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Lax Policing of Doctor and Pharmacy Conflicts Is Found in Medicare Coverage Decisions
WASHINGTON — Deciding which drugs will be covered by Medicare can influence huge amounts of spending, but government officials do little to police conflict of interest among doctors and pharmacists who make those decisions, federal investigators said Monday.
In a new report, Daniel R. Levinson, the inspector general at the Department of Health and Human Services, said the federal Medicare agency had not clearly defined “conflict of interest” and did not enforce standards meant to prevent such conflicts from influencing coverage decisions by the panels, known as pharmacy and therapeutics committees.
Read the full story: http://nyti.ms/WLfpWM
Source: The New York Times
Care Quality Metrics in Medicare During COVID-19 Pandemic
August 12th 2025Medicare Advantage outperformed traditional Medicare on clinical quality measures before and during the COVID-19 pandemic; mid-pandemic, however, traditional Medicare narrowed the gap on some in-person screenings.
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AI Meets Medicare: Inside CMS’s WISeR Model With Sanjay Doddamani, MD, MBA, Part 2
August 5th 2025In this second part of his interview with The American Journal of Managed Care®, Sanjay Doddamani, MD, MBA, a former senior advisor to CMMI and founder and CEO of Guidehealth, continues a dialogue on the future of value-based care and the promise—and limits—of AI-enabled innovation, reflecting on challenges like rising Medicare costs and patients’ growing financial burdens.
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