Thu.Jan 13, 2022

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CMS “Splits the Baby” on Aduhelm—Medicare Coverage but Only with Evidence Development for Now

Health Law Advisor

The proposed decision, which is subject to public comments that are due to CMS by February 10, 2022, does not endorse nationwide Medicare coverage for these drugs. The FDA’s determination does not mandate Medicare coverage for Aduhelm. The Medicare Part B program would not cover the drugs in any other setting.

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Biden Administration Announces 2023 Out-of-Pocket Limits and PCORI Fee for the Upcoming Year

Compliance Now

The limits for 2023, as announced by the Centers for Medicare and Medicaid Services, are listed below in comparison to the 2022 limits: Out-of-Pocket Limits Coverage Type 2022 2023 Self-Only Coverage $8,700 $9,100 Family Coverage $17,400 $18,200. Premiums and spending for non-covered services do not count towards the out-of-pocket limits.

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