Billy Wynne

Agency Releases List of 43 Part B Prescription Drugs Subject to IRA Inflation Rebates The Biden administration announced (press release; fact sheet) a list of 43 Part B prescription drugs where beneficiaries may see lower coinsurances between July 1 – September 30, 2023. The Medicare Prescription Drug Inflation Rebate Program, a provision of the Inflation…

Department Releases First-Ever STI Federal Implementation Plan The Department of Health and Human Services (HHS) unveiled the STI Federal Implementation Plan, which outlines federal actions aimed at reducing the burden of sexually transmitted infections (STIs) in the United States by 2025. The plan comes in response to a significant rise in STI cases reported between…

Hearing Highlights Concerns Over Health Care Consolidation and Calls for Transparency and Reform The Senate Committee on Finance convened a hearing to address significant concerns regarding consolidation and corporate ownership in the health care system that often lead to increased costs and lower quality of care. As the Committee responsible to much of the federal…

Innovation Center Announces New Making Care Primary (MCP) Model; RFA is Forthcoming, Will Launch July 1, 2024 Today, the Center for Medicare & Medicaid Innovation (CMMI/Innovation Center) announced (press release; fact sheet (attached); model website) it is planning to test a new voluntary, advanced primary care model. The Making Care Primary (MCP) model builds off…

Final Rule Issued on Medicare Advantage Days in the Calculation of a Hospital’s Medicare Disproportionate Patient Percentage The Centers for Medicare and Medicaid Services (CMS) issued a final rule to create a policy governing the treatment of days associated with beneficiaries enrolled in Medicare Advantage (MA) for the purposes of determining a hospital’s Medicare disproportionate patient…

CBO Published New Health Insurance Coverage Projections for 2023 to 2033; 6.2 Million People Projected to Become Uninsured Due to Medicaid Unwinding The Congressional Budget Office (CBO) released updated projections on health insurance coverage for individuals under 65, revealing a record low uninsurance rate of 8.3%. This decrease is attributed to increased enrollment in Medicaid…

Final Research Plan Published: Interventions to Prevent Perinatal Depression The U.S. Preventive Services Task Force (USPSTF) published a final research plan on interventions to prevent perinatal depression. The draft research plan on this topic was made available for public comment from February 23, 2022 to March 22, 2023, and USPSTF says all comments were taken…

Agency to Provide Broader Coverage of Traditionally Approved Drugs to Slow the Progression of Alzheimer’s Disease Today, the Centers for Medicare and Medicaid Services (CMS) announced that if the Food and Drug Administration (FDA) grants traditional approval to Leqembi, the agency would provide broader Medicare coverage on the same day of approval. The announcement further…

COVID-19 Vaccination HCP Requirement for Medicaid, Medicare Providers Ended The Centers for Medicare and Medicaid Services (CMS) issued a final rule that makes regulatory changes to COVID-19 vaccination and testing requirements as part of the agency’s transition out of the COVID-19 public health emergency (PHE), which ended on May 11, 2023. What it is. During…

Proposed Rule Issued to Require Patient Medication Information in Labeling; Comments are Due Nov. 27 The Food and Drug Administration (FDA) issued a proposed rule to amend its prescription drug labeling regulations to require the inclusion a new Medication Guide, referred to as Patient Medication Information (PMI) (press release). The FDA details that PMI would…