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Tavenner Withdraws Fractious Part D Changes
Under pressure from the industry and Congress, the Centers for Medicare & Medicaid Services is withdrawing several proposed changes to the Medicare drug program, but still charging ahead with others that could prove disruptive.
Under pressure from the industry and Congress, the Centers for Medicare & Medicaid Services is withdrawing several proposed changes to the Medicare drug program, but still charging ahead with others that could prove disruptive.
In a large batch of Medicare Part D proposed regulations first published in January, CMS announced plans to end three protected classes of drugs, standardize preferred pharmacy networks, extend negotiated drug pricing across the program and limit the number of plans available in a region, among other things the agency argued would collectively help save $1 billion over five years.
Those proposals and others drew criticism from various corners of Congress and the health, insurance and pharmaceutical industries, especially the elimination of the protected classes of antidepressants, antipsychotics and immunosuppressants and a new interpretation of the Part D “non-interference” clause that would give every pharmacy the ability to contract with plans under preferred terms and conditions.
Read the full story here: http://bit.ly/1iAmp2S
Source: Healthcare Payer News
Hospital Participation in Medicare ACOs: No Change in Admission Practices and Spending
August 19th 2025Hospital accountable care organization (ACO) participation did not impact emergency department admission rates, length of stay, or costs, suggesting limited effectiveness in reducing spending for unplanned admissions and challenging hospital-led ACO cost-saving strategies.
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Laundromats as a New Frontier in Community Health, Medicaid Outreach
May 29th 2025Lindsey Leininger, PhD, and Allister Chang, MPA, highlight the potential of laundromats as accessible, community-based settings to support Medicaid outreach, foster trust, and connect families with essential health and social services.
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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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