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Five Things to Watch When First “Maximum Fair Prices” for Selected Drugs Announced

The Centers for Medicare & Medicaid Services (CMS) is required to make public by September 1 the “maximum fair prices” (MFP) that CMS is setting for the first ten drugs subject to the Medicare Drug Price Negotiation Program...more

The Inflation Reduction Act: Medicare Part D Benefit Redesign

On August 16, President Joe Biden signed into law H.R. 5376 , the Inflation Reduction Act of 2022, which makes arguably the most significant changes to U.S. prescription drug price regulation ever, including by...more

The Inflation Reduction Act: Implementation of the Medicare Prescription Drug Inflation Rebates

On August 16, President Joe Biden signed into law H.R. 5376 , the Inflation Reduction Act of 2022, which makes arguably the most significant changes to U.S. prescription drug price regulation ever, including by...more

The Inflation Reduction Act: Implementation of Prescription Drug Medicare Price Regulation

On August 16, President Joe Biden signed into law H.R. 5376, the Inflation Reduction Act of 2022, which makes arguably the most significant changes to U.S. prescription drug price regulation ever, including by...more

[Webinar] Preparing for Change: A Guide to the Inflation Reduction Act Drug Pricing Provisions - August 23rd, 1:00 pm - 2:00 pm ET

The Inflation Reduction Act (IRA) will make arguably the most significant changes to U.S. prescription drug pricing regulations ever, but certainly since the creation of the Medicaid Drug Rebate Program in 1990. For the first...more

CMS Aduhelm Decision: Precedent for Future Coverage or a One-Off?

On April 7, the Centers for Medicare & Medicaid Services (CMS) released its highly anticipated final National Coverage Determination (NCD) for Aduhelm and other similar therapies in the pipeline for Alzheimer’s disease. The...more

Build Back Better: All Eyes on the Senate

The Big Picture - On November 19, the House of Representatives passed the Build Back Better Act (BBB) (H.R. 5376) by a vote of 220–213. The BBB contains a number of health and social policy priorities that are widely viewed...more

Senate Lays Groundwork for Fall Health Care Negotiations Before Recessing This Month

The Big Picture - Before leaving for its August recess, the Senate made progress on two major Biden Administration priorities by passing bipartisan infrastructure legislation and a fiscal year (FY) 2022 budget resolution....more

Significant Changes Proposed to Medicare Part D Benefit

On May 23, the bipartisan leadership of the House Ways and Means Committee released a four-page draft discussion bill that, if enacted, would make the most significant changes to the Part D benefit since the Affordable Care...more

New Podcast: Would CMS’s Drug Price Transparency Requirement Really Lower Prices?

Editor’s Note: On October 15, the Trump administration’s Centers for Medicare & Medicaid Services (CMS) published a proposed rule that, if finalized, would require prescription drugmakers to include prescription drug price...more

Medicare Part B Drug Payment Model

The Department of Health and Human Services (HHS) has proposed a major, national payment model that would, if implemented, significantly impact how Medicare pays for drugs provided through the Part B program. Under the...more

Health Update - July 2014

Avoiding the Regulatory Land Mines of Commercial ACOs - While providers are showing great interest in creating ACOs to participate in the Medicare Shared Savings Program (MSSP), they are showing even greater enthusiasm...more

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