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

Natalia Mazina

Back in 2017, the California Department of Healthcare Services (DHCS) approved a new methodology – National Average Drug Acquisition Cost (NADAC) – for reimbursing pharmacies for their drug cost. NADAC prices significantly reduced pharmacy reimbursements. See a related blog post. This lead to overpayments to pharmacies.

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CMS Finalizes Major Changes to Hospital Price Transparency Rule

Hall Render

The Centers for Medicare & Medicaid Services (“CMS”) finalized significant updates to the Hospital Price Transparency regulation for the first time since the rule took effect on January 1, 2021. This data element supplements the existing requirement to disclose payer-specific negotiated charges for all items and services.

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Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Funding Opportunity: Measure Development for the Quality Payment Program

CMS.gov

Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Funding Opportunity: Measure Development for the Quality Payment Program. They are concrete quality topics which reflect core issues that are most vital to high quality care and better patient outcomes. Jeremy.Booth@c…. Fri, 03/02/2018 - 16:30. Kate Goodrich, M.D.,

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How Patient Movement Benefits from Standardized Acuity Scoring

HIT Consultant

Taking a standardized approach to acuity assessments not only provides more objectivity, but also gives hospitals the data they need to make a variety of tactical and strategic decisions, from daily unit staffing to future space, specialty services, and bed capacity. . Martin Sellberg.

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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. What are DIR fees?

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Patient advocates shred Becerra’s copay accumulator comments during House hearing

Fierce Healthcare

Lawmakers pressed Department of Health and Human Services Secretary Xavier Becerra over the Biden administration’s stance toward Medicare Advantage, rural health and more during budgetary hearings | HHS Secretary Xavier Becerra's comments on copay accumulators left patient advocacy groups baffled during a House hearing on the fiscal year 2025 (..)

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Heart Health at #CES2019 – Food and Tech as Medicine

Health Populi

An important example of this self-care approach is the evidence-based Ornish food regimen which is reimbursed by Medicare (as a form of cardiac rehabilitation). Now, people seek better customer service, enchanting design, streamlined workflows, and more confidence in their medical care.

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