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CBO Underestimates Medicare Part D savings by $4 Billion Due to Oversight Lapse

In the Bipartisan Budget Act of 2018 the Congressional Budget Office underestimated – by $4 billion – the amount Medicare would save due to changes in Medicare Part D. Instead of saving $7.7 billion, Medicare will actually save $11.8 billion. The savings come from an increase in the government mandated discount that drug manufacturers must offer enrollees [...] Read More

Biosimilar Access and Savings: Ensuring a Reliable Reimbursement System

Here are some reimbursement related reasons why access to biosimilars has been slower than hoped, even though patient out-of-pocket costs are lower. Current System Is an Improvement Over Earlier System, But Could Be Better Part B Is For Biologics (and Some Drugs) When I was working at the Senate Legislative Counsel’s office drafting the Average [...] Read More

Medicare Should Help Patients Avoid the Angst of an Incorrect Alzheimer’s Diagnosis

Every year, thousands of Americans hear the devastating news that they have Alzheimer’s disease.  This diagnosis carries with it a certain future of declining mental and behavioral capabilities, and the eventual need for round-the-clock end-of-life care. The financial costs can be staggering, and the emotional costs immeasurable. While the impact of Alzheimer’s can be slowed, […]

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Medicare Blunts Incentives & Consequences of its Quality Payment Program

The Centers for Medicare & Medicaid Services (CMS) has released its much-anticipated Calendar Year (CY) 2018 Quality Payment Program (QPP) Final Rule. In this final rule, CMS details changes to both the Advanced Alternative Payment Models (APMs) track and the Merit-Based Incentives Payment System (MIPS) track of the QPP. CMS says it expects this program to, “Modernize […]

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