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DIR Reform: what you need to know

Natalia Mazina

Many pharmacy and patient advocacy groups have spoken out against the obscure methods employed by PBMs to increase their profits. These groups have advocated for the fees to be applied at the time a patient picks up the medication at the pharmacy rather than subjecting pharmacies to these fees months later.

Medicare 137
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California pharmacies will no longer be required to pay back the state under its new reimbursement methodology

Natalia Mazina

Several pharmacists and patient advocacy groups filed legal actions against the DHCS and worked with legislature to eliminate these chargebacks to pharmacies. This lead to overpayments to pharmacies.

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Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Funding Opportunity: Measure Development for the Quality Payment Program

CMS.gov

Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Funding Opportunity: Measure Development for the Quality Payment Program. They are concrete quality topics which reflect core issues that are most vital to high quality care and better patient outcomes. Jeremy.Booth@c…. Fri, 03/02/2018 - 16:30. Kate Goodrich, M.D.,

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CMS Finalizes Major Changes to Hospital Price Transparency Rule

Hall Render

The Centers for Medicare & Medicaid Services (“CMS”) finalized significant updates to the Hospital Price Transparency regulation for the first time since the rule took effect on January 1, 2021.

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Home Health PPS Final Rule for CY 2024: CMS Steps Back from the Brink

Hall Render

On November 1, 2023, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2024 Home Health Prospective Payment System Rate Update Final Rule (“2024 Final Rule”), which has since been filed in the Federal Register. Deactivation.

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Wasted: $1 of Every $4 Spent on Health Care In America

Health Populi

The Centers for Medicare and Medicaid Services (CMS) forecasts that prescription drug spending will be the fastest-growing cause of rising health spending by 2027. patients). Pricing failure, the second big waste factor, is predominantly challenged by pharmaceutical/prescription drug pricing based on this research.

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How Hospitals Can Help Patients Meet Financial Obligation While Driving Revenue Excellence

HIT Consultant

Today, patients are the third-largest payer – behind Medicaid and Medicare. But the patient’s financial experience is often challenging, even for those with insurance. By focusing on three critical areas, providers can help simplify the process and reduce the staggering patient financial burden.