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 Reduction Act (IRA), penalizes drug companies for raising prices on Medicare prescription drugs faster than inflation. The Centers for… (Marceno, Testa, June 9, 2023) #Drug Pricing

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 2020 and 2021, including chlamydia, gonorrhea, and syphilis. The plan highlights over… (Colocho, June 9, 2023) #Health Equity, #Prevention

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 health policy Chairman Ron Wyden (D-OR) stressed the need to identify financial incentives that lead to increased corporatization…. (Colocho, June 9, 2023) #Accountable Care Organizations, #Drug Pricing, #Hospitals, #Pharmacy Benefit Managers, #Physicians, #Prevention, #Primary Care, #Quality, #Transparency, #Value-Based Insurance Design

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 of previous primary care models tested by CMMI, including the Comprehensive Primary Care (CPC), CPC+, Primary Care First, and the Maryland Primary… (Testa, June 8, 2023) #Costs, #Delivery Reform, #Health Equity, #Mental and Behavioral Health, #Physicians, #Prevention, #Primary Care, #Quality, #Social Determinants of Health, #Value-Based Purchasing

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 percentage for discharges on or before October 1, 2013. The final rule intends to resolve any legal ambiguity surrounding the inclusion of MA… (Slifer, June 8, 2023) #Disproportionate Share Hospitals (DSH), #Medicare Advantage

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 and marketplace plans, driven by temporary pandemic policies. However, the CBO anticipates a decline in Medicaid enrollment and projects that 6.2 million people will become uninsured. The… (Colocho, June 5, 2023) #COVID-19, #Insurance Coverage, #Public Health

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 into consideration as it finalized the research plan. In response to public comment, USPSTF… (Colocho, June 5, 2023) #Coverage Decisions, #Mental and Behavioral Health, #Prevention, #Women’s Health

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 explains that if the FDA grants traditional approval to other drugs in the same class, those products would also be eligible… (Slifer, June 1, 2023) #Coverage Decisions, #Prescription Drugs

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 the COVID-19 PHE, CMS established various requirements to minimize the spread and impact of… (Llamas, June 1, 2023) #COVID-19

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 be a one-page document with standardized format and content intended to provide patients with clear, concise, accessible, and useful written… (Slifer, May 31, 2023) #Food and Drug Administration, #Prescription Drugs