Late last month, the Centers for Medicare & Medicaid Services (CMS) released an advance notice of proposed rulemaking (ANPRM), seeking feedback on a potential drug pricing model called the International Pricing Index (IPI) model. This comment solicitation is in alignment with the administration’s blueprint to lower drug costs and reduce out-of-pocket costs, and is an…
Search results for: Medicare Part B
Trump Seeks to Base Medicare Drug Prices on Lower Overseas Rates
WASHINGTON (Reuters)—U.S. President Donald Trump said on Thursday his administration is seeking to lower prescription drug prices by determining the price the government’s Medicare program pays for some medications based on the lower prices paid in other countries. Trump said the move takes aim at what he characterized as “global freeloading” on prescription drugs. “The…
Aetna, Seeking Antitrust Nod, Sells Medicare Drug Business to WellCare
(Reuters)—Health insurer Aetna Inc said on Thursday it will sell its standalone Medicare prescription drug plan business to WellCare Health Plans Inc as it seeks U.S. antitrust approval for a planned acquisition by CVS Health Corp. The $69 billion CVS-Aetna deal would be the second large deal this year between insurers and pharmacy benefit managers,…
U.S. to Boost Drug Price Negotiation in Medicare Advantage Health Plans
(Reuters)—The Trump administration said on Tuesday it would give Medicare Advantage health plans for the elderly new tools to negotiate for lower prescription drug prices. The Centers for Medicare and Medicaid Services (CMS) said Medicare Advantage plans will be allowed to require that patients first try certain lower-cost drugs before moving to a more expensive…
ACR & NPF Highlight Medicare Access Challenges in Capitol Hill Briefing
Concerns about how the Trump administration’s ideas to lower drug prices could reduce patient access to medicines led the ACR to speak out on many different fronts. On June 25, at a briefing hosted by the ACR and the National Psoriasis Foundation (NPF), a packed room of Congressional staffers and reporters learned from rheumatologists and…
ACR Praises Congress for Bill with Part B Fix, Therapy Caps Repeal
The ACR praises Congressional leaders for passing the sweeping spending agreement, which includes a technical provision reversing a Centers for Medicare & Medicaid Services (CMS) policy that would have linked physicians’ quality payment adjustments to Medicare Part B drug costs starting in 2019. The ACR also applauds the inclusion of provisions that permanently repeal Medicare…
Participate in CMS Reporting Study to Receive 2018 Improvement Activity Credit
The Centers for Medicare & Medicaid Services (CMS) is conducting the 2018 Burdens Associated with Reporting Quality Measures Study, as outlined in the Quality Payment Program Year 2 final rule (CMS 5522- FC). The CMS is conducting this study to: Examine clinical workflows and data-collection methods using different submission systems; Understand the challenges clinicians face when…
Congress Urged to Fix CMS Rule Distorting Part B Drug Reimbursement
LATE-BREAKING NEWS Editor’s note: The ACR praises Congressional leaders for passing today’s (2/9) sweeping spending agreement, which includes a technical provision reversing a Centers for Medicare & Medicaid Services (CMS) policy that would have linked physicians’ quality payment adjustments to Medicare Part B drug costs starting in 2019. The ACR also applauded the inclusion of…
U.S. Telehealth Industry Eyes Medicare for Its Next Big Check
(Reuters)—After years of lobbying in Washington, U.S. telehealth providers have the first hints that the dam could break on public funding for an industry they say could save taxpayers billions. Four bills that could be signed into law over the next year carry the solutions to barriers that have prevented the U.S.s’ huge over-65 health…
Medicare Access & CHIP Reauthorization Act Preparation Tips
The ABCs of MACRA The transition year under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is at an end. MACRA repealed the Medicare Sustainable Growth Rate (SGR) methodology for updates to the Physician Fee Schedule (PFS) and replaced it with a value-driven payment system. The new approach to payment is called the…
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