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California pharmacies will no longer be required to pay back the state under its new reimbursement methodology

Natalia Mazina

Several pharmacists and patient advocacy groups filed legal actions against the DHCS and worked with legislature to eliminate these chargebacks to pharmacies. This lead to overpayments to pharmacies.

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White House looks to CMMI to test new ways to lower drug prices

C&M Health Law

CMMI has broad statutory authority not only to test, design, and implement health care payment and delivery models for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) but in certain instances, can implement such models without Congressional action. The Biden administration formally rescinded the MFN in 2021.

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Weekly Roundup – October 22, 2022

Healthcare IT Today

At the recent RARE Patient Advocacy Summit, John caught up with three entrepreneurs who used their personal experiences with rare diseases to create solutions for themselves, their loved ones, and patients facing the same challenges. Read more… A Look at 3 Startups in the Rare Disease Space.

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Our Nursing Home Industry – A National Scandal

HIT Consultant

It has led me to found Tapestry Health, a multispecialty medical practice that focuses on providing medical infrastructure in skilled nursing facilities (SNFs), as well as Project Patient Care, a patient advocacy organization based in Chicago, Illinois. Why should the government be in the job of making nursing homes better?

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TAKE TWO: CMS’s Second Attempt to Streamline Breakthrough Device Coverage Limited to 5 Devices Per Year

Health Law Advisor

On June 22, 2023, the Centers for Medicare & Medicaid Services (CMS) announced its proposed “Transitional Coverage for Technologies” (TCET) pathway—the Biden administration’s highly anticipated take on a mechanism to expedite coverage for certain devices designated by the U.S. Medicare and Medicaid Serv., 2,987, 2,990 (Jan.

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Can a Food-As-Medicine App Extend Chronic Health Management at the Grocery Store?

Health Populi

For many years, I’ve advocated for siloes to break down so that these organizations, all of which have mission statements that speak to benefit patient care and health outcomes, to more effective reach those Holy Grails. This was met with a range of responses, from smirks and cynicism to surprise and questions of, “why?

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DIR Reform: what you need to know

Natalia Mazina

Many pharmacy and patient advocacy groups have spoken out against the obscure methods employed by PBMs to increase their profits. These groups have advocated for the fees to be applied at the time a patient picks up the medication at the pharmacy rather than subjecting pharmacies to these fees months later.

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