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Pay and Practice: Semi-Permanent SGR Repeal?
It sounds like an oxymoron -- semi-permanent repeal -- but some former Medicare administrators are suggesting it as a solution to permanently repealing Medicare's much-hated sustainable growth rate (SGR) payment formula.
It sounds like an oxymoron -- semi-permanent repeal -- but some former Medicare administrators are suggesting it as a solution to permanently repealing Medicare's much-hated sustainable growth rate (SGR) payment formula.
Their idea is a 5-year SGR suspension, which fits somewhere in between familiar 1-year patches and a permanent repeal Congress is working toward now. Essentially, the idea is to take the 10-year SGR repeal legislation that various congressional committees are working on now and implement only the first 5 years.
A 5-year suspension of SGR would be cheaper for Congress to finance as opposed to a permanent repeal, said Mark McClellan, MD, PhD, who ran the Centers for Medicare and Medicaid Services (CMS) from 2004 to 2006. A repeal is considered permanent if it's funded for at least 10 years.
Read the full story here: http://n.pr/1mRHXVd
Source: MedPage Today
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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