards of mobility very seriously, which is why we must explore our options.”

The department faces an $8.1 billion gap in its annual highway and bridge transportation funding to keep the network in a state of good repair. Federal funding has remained essentially flat for several years despite rising inflation. Gas taxes, which comprise 74 percent of PennDOT’s funding, have become increasingly unreliable.

Through the PennDOT Pathways program, the department is launching an extensive initiative to examine possible near- and long-term funding solutions – and how they could potentially work in Pennsylvania. As part of this program, PennDOT recently launched an alternative funding Planning and Environmental Linkages (PEL) Study as part of the PennDOT Pathways program to explore options for funding the maintenance and improvement of Pennsylvania’s highways and bridges.

PennDOT encourages the public to review the information presented on its online engagement platform and to provide comments. Online comments can be submitted directly from the website, or through the below methods:

• Email: PennDOTPathways@pa.gov
• Hotline: 717-325-6129
• Mail: PA Department of Transportation, Keystone Building, 400 North St., Fifth Floor, Harrisburg, PA 17120

For more information about PennDOT Pathways, visit www.penndot.gov/funding.

Pennsylvania State Veterinarian Dr. Kevin Brightbill urged Pennsylvania’s poultry industry, including backyard bird owners, to step up their biosecurity practices as East Asia and Europe report cases of Highly-Pathogenic Avian Influenza.

“Written biosecurity plans are good, but they are only effective when deliberately acted upon day in and day out by you and every farm-hand,” said Brightbill. “When practical biosecurity practices are implemented, they not only safeguard your farm and your flock from high consequence disease, but may enhance the productivity and long-term sustainability of your farm.”

Highly Pathogenic Avian Influenza (HPAI) is reported to be circulating in East Asia and Europe including the countries of Bulgaria, Cambodia, China, Czech Republic, Denmark, Germany, Hungary, Ireland, Japan, Kazakhstan, Laos, Netherlands, Poland, Slovakia, Romania, Russia, South Korea, Taiwan, United Kingdom, Ukraine, and Vietnam. HPAI is known to spread rapidly and be fatal for chickens and turkeys. The last outbreak of HPAI in Pennsylvania, H5N2 in 1983, resulted in the loss of more than 17 million chickens, turkeys, and guinea fowl to contain and eradicate the disease.

Pennsylvania poultry producers should limit exposure of poultry to wild birds through confinement rearing and other biosecurity measures to reduce the risk of introduction of avian influenza virus from wild birds. Such practices are key to decreasing the risk of circulating strains of Avian Influenza from evolving into highly pathogenic forms. Recent detection by USDA Wildlife Services during routine wild bird surveillance of migratory waterfowl in Washington County detected H4N8 Low Pathogenic North American wild bird lineage virus in a mallard duck, which confirms avian influenza is circulating in Pennsylvania and producers should be on-guard to protect their flocks.

 Biosecurity basics for poultry producers include:

• Allow only essential personnel to access your property and your birds. Disinfect any vehicles that enter your farm.
• Don’t lend or borrow equipment from other farms. Bring only cleaned and disinfected items into your bird area.
• Avoid contact with other poultry. If you cannot avoid contact, change clothes and shoes before working with your own birds.
• Wash your hands thoroughly with soap and water before entering your bird area.
• Use footbaths when entering or leaving your bird housing (change disinfectant frequently), or wear disposable boot covers.
• Keep poultry separate from wild birds. Don’t let them share water sources or have access to common areas frequented by wild birds.
• Eliminate standing water on your farm and clean up feed spills to avoid attracting wild birds.

For more information about good biosecurity practices visit healthybirds.aphis.usda.gov.

Watch for these signs of illness and immediately report sick or dying birds:

• Sudden increase in bird deaths in your flock
• Sneezing, gasping for air, coughing, and nasal discharge
• Watery and green diarrhea
• Lack of energy and poor appetite
• Drop in egg production or soft- or thin-shelled, misshapen eggs
• Swelling around the eyes, neck, and head
• Purple discoloration of the wattles, comb, and legs
• Ruffled feathers, listlessness, lethargy

Poultry producers with sick or dying birds should immediately report them to Pennsylvania’s state veterinarian by calling 717-772-2852 and press option 1.

“Don’t wait for tomorrow – take steps today to prevent catastrophic loss of flock and your livelihood,” said Brightbill. “Review your biosecurity plans, strengthen them, and retrain your farm hands by working with your herd or flock veterinarian.”

Producers with questions about biosecurity planning are encouraged to contact Pennsylvania’s

Center for Poultry and Livestock Excellence, a result of Governor Tom Wolf’s 2019 Pennsylvania Farm Bill, for resources.