- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
COA Releases Statement on CMS' Proposed Rules for 2019 Medicare Physician Fee Schedule
Following CMS’ announcement of proposed rules for the 2019 Medicare Physician Fee Schedule, Community Oncology Alliance (COA) released a statement calling the proposals “puzzling.” The statement details concern with 2 proposals.
Following CMS’ announcement of proposed rules for the 2019 Medicare Physician Fee Schedule, Community Oncology Alliance (COA) released a statement calling the proposals “puzzling.” The statement details concern with 2 proposals.
The first is CMS’ proposal to cut payment for the evaluation and management of more complex cancer cases from $172 to $135 for a new patent and from $148 to $93 for an existing patient. According to COA, the proposal undervalues the evaluation and management of seniors with cancer, especially life-threatening, complex cases.
The second highlighted proposal is cutting Medicare Part B reimbursement for new cancer drugs and other specialty therapies to the rate of list price plus 1.35%—down from wholesale acquisition cost plus 6%—for the first 6 months on the market. COA believes that the payment cut for new cancer drugs will result in drug manufacturers increasing WAC list prices.
Read the full press release here.
Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
Listen
Shaping Dermatology's Future by Increasing Access, Data, and Advocacy
March 7th 2025Thy N. Huynh, MD, FAAD, Bruce A. Brod, MHCI, MD, FAAD, and Melissa Piliang, MD, FAAD, discussed expanding access to pediatric dermatology, dermatology data aggregation, and advocacy for Medicare physician payment reform, respectively.
Read More
Politics vs Science: The Future of US Public Health
February 4th 2025On this episode of Managed Care Cast, we speak with Perry N. Halkitis, PhD, MS, MPH, dean of the Rutgers School of Public Health, on the public health implications of the US withdrawal from the World Health Organization and the role of public health leaders in advocating for science and health.
Listen
Eliminating Enhanced PTCs Would Have Cascading Economic Impacts, Report Estimates
March 6th 2025Enhanced premium tax credits (PTCs) have made marketplace health insurance more affordable, and eliminating them could have sweeping impacts on consumers and the health care industry, according to a new report.
Read More
