The Centers for Medicare & Medicaid Services (CMS) released its annual proposed rule updating the Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2025....more
8/12/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Digital Health ,
Health Care Providers ,
Healthcare ,
Medicare ,
Mental Health ,
Physician Fee Schedule ,
Physicians ,
Telecommunications ,
Telehealth ,
Telemedicine
Since becoming aware of the cyberattack on Change Healthcare in late February, the Centers for Medicare & Medicaid Services (CMS) has announced a number of flexibilities to support affected providers that have experienced...more
The Center for Medicare and Medicaid Innovation (CMMI) has provided new updates on CMS’ planned initiatives to address prescription drug costs in a blog post from Director Liz Fowler. One test, the Accelerating Clinical...more
10/31/2023
/ CMMI ,
Drug Pricing ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Life Sciences ,
Medicare ,
Medicare Advantage ,
Medicare Part D ,
Pharmaceutical Industry ,
Prescription Drugs
Provider-sponsored plans are increasingly popular with hospitals, health systems and medical groups/independent physician associations (IPAs). Offering a plan can deliver many significant advantages to providers, enabling...more
On December 6, 2022, the Centers for Medicare & Medicaid Services (CMS) proposed a rule—the Interoperability and Patient Access final rule—that introduces new requirements for health care payers aiming to enhance patient data...more
Medicare Advantage (MA) plans now cover about half of Medicare beneficiaries, and with that enrollment growth has come increased scrutiny from federal and state regulators. As federal regulators complete a busy season of...more
3/28/2023
/ Audits ,
Centers for Medicare & Medicaid Services (CMS) ,
Continuing Legal Education ,
Enforcement ,
False Claims Act (FCA) ,
Health Care Providers ,
Health Insurance ,
Health Plan Sponsors ,
Medical Necessity ,
Medicare ,
Medicare Advantage ,
Medicare Advantage Organizations (MAOs) ,
Medicare Beneficiaries ,
New Rules ,
Risk Adjustment Formula ,
Webinars
Americans are strongly focused on the upcoming midterm elections. An NBC News survey shows that 68% of Republicans and 66% of Democrats are expressing high interest in the midterms. Which issues are most critical to voters...more
9/26/2022
/ Abortion ,
Health Care Providers ,
Health Insurance ,
Healthcare Costs ,
Healthcare Reform ,
Legislative Agendas ,
Prescription Drugs ,
Regulatory Agenda ,
Reproductive Healthcare Issues ,
State Elections ,
Webinars
The Inflation Reduction Act of 2022 (IRA) includes the most dramatic change to U.S. drug price regulation in history. The new law allows the federal government to “negotiate” the price of many drugs dispensed to Medicare...more
9/7/2022
/ Biosimilars ,
Continuing Legal Education ,
Drug Pricing ,
Generic Drugs ,
Health Care Providers ,
Inflation Reduction Act (IRA) ,
Manufacturers ,
Medicaid ,
Medicare ,
Medicare Beneficiaries ,
Medicare Part D ,
New Regulations ,
Pharmaceutical Industry ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Section 340B ,
Webinars
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
8/18/2022
/ Continuing Legal Education ,
Drug Pricing ,
Health Care Providers ,
Inflation Reduction Act (IRA) ,
Medicare ,
Medicare Part D ,
Out-of-Pocket Expenses ,
Pharmaceutical Industry ,
Prescription Drugs ,
Rebates ,
Webinars ,
Wholesale
On January 12, the Centers for Medicare & Medicaid Services (CMS) released the Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs proposed rule,...more
1/25/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Drug Pricing ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
Medicaid ,
Medical Loss Ratio ,
Medicare ,
Medicare Advantage ,
Medicare Part D ,
Prescription Drug Coverage ,
Prescription Drugs
The Big Picture -
Until late December, few if any Medicare policy changes were anticipated as part of a year-end healthcare package, barring extensions of funding for programs that otherwise would have expired. But after...more
Social determinants of health (SDOH) are conditions in the environments in which people are born, live, learn, work, play, worship and age that affect a wide range of health, functioning, and quality-of-life outcomes and...more