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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
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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