Healthcare Law Blog

JUNE 2, 2023

In the underlying Seventh Circuit cases, relators alleged that retail pharmacies had knowingly submitted false reports of their Usual and Customary (“U&C”) drug prices to the government for reimbursement under Medicare Part D and Medicaid, because the reports allegedly did not account for discounted drug prices offered through certain prescription (..)

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Prescription Drug Pricing Governance Medicaid Medicaid 52

Health Care Law Brief

JANUARY 19, 2022

On December 31, 2021, New York Governor Kathy Hochul signed landmark legislation to increase the transparency of prescription drug pricing and to establish requirements on pharmacy middlemen. Medicare and Medicaid have had similar price transparency rules, but now those rules will apply across all lines of business in New York.

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Health Populi

JANUARY 18, 2019

As the Harvard Chan-POLITICO study points out, prescription drug costs are top-of-mind for health consumers in America. As patients continue to morph into consumers who pay for health care services, they are seeking price transparency — but not finding it so easy. And see here on JD Supra for more details on the rules.

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Prescription Drug Pricing Health Insurance Doctors Medicare 66

Jane Sarashon

JULY 18, 2024

One-third were specifically worried about paying for prescription drugs in the next 12 months, an increase from 25% in 2022. Millions of seniors (8 million, the report quantifies) in Medicare were also part of this large contingent of health citizens concerned about their ability to access medicines.

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Doctors Prescription Drug Pricing Hospitals Health Insurance 59

Health Populi

OCTOBER 8, 2019

Pricing failure, the second big waste factor, is predominantly challenged by pharmaceutical/prescription drug pricing based on this research. 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.

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Hall Render

FEBRUARY 25, 2022

The 55 hospitals penalized by Medicare 8 years straight over patient complications. Why some Medicaid providers in Colorado aren’t getting paid. Medicare penalizes 40 hospitals in Florida for patient safety. Whitmer signs bills designed to lower prescription drug prices in Michigan. NORTH CAROLINA.

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Hall Render

FEBRUARY 18, 2022

13-year Medicare payment dispute will return to HHS, court rules. Colorado mental health professionals incensed after Medicaid forum that was intended to clear the air. Florida health system settles improper Medicaid payment allegations for $5.5M. Medicaid Managed-Care Proposal Goes to Mississippi Senate. MISSISSIPPI.

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Hall Render

MAY 10, 2024

Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’ Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’ million expansion ‘Very, very unusual.’

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Hall Render

JULY 22, 2022

CMS releases Medicare OPPS and ASC proposed rule. Long Beach Memorial avoids losing Medicare funding after serious patient care lapses. Delaware Adds Centene Plan to Medicaid Managed Care Offerings. Key advocates reflect on Hawaii postpartum Medicaid coverage extension. CMS pitches outpatient payment rule. CMS proposes 2.7%

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Hall Render

OCTOBER 4, 2024

NATIONAL 5 Stark law issues physicians are closely watching Anti-monopoly advocates urge FTC to block McKesson, Cardinal Health’s big-ticket oncology acquisitions Biden administration doles out $68.5M

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Health Law Advisor

MAY 22, 2023

1339) reflects the overarching legislative push by members from both sides of the aisle and chambers of Congress to address drug pricing issues through federal fixes to the PBM framework. Unlike the IRA, which targeted the Medicare program, the provisions of S. 1339, adding several new amendments to create the version of S.

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Medicaid Medicaid Medicare Medicare 52

Hall Render

APRIL 12, 2024

New president tapped to lead major hospital system in Denver area New president to lead opening of $650M hospital in Wheat Ridge Telehealth program offers support to forensic nurses Colorado Medicaid program settles lawsuit over lack of mental health care for children Colorado is trying to cut prescription drug prices.

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Nursing Homes Nurses Hospitals Medicaid 40

Hall Render

JANUARY 3, 2025

in Medicare fraud settlement 10 behavioral health policy changes taking effect in 2025 An uncertain era for Stark law: 12 updates in 2024 CMS launches campaign to support nursing home staffing rule CMS taps 4 states for behavioral innovation model: 5 things to know Epic files to dismiss antitrust lawsuit Healthcare company to pay $15.2

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Health Populi

MAY 8, 2019

In 2018, we saw more incentives to inspire adherence to prescription drug regimens, particularly in Medicare Part D along with increasing focus by pharmacists and providers. For people enrolled in Medicare Part D, 20% faced over $500 in OOP costs. A cost of $125 or more yields abandonment of at least 50%.

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Prescription Drug Pricing Medicare Medicare Health Insurance 63

Hall Render

NOVEMBER 11, 2022

Physician leaders balk at Medicare 4.48% physician fee cut. Supreme Court Weighs Whether Medicaid Residents Can Sue State-Owned Nursing Homes. Arkansas governor announces rural health coverage with Medicaid program. CMS Approves Arkansas Medicaid Waiver to Address SDOH. in prescription drug pricing case.

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US Department of Health and Human Services Nursing Homes COVID-19 Nurses 40

Hall Render

FEBRUARY 24, 2023

Dunleavy adds $9M to budget to address food stamp, Medicaid backlog New study provides snapshot of increase in maternal deaths in Alaska Mental Health Trust Grants $1.6M Dunleavy adds $9M to budget to address food stamp, Medicaid backlog New study provides snapshot of increase in maternal deaths in Alaska Mental Health Trust Grants $1.6M

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Hall Render

JUNE 23, 2023

Greenwich Hospital Ribbon Cutting Celebrates Opening of New Pediatric Ambulatory Surgery Center Hartford HealthCare names Joanne Berger-Sweeney new board chair What changes did CT make to its Medicaid program in 2023? too much.

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US Department of Health and Human Services Nurses Hospitals COVID-19 40

Health Populi

JUNE 18, 2020

Kesselheim, are affiliated with the London School of Economics and Brigham and Women’s Hospital in Boston, note that 1% of medicines dispensed under Medicare Part D and Medicaid accounted for nearly $1 in $3 of drug spending in each program in 2015. bn for Medicaid. bn to $32.8 bn to $9.9

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Prescription Drug Pricing COVID-19 Medicaid Medicaid 79

Medval Compliance Blog

SEPTEMBER 1, 2021

Recognizing the mounting attention given to hidden fees and surprise billing, on June 24, 2019, former President Trump signed an executive order (EO) directing the Department of Health and Human Services (and additional agencies) to take steps to improve price and quality transparency in healthcare. Medicare Set-Aside Considerations.

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Prescription Drug Pricing Medicare Medicare Hospitals 52

Health Populi

SEPTEMBER 4, 2024

The post Where Democrats and Republicans Agree on Health Care Policies – From Medicare and Prescription Drugs to Gun Safety appeared first on HealthPopuli.com. He led the creation of the Northwell Health’s Center for Gun Violence Prevention in 2020.

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Medicare Medicare Prescription Drug Pricing Public Health 62

Health Populi

MAY 14, 2018

This is what happened to pharma stock prices on Friday after President Trump and Secretary of Health and Human Services Alex Azar outlined their new policies focusing on prescription drug prices. ” These prescriptions for lower pharma costs contrast with what most U.S. The graph is the Nasdaq U.S.

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Prescription Drug Pricing Governance ACA Medicare 48

Kaiser Health News

AUGUST 12, 2022

First, it would give the federal government the ability to negotiate prices of some drugs purchased by Medicare beneficiaries, a tool that has long been opposed by the drug industry. Never before have we been able to negotiate prescription drug prices. Those prices would take effect in 2026.

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Medicare Medicare Prescription Drug Pricing Governance 95

Hall Render

JUNE 2, 2023

Ezequiel Molina targets expansion of Piedmont’s heart transplant system Grady Health System’s Cole Tatman set the tone for calm in Burn Unit Northside Hospital emergency specialist Trystan Drummond has ‘uncanny’ ability to solve problems, move forward Wellstar Health System to open center for $100M innovation fund in Atlanta Wellstar, Northeast Georgia (..)

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Jane Sarashon

AUGUST 26, 2024

Hear how nurses Jeanne Ayers RN, MPH , Lisa Schavrien RN, BSN and Erin Ainslie Smith MS, BSN, CPST have crafted creative approaches to remove barriers to voting for the benefit of both patients and colleagues in clinical practice.

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Prescription Drug Pricing Nurses Public Health Hospitals 59

Jane Sarashon

DECEMBER 20, 2023

Complementing this effort, Kroger also launched a personalized health and nutrition program collaborating with Soda Health earlier in December – importantly, aimed at people enrolled in Medicaid and Medicare programs.

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Prescription Drug Pricing Medical Billing Health Insurance Public Health 72

Health Populi

AUGUST 28, 2019

These two surveys are: The Morning Consult’s poll published today finding growing support among Democratic voters for Medicare for All as the centerpiece for health reform in America; and, A recent study from Eligibility.com on “Medicare Myths Explained,” with the tagline, “How much do you know about Medicare?”

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Health Populi

DECEMBER 6, 2023

The future of Medicare and Medicaid as well as access to mental health care also rank high among two-thirds of U.S. Stay tuned to IRA components addressing prescription drug costs, and Medicare and Medicaid status (provider payments for the former, state-level moves for the latter).

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Health Populi

NOVEMBER 7, 2018

While we have a divided government via split legislature, one winner in the 2018 midterm outcome is Medicaid. In these midterms, governors flipped from Republican to Democrat in Kansas, Maine and Wisconsin, all of whom promised to expand Medicaid through the Affordable Care Act. Lloyd Doggett (D-TX) said to the Washington Examiner.

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Prescription Drug Pricing Medicaid Medicaid Medicare 40

Health Populi

NOVEMBER 5, 2018

Lowering the costs of care, ensuring the integrity of Medicare benefits, ensuring that low-income people don’t lose Medicaid coverage, and lowering prescription drug prices gain majority support across all health care voters who say health care is extremely important in the choice for members of Congress this year.

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Medicaid Medicaid ACA Health Insurance 78

Health Populi

JUNE 28, 2019

Sanders, noting his call for big new government benefits like universal health care through Medicare for All and free college tuition. Senator Harris, too, mentioned government benefits like free college and Medicare for All as her health plan preference. Instead, he is for “Medicare for All Who Want It,” in his words.

Medicare 74

Medicare Medicare Health Insurance Governance 74

Jane Sarashon

NOVEMBER 14, 2024

consumer dissatisfaction with drug prices — across political party identification. insured consumers’ perspectives on prescription drug pricing and the role of PBMs (pharmacy benefit managers). 9 in 10 insured Americans felt that prescriptions are more expensive in the U.S.

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Prescription Drug Pricing ACA Health Insurance Medicaid 52