In its May 2023 Medicaid Program; Misclassification of Drugs, Program Administration and Program Integrity Updates Under the Medicaid Drug Rebate Program (MDRP) proposed rule[1], the Centers for Medicare…
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Copay accumulators, copay maximizers, and alternative funding programs (AFPs) are the three main categories of patient assistance programs, and the legal and regulatory landscape shapes their use. Under…
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Applied Policy Health Policy Vice President Alison Falb and Senior Health Policy Associate Emma Hammer joined nearly 3,000 attendees at the Academy of Managed Care Pharmacy (AMCP) Nexus…
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On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) final rule for calendar year (CY)…
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On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the Hospital Outpatient Prospective Payment (OPPS) and Ambulatory Surgical Center (ASC) Payment Systems final rule,…
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On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2025 Home Health Prospective Payment System final rule for home health…
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On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the final calendar year (CY) 2025 Physician Fee Schedule (PFS), which finalizes policies for physician…
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On October 10-11, 2024, the Medicare Payment Advisory Commission (MedPAC) held a virtual public meeting, which included the following sessions: Medicare beneficiaries in nursing homes; Findings from MedPAC’s…
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On Wednesday, September 4, 2024, the Centers for Medicare & Medicaid Services released a Request for Information (RFI)[1] to solicit feedback on the potential consolidation of four Medicare…
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The Centers for Medicare & Medicaid Services (CMS) released the long-awaited results of its negotiations over the price of ten widely used Medicare Part D drugs in August.…
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On September 19 and 20, 2024, the Medicaid and CHIP Payment and Access Commission (MACPAC) held a virtual public meeting, which included the following sessions: The full agenda…
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Congress has once again delayed significant Medicare reimbursement cuts for clinical laboratory tests. Signed by President Biden on September 26, 2024, the short-term government funding bill delays the…
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