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.

Prescription Drug Pricing 52

Prescription Drug Pricing Licensing Compliance Medicaid 52

Jane Sarashon

JULY 18, 2024

Health Populi’s Hot Points: Affording health care is a greater challenge for more Americans these days, the latest West Health-Gallup Health Care Affordability Index research revealed this week.

Doctors 59

Doctors Prescription Drug Pricing Hospitals Health Insurance 59

Health Populi

JANUARY 18, 2019

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.

Prescription Drug Pricing 66

Prescription Drug Pricing Health Insurance Doctors Medicare 66

Innovaare Compliance

JUNE 27, 2024

How M3P Payments are Calculated Under M3P, payments are calculated using a formula defined by the Centers for Medicare and Medicaid Services (CMS). These requirements include: Detailed Reporting: Plans must submit comprehensive data on prescription drug pricing, utilization, and patient outcomes.

Medicare 52

Medicare Medicare Compliance Prescription Drug Pricing 52

Healthcare Law Blog

FEBRUARY 22, 2023

All rebate payments will be deposited into the Medicare Prescription Drug Account in the Federal Supplementary Medical Insurance Trust Fund. The Rebate Programs implement inflation-based rebates for the Medicare program that mirror those under the Medicaid Drug Rebate Program. 9, 2023). [2] 11] See DOJ Press Release No.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

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.

Prescription Drug Pricing 108

Prescription Drug Pricing Medicare Medicare ACA 108

Hall Render

FEBRUARY 25, 2022

Why some Medicaid providers in Colorado aren’t getting paid. Whitmer signs bills designed to lower prescription drug prices in Michigan. Missouri Takes Months to Process Medicaid Applications — Longer Than Law Allows. North Carolina legislative Medicaid expansion panel eyes worker shortages, hospitals.

COVID-19 40

COVID-19 Nursing Homes Nurses Hospitals 40

Hall Render

FEBRUARY 18, 2022

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. Bill on prescription drug pricing inspires support from Maine residents, opposition from pharmaceutical industry. MISSISSIPPI.

COVID-19 40

COVID-19 Nursing Homes Nurses COVID-19 Vaccine 40

Hall Render

MAY 10, 2024

Health Policy Commission still missing key document in Steward sale to Optum Local obesity drug developer lands deal worth up to $600M with Novo Nordisk Mass. Health Policy Commission still missing key document in Steward sale to Optum Local obesity drug developer lands deal worth up to $600M with Novo Nordisk Mass.

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

Hall Render

JULY 22, 2022

Delaware Adds Centene Plan to Medicaid Managed Care Offerings. Key advocates reflect on Hawaii postpartum Medicaid coverage extension. Hospital System Says It’s Hurt by Lack of Medicaid Expansion. Medicaid expansion discussions return as Mississippi hospitals face financial struggles. Will health systems step up?

COVID-19 40

COVID-19 Nursing Homes Nurses Hospitals 40

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. Other provisions in the legislation are similar to policy proposals to regulate PBM activity in other payor markets, such as Medicaid.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Health Populi

MAY 8, 2019

Adherence is not equal across every state in America, IQVIA Institute learned: for major chronic conditions of hypertension, cholesterol and diabetes, adherence was a low of around 50% among Medicaid enrollees in Arkansas, Iowa and New York; and as high approaching 90% in Minnesota for Medicare Part D enrollees in that state.

Prescription Drug Pricing 63

Prescription Drug Pricing Medicare Medicare Health Insurance 63

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

US Department of Health and Human Services 40

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

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.

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

Medval Compliance Blog

SEPTEMBER 1, 2021

The Centers for Medicare & Medicaid Services (CMS) has identified 70 services that must be included in the list. In contrast, prescription drug prices could be high in some instances, as pharmacy benefit managers may not be getting the best pricing for drugs from a particular pharmacy.

Prescription Drug Pricing 52

Prescription Drug Pricing Medicare Medicare Hospitals 52

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? Here’s what we know. Some patients die waiting.

US Department of Health and Human Services 40

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

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. The graph is the Nasdaq U.S.

Prescription Drug Pricing 48

Prescription Drug Pricing Governance ACA Medicare 48

Health Populi

OCTOBER 19, 2020

Women, being Chief Health Officers of their Families, influencing 80% of health care decisions, well know how to connect the dots between health care costs and their household financial wellness.

COVID-19 105

COVID-19 Health Insurance Prescription Drug Pricing ACA 105

Hall Render

NOVEMBER 11, 2022

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. Supreme Court to hear Indiana nursing home case involving Medicaid benefits. in prescription drug pricing case.

US Department of Health and Human Services 40

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

Nursing Homes 40

Nursing Homes COVID-19 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.

Prescription Drug Pricing 59

Prescription Drug Pricing Nurses Public Health Hospitals 59

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

Prescription Drug Pricing 79

Prescription Drug Pricing COVID-19 Medicaid Medicaid 79

Health Populi

SEPTEMBER 4, 2024

The top five issues were: Establishing an organ donation registry to streamline matching with recipients (89% of Dems, 79% of GOP) Expanding Medicare to cover dental, vision, and hearing coverage (92% Dems, 77% GOP) Capping annual out-of-pocket costs for prescription drugs (86% Dems, 76% GOP) Increasing federal funding for counseling for people with (..)

Medicare 62

Medicare Medicare Prescription Drug Pricing Public Health 62

Hall Render

JUNE 2, 2023

operating margin, $579M net gain for its first post-merger quarter GE HealthCare invests in augmented reality firm on ‘X-ray vision’ technology Marshfield Clinic reports $32.6M

US Department of Health and Human Services 40

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

Kaiser Health News

AUGUST 12, 2022

Never before have we been able to negotiate prescription drug prices. Under the bill, all vaccines recommended by the federal Advisory Committee on Immunization Practices will be fully covered by Medicare, as well as by Medicaid and the Children’s Health Insurance Program. “It’s historic.

Medicare 96

Medicare Medicare Prescription Drug Pricing Governance 96

Health Populi

AUGUST 28, 2019

In fact, Democrats’ keen concern for several health care issues — at the top of that list, prescription drug prices, guaranteed coverage for pre-existing conditions, and women’s health care access — drove many voters to the polls in the 2018 mid-term elections.

Medicare 99

Medicare Medicare ACA Prescription Drug Pricing 99

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).

Prescription Drug Pricing 87

Prescription Drug Pricing Medicaid Medicaid ACA 87

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.

Prescription Drug Pricing 72

Prescription Drug Pricing Medical Billing Health Insurance Public Health 72

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.

Prescription Drug Pricing 40

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.

Medicaid 78

Medicaid Medicaid Health Insurance ACA 78

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.

Prescription Drug Pricing 52

Prescription Drug Pricing ACA Health Insurance Medicaid 52

Health Populi

JUNE 28, 2019

“Millions do not have health insurance as they make too much money to get on Medicaid.” ” Lower my drug prices. The cover theme of the May 2019 AARP Bulletin focused on “the fight to lower prescription drug prices,” saying that, “medicine can be made more affordable.

Medicare 74

Medicare Medicare Health Insurance Governance 74