Healthcare Law Blog

JUNE 2, 2023

In the underlying Seventh Circuit cases, relators alleged that retail pharmacies had knowingly submitted false reports of their Usual and Customary (“U&C”) drug prices to the government for reimbursement under Medicare Part D and Medicaid, because the reports allegedly did not account for discounted drug prices offered through certain prescription (..)

Prescription Drug Pricing 52

Prescription Drug Pricing Governance Medicaid Medicaid 52

Healthcare Law Blog

FEBRUARY 22, 2023

The Rebate Programs are administered as part of the prescription drug affordability provisions of the Inflation Reduction Act (the “IRA”), which is aimed at “lower[ing] out-of-pocket drug costs for people with Medicare and improv[ing] the sustainability of the Medicare program for current and future generations.” [1]

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Health Populi

APRIL 30, 2021

As such, the debate on prescription drug pricing in the U.S. is heating up, with President Biden mentioning the scenario of Medicare negotiating drug prices with pharmaceutical manufacturers in his latest speech measuring progress at 100 days in the White House.

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COVID-19 Prescription Drug Pricing Medicare Medicare 62

Medval Compliance Blog

SEPTEMBER 1, 2021

Recognizing the mounting attention given to hidden fees and surprise billing, on June 24, 2019, former President Trump signed an executive order (EO) directing the Department of Health and Human Services (and additional agencies) to take steps to improve price and quality transparency in healthcare. Medicare Set-Aside Considerations.

Prescription Drug Pricing 52

Prescription Drug Pricing Medicare Medicare Hospitals 52

Jane Sarashon

DECEMBER 20, 2023

At the end of each year since I launched the Health Populi blog, I have put my best forecasting hat on to focus on the next year in health and health care. At this moment, the price of gas at the pump was playing a big role in U.S. There’s a sort of health care “shrinkflation” that has been shaping patients-as-payors of medical bills.

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Prescription Drug Pricing Medical Billing Health Insurance Public Health 67

Health Populi

NOVEMBER 5, 2018

In my 11 years of writing every one of over 2,000 Health Populi posts on this blog, I have never, ever mentioned the “f-word” here. In this case, I feel it’s important to capture the Zeitgeist of the Republican Party’s commitment to cutting down the ACA since President Trump took office in January 2017.

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Medicaid Medicaid Health Insurance ACA 76

Drug & Device Law

OCTOBER 10, 2022

The manufacturer sought to cover Medicare patients’ Part D cost-sharing obligations for the drug – which were estimated at approximately $13,000 per year – but the OIG said “no thanks,” and the Second Circuit has affirmed that outcome. The problem is, as stated before, the drug is expensive; an annual course costs $225,000.

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Medicare Medicare FDA Prescription Drug Pricing 52