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Medicare Physician Payment Reform Bills Released by Congressional Committees
The Senate Finance Committee and House Ways and Means Committee jointly released their draft legislation to reform physician payment under Medicare on October 30.
The Senate Finance Committee and House Ways and Means Committee jointly released their draft legislation to reform physician payment under Medicare on October 30. The Committees provided an eight page summary of the proposed bill and have asked ASH and other specialty societies to provide comments by November 12.
Briefly, the proposed legislation does the following:
- Repeals the Sustainable Growth Rate (SGR) formula preventing a 24 percent cut in physician payment in 2014 and annual cuts thereafter.
- Freezes the conversion factor (monetary index used to determine physician payment under the Medicare Physician Fee Schedule) for 10 years.
- Starting in 2017, physician payments would be adjusted based on the physician's performance in a Value-Based Performance Payment Program (VBP).
Read the full story here: http://bit.ly/17IDlQa
Source: ASH
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.
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How Access to SMA Treatment Varies Globally and by Insurance Type
March 18th 2025Posters presented at the 2025 Muscular Dystrophy Association (MDA) Clinical & Scientific Conference show that therapeutic advances in treating spinal muscular atrophy (SMA) are not uniformly making it into the hands of patients who could benefit.
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A Focus on MAHA, Lasting Changes to Health Care Programs for Trump’s Second Term
March 13th 2025The second Trump administration is expected to bring changes to Medicaid, Medicare Advantage, and the health insurance exchanges, as well as highlight the Make America Healthy Again (MAHA) movement, speakers at the Value-Based Insurance Design Summit said.
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