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Understanding the 2025 Medicare Part D Re-design: What You Need to Know

Innovaare Compliance

The Prescription Drug Program, commonly known as Medicare Part D, is undergoing significant transformations in 2025 due to the Inflation Reduction Act (IRA) of 2022. Medicare Part D will have three (3) phases instead of four (4) – Deductible, Initial Coverage Phase and Catastrophic Phase. generics) in the catastrophic phase.

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NYS DFS Revisits PBM Regulation with Scaled-Back Draft Rules

Health Care Law Brief

On February 6, 2024, the New York State Department of Financial Services (“DFS”) released “pre-proposed” consolidated rulemaking related to the business practices of Pharmacy Benefit Managers (“PBMs”) licensed to operate in New York.

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CMS Approves a New 1115 Waiver Amendment:  The New York Health Equity Reform (NYHER) Program

NY Health Law

On January 9, 2024, the federal Centers for Medicare and Medicaid Services (CMS) finally approved New York State’s 1115 waiver amendment to establish the New York Health Equity Reform (NYHER) Program. The State is also required to invest approximately $199 million in rate increases, even if no Medicaid rates are below 80% of Medicare rates.

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Healthcare Workforce – 2023 Health IT Predictions

Healthcare IT Today

The 2023 final Medicare Physician Fee Schedule (PFS) eased supervisory requirements for care delivered by a licensed professional counselor or licensed marriage and family therapist. health expenses by 2027, thanks to rising labor and supply costs. Almost 75% say that this impacts patient care moderately to severely.

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Healthcare Reforms Under the IRA: Expanding Access to Care

Healthcare Law Blog

The expansive legislation includes key health care provisions, including drug pricing reforms, inflationary rebates, Medicare Part D benefit redesign, as well as myriad other updates. Medicare Drug Price Negotiation Program. The Inflation Reduction Act (“IRA”) was signed into law by President Biden on August 16, 2022.

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Health Provider News

Hall Render

NATIONAL 80 hospitals sue HHS over Medicare Advantage Days payment rule AHA op-ed in Medical Economics sets the record straight on 340B program growth and the role of drug companies As hospitals close obstetric units, maternity care deserts become more common At Catholic hospitals, a mission of charity runs up against high care costs for patients Bill (..)

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CMS Issues CY2024 Proposed Rule for Medicare Advantage Organizations and Part D Sponsors

Healthcare Law Blog

Just in time for the holidays, the Centers for Medicare and Medicaid Services (“CMS”) issued the Contract Year 2024 Proposed Rule for Medicare Advantage organizations (“MAOs”) and Part D sponsors (the “Proposed Rule”). Health Equity in Medicare Advantage. We’ve summarized some of the key changes in the Proposed Rule.