Innovaare Compliance

JUNE 28, 2024

The upcoming Medicare Prescription Payment Plan (M3P), set to launch in January 2025, marks a significant shift in Medicare’s approach to prescription drug coverage. Price Transparency: Increased transparency in drug pricing to enable beneficiaries to make informed decisions.

Medicare 94

Medicare Medicare Prescription Drug Pricing Compliance 94

Center for Health Insurance Reform

JANUARY 9, 2025

This month we read about prescription drug pricing and the impacts of rebates on consumers, as well as market shares of Medicare Advantage carriers. A snowy first week of January gave us plenty of time to read some of the last research from 2024.

Prescription Drug Pricing 52

Prescription Drug Pricing Medicare Medicare 52

HIT Consultant

FEBRUARY 22, 2024

What You Should Know: Waltz Health, a digital health company developing smarter, technology-enabled ways to price, distribute and prescribe medications, today announced its entry into the Medicare market. The struggle with out-of-pocket drug expenses affects millions of Medicare beneficiaries annually, particularly underserved groups.

Medicare 52

Medicare Medicare Prescription Drug Pricing Health Outcomes 52

Health Law Advisor

MARCH 7, 2023

To advance these efforts, CMS established a Medicare Drug Rebate and Negotiations Group dedicated to the IRA and set forth the agency’s intended overarching timeline to implement the various IRA provisions, such as the Medicare Drug Price Negotiation Program and the Part D redesign.

Medicare 52

Medicare Medicare Prescription Drug Pricing Medicaid 52

Innovaare Compliance

JUNE 27, 2024

The upcoming Medicare Prescription Payment Plan (M3P), set to launch in January 2025, marks a significant shift in Medicare’s approach to prescription drug coverage. Price Transparency: Increased transparency in drug pricing to enable beneficiaries to make informed decisions.

Medicare 52

Medicare Medicare Compliance Prescription Drug Pricing 52

Jane Sarashon

FEBRUARY 27, 2024

In addition to highlighting the Patient’s Bill of Rights, NABIP’s keynotes and general sessions will speak to similar topics being brainstormed at VIVE this week — including mental health, maternal health, pharmacy and prescription drugs (pricing, PBMs), population health, and Medicare and Medicaid innovations.

ACA 118

ACA Prescription Drug Pricing Health Insurance Hospitals 118

Health Populi

OCTOBER 15, 2021

Drug price negotiation, say by the Medicare program, is a unifying public policy in the current era of political schisms in America, based on the findings in a special Kaiser Family Foundation (KFF) Health Tracking Poll conducted in late September-early October 2021.

Prescription Drug Pricing 71

Prescription Drug Pricing Medicare Medicare COVID-19 71

Health Populi

MARCH 6, 2019

is prescription drug prices — that they’re too high, that the Federal government should negotiate to lower costs for Medicare enrollees, and that out-of-pocket costs for drugs should be limited. The biggest culprit/contributor to prescription drug prices? consumers were asked.

Prescription Drug Pricing 59

Prescription Drug Pricing Governance Doctors Medicare 59

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

Health Populi

JANUARY 18, 2019

As the Harvard Chan-POLITICO study points out, prescription drug costs are top-of-mind for health consumers in America. As patients continue to morph into consumers who pay for health care services, they are seeking price transparency — but not finding it so easy. And see here on JD Supra for more details on the rules.

Prescription Drug Pricing 66

Prescription Drug Pricing Health Insurance Doctors Medicare 66

Health Populi

OCTOBER 28, 2019

When asked what factors contribute to rising health care costs in America, most consumers cite the cost of prescription drugs. Taken together, these two data points demonstrate the potent political import of prescription drug prices as the U.S. approaches the 2020 Presidential election.

Hospitals 54

Hospitals Prescription Drug Pricing Pharmaceutical Industry Medical Billing 54

Health Care Law Brief

JANUARY 19, 2022

On December 31, 2021, New York Governor Kathy Hochul signed landmark legislation to increase the transparency of prescription drug pricing and to establish requirements on pharmacy middlemen. Medicare and Medicaid have had similar price transparency rules, but now those rules will apply across all lines of business in New York.

Prescription Drug Pricing 52

Prescription Drug Pricing Licensing Compliance Medicaid 52

Health Law Advisor

MAY 22, 2023

1339) reflects the overarching legislative push by members from both sides of the aisle and chambers of Congress to address drug pricing issues through federal fixes to the PBM framework. Unlike the IRA, which targeted the Medicare program, the provisions of S. 1339, adding several new amendments to create the version of S.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Healthcare It News

APRIL 28, 2022

"With prescription drug prices rising at every turn, patients need price transparency and the ability to discuss options with their doctors during office visits," Davis advised. ADVICE FOR OTHERS.

Prescription Drug Pricing 258

Prescription Drug Pricing Hospitals Medicare Medicare 258

Health Populi

AUGUST 28, 2019

These two surveys are: The Morning Consult’s poll published today finding growing support among Democratic voters for Medicare for All as the centerpiece for health reform in America; and, A recent study from Eligibility.com on “Medicare Myths Explained,” with the tagline, “How much do you know about Medicare?”

Medicare 99

Medicare Medicare ACA Prescription Drug Pricing 99

Health Populi

JUNE 18, 2020

The authors, Dr. Naci and Dr. Kesselheim, are affiliated with the London School of Economics and Brigham and Women’s Hospital in Boston, note that 1% of medicines dispensed under Medicare Part D and Medicaid accounted for nearly $1 in $3 of drug spending in each program in 2015. bn to $32.8 bn to $9.9 bn for Medicaid.

Prescription Drug Pricing 79

Prescription Drug Pricing COVID-19 Medicaid Medicaid 79

HIT Consultant

JANUARY 21, 2022

An AARP report finds in 2020 that the price of hundreds of brand-name medications rose more than twice as fast as inflation. Part of Biden’s Build Back Better plan would enforce an annual out-of-pocket cap on what people on Medicare pay for their prescription drugs. Partnership Details.

Prescription Drug Pricing 95

Prescription Drug Pricing Medicare Medicare 95

Health Populi

DECEMBER 6, 2023

The future of Medicare and Medicaid as well as access to mental health care also rank high among two-thirds of U.S. Stay tuned to IRA components addressing prescription drug costs, and Medicare and Medicaid status (provider payments for the former, state-level moves for the latter).

Prescription Drug Pricing 87

Prescription Drug Pricing ACA COVID-19 Medicaid 87

Jane Sarashon

JULY 18, 2024

One-third were specifically worried about paying for prescription drugs in the next 12 months, an increase from 25% in 2022. Millions of seniors (8 million, the report quantifies) in Medicare were also part of this large contingent of health citizens concerned about their ability to access medicines.

Doctors 59

Doctors Prescription Drug Pricing Hospitals Health Insurance 59

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

OCTOBER 24, 2022

health care system not seen since the 1968 creation of Medicare, coupled with decreased reimbursement due to health care reform. The XY supply demand curve shown above from Trilliant’s analysis illustrates a government price ceiling shock to health care pricing.

COVID-19 54

COVID-19 Prescription Drug Pricing Health Insurance Health Care Reform 54

Jane Sarashon

SEPTEMBER 9, 2022

The decline of the pharma industry reputation is an important reality-check here given that even Republican voters have been keen to see greater regulation of prescription drug pricing in recent health tracking polls.

Prescription Drug Pricing 52

Prescription Drug Pricing Health Insurance Medical Billing Doctors 52

Kaiser Health News

AUGUST 12, 2022

First, it would give the federal government the ability to negotiate prices of some drugs purchased by Medicare beneficiaries, a tool that has long been opposed by the drug industry. Never before have we been able to negotiate prescription drug prices. Those prices would take effect in 2026.

Medicare 95

Medicare Medicare Prescription Drug Pricing Governance 95

Health Populi

OCTOBER 8, 2019

Pricing failure, the second big waste factor, is predominantly challenged by pharmaceutical/prescription drug pricing based on this research. The Centers for Medicare and Medicaid Services (CMS) forecasts that prescription drug spending will be the fastest-growing cause of rising health spending by 2027.

Prescription Drug Pricing 108

Prescription Drug Pricing Medicare Medicare ACA 108

Jane Sarashon

DECEMBER 20, 2023

Complementing this effort, Kroger also launched a personalized health and nutrition program collaborating with Soda Health earlier in December – importantly, aimed at people enrolled in Medicaid and Medicare programs.

Prescription Drug Pricing 72

Prescription Drug Pricing Medical Billing Health Insurance Public Health 72

Health Populi

SEPTEMBER 4, 2024

The post Where Democrats and Republicans Agree on Health Care Policies – From Medicare and Prescription Drugs to Gun Safety appeared first on HealthPopuli.com. He led the creation of the Northwell Health’s Center for Gun Violence Prevention in 2020.

Medicare 62

Medicare Medicare Prescription Drug Pricing Public Health 62

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.

COVID-19 62

COVID-19 Prescription Drug Pricing Medicare Medicare 62

Health Populi

NOVEMBER 5, 2018

Lowering the costs of care, ensuring the integrity of Medicare benefits, ensuring that low-income people don’t lose Medicaid coverage, and lowering prescription drug prices gain majority support across all health care voters who say health care is extremely important in the choice for members of Congress this year.

Medicaid 78

Medicaid Medicaid ACA Health Insurance 78

Health Populi

OCTOBER 12, 2018

Since the CVS+Aetna announcement last December, the Kaiser Family Foundation ran some numbers on how the merged organization could impact Medicare — a key payor for both health insurance and prescription drugs under Part D. The Academy convened a team with experience and gravitas to inform this report.

US Department of Health and Human Services 61

US Department of Health and Human Services Prescription Drug Pricing Health Insurance Medicare 61

Health Populi

NOVEMBER 7, 2018

Another healthcare issue that should get traction in this legislative environment is prescription drug pricing. Doggett has been drafting legislation to allow the government such authority for drugs covered by Medicare Part D. Idaho, Nebraska, and Utah voters also opted into Medicaid expansion.

Prescription Drug Pricing 40

Prescription Drug Pricing Medicaid Medicaid Medicare 40

Health Populi

MARCH 13, 2018

President Trump made clear on the campaign trail and in his interview with TIME magazine as Person of the Year that pharmaceutical companies’ pricing needed to be reined in using government pressure.

Prescription Drug Pricing 67

Prescription Drug Pricing FDA Hospitals Medicare 67

Kaiser Health News

JULY 21, 2022

But work continues, particularly on a Senate bill that could, for the first time, allow Medicare to negotiate prescription drug prices and cap seniors’ out-of-pocket medication costs. The bill, which hasn’t been released in full, will include only those provisions that have been approved by Sen.

Prescription Drug Pricing 67

Prescription Drug Pricing COVID-19 Medicare Medicare 67

Hall Render

APRIL 12, 2024

New president tapped to lead major hospital system in Denver area New president to lead opening of $650M hospital in Wheat Ridge Telehealth program offers support to forensic nurses Colorado Medicaid program settles lawsuit over lack of mental health care for children Colorado is trying to cut prescription drug prices.

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

Hall Render

MAY 10, 2024

Health Policy Commission still missing key document in Steward sale to Optum Local obesity drug developer lands deal worth up to $600M with Novo Nordisk Mass. Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’ million expansion ‘Very, very unusual.’

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

Health Populi

FEBRUARY 4, 2020

voters’ priorities, across political party – prescription drug prices. voters in 2020 quite like supporting Medicare’s ability to negotiate drug prices with pharmaceutical companies, shown by the October 2019 Kaiser Family Foundation Health Tracking Poll. Few issues unite U.S.

Prescription Drug Pricing 83

Prescription Drug Pricing Medicare Medicare Health Insurance 83

Hall Render

FEBRUARY 24, 2023

NATIONAL Addressing Staff Burnout In Healthcare Design Amazon completes $3.9B Staff shortages could spur next public health crisis, Baystate Health CEO warns CommonSpirit, Mass General, Moffitt execs to judge telehealth challenge Brigham and Women’s, AI company get $2.5M grant to improve early cognitive decline detection via EHRs How Mass.

Nursing Homes 40

Nursing Homes COVID-19 Nurses Hospitals 40

Health Populi

DECEMBER 30, 2019

Humana’s Bold Goal initiative targeting Medicare Advantage enrollees. Even seemingly popular plan ideas like prescription drug pricing and coverage for pre-existing conditions can’t get traction in Congress or through the White House’s executive pen.

US Department of Health and Human Services 130

US Department of Health and Human Services Prescription Drug Pricing Public Health Medicare 130