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Carrie Antlfinger / AP

Several health care company executives and lobbyists who quietly met with federal government policymakers a couple months ago secured favorable policies in Medicare's latest payment rules. Clinical laboratories, outpatient heart labs and a bladder cancer drug each won particular measures.

Why it matters: Medicare's annual payment rules are buried in bureaucratic and complex language. But that's where a lot of policy action is, and companies spend a lot of time and money influencing the process, often to get higher Medicare payouts. The 2018 proposals are no different.

The outpatient rule and physician fee schedule are still proposals and can change before final drafts are released in a couple months. But the cases below outline how the health care industry met with top policy people who work in the Department of Health and Human Services and the Centers for Medicare and Medicaid Services months before the rule release — and ultimately got what they wanted.

The win for clinical labs

  • Who met with the feds: Lobbyists with lab testing companies Myriad Genetics and Veracyte, pharmaceutical company Boehringer Ingelheim, and lobbying firm Todd Strategy, federal meeting records show.
  • What they wanted: An open comment period on the "14-day" regulation, likely with the goal of adjusting or eliminating it, according to a lobbying presentation.
  • The "14-day" regulation stipulates that if lab tests are ordered within 14 days of a patient's discharge from a hospital, the hospital must bill Medicare for the tests. The lab then seeks payment from the hospital. Anything after 14 days, the lab can bill Medicare directly.
  • The companies argued in the presentation that the rule limits access to lab tests because hospitals may be reluctant to bill Medicare for labs after patients leave.
  • What they got: An open comment period, and a modification to the policy that would allow labs to bill Medicare directly for some tests.

The win for heart catheterization labs

  • Who met with the feds: Lobbyists with Fresenius Medical Care, a giant health care conglomerate that owns National Cardiovascular Partners, an outpatient heart lab company, according to federal meeting records.
  • What they wanted: A requirement for Medicare to pay for more heart procedures in an ambulatory surgery center or outpatient heart lab, per a lobbying presentation.
  • What they got: Citing the "continued shift of services from the inpatient setting to the outpatient setting," Medicare is willing to go along with their ask and opened up public debate to nail down specifics.

The win for Photocure

  • Who met with the feds: Ambaw Bellete, a top executive at Photocure, and lobbyists with King & Spaulding, meeting records show. Photocure makes Cysview, a drug solution that is used to help detect bladder cancer.
  • What they wanted: Either an exclusion of drugs from outpatient bundled payments, or higher pay for procedures that use Cysview, according to a lobbying presentation.
  • The presentation included a testimonial from a patient who said Cysview "SAVED MY LIFE" and an email from a hospital urology director who said Photocure wouldn't be used on bladder cancer patients "until the reimbursement issue is settled."
  • What they got: Medicare will not pay separately for Cysview, but the administration proposed new add-on billing codes that ultimately would pay more for procedures that use Cysview.

Go deeper

Ina Fried, author of Login
2 hours ago - Technology

Intel CEO sees making own chips as a matter of national security

Pat Gelsinger. Photo: Axios on HBO

Intel CEO Pat Gelsinger is putting the pressure on the U.S. government to help subsidize chip manufacturing, insisting the current reliance on plants in Taiwan and Korea as "geopolitically unstable."

Why it matters: There is bipartisan support for funding the domestic semiconductor industry, but Congress has yet to sign the check. The Senate has passed the CHIPS Act that includes $52 billion in semiconductor investment, but it has yet to pass the House.

Updated 2 hours ago - World

17 U.S. and Canadian missionaries kidnapped in Haiti

Haitian soldiers guard the public prosecutor's office in Port-au-Prince this month. Photo: Richard Pierrin/AFP via Getty Images

Children are among a group of 17 missionaries kidnapped in Port-au-Prince, Haiti, per a statement from Christian Aid Ministries Sunday.

The latest: "The group of 16 U.S citizens and one Canadian citizen includes five men, seven women, and five children," the Ohio-based group said. Haitian police inspector Frantz Champagne on Sunday identified the 400 Mawozo gang as the group responsible, in a statement to AP.

Ina Fried, author of Login
4 hours ago - Technology

Intel CEO wants to compete against Apple

Intel CEO Pat Gelsinger hasn't given up on the idea of the Mac once again using Intel chips, but he acknowledges it will probably be years before he gets that chance.

  • In the meantime, he is focused on powering Windows machines that give Apple CEO Tim Cook a run for his money.

Why it matters: In getting pushed out of the Mac, Intel not only lost a customer but picked up a new rival.