Archive for: Part D

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Payment Innovation: Other

MedPAC Discusses Innovation and Quality at October 2019 Public Meeting

MedPAC is discussing several innovation and quality topics at their next public meeting scheduled for October 3 to 4, 2019.

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Prescription Drug: Legislation

Summary of Senate Finance Prescription Drug Package

Senate Finance Committee posts description of the Chairman’s mark of its legislation addressing prescription drug pricing.

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Payment Innovation: Other

MedPAC Releases 2019 Health Care Spending Data Book

On July 19, 019, MedPAC released their 2019 Health Care Spending and the Medicare Program data book.

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Prescription Drug: Pricing

Administration Withdraws Rebate Overhaul Proposal

The Administration has announced it is no longer pursuing its drug pricing proposal that would have required pharmacy benefit managers to pass rebates directly on to the patient.

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Prescription Drug: Regulation

CMS Releases Final Part D Rule

On May 16, 2018, CMS released the final Part D and Medicare Advantage rule aimed at lowering drug prices.

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Payment Innovation: Other

Medicare Spending Projected to Grow to 5.9 Percent of GDP by 2038

The Medicare Board of Trustees projected that Medicare spending will grow to 5.9 percent of GDP by 2038.

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Prescription Drug: Other

Members Send Letter to HHS Opposing Changes to Protected Classes

On March 13, 2019, more than 70 members joined Representatives Barbara Lee (D-CA) and Will Hurd (R-TX) in sending a letter to Secretary and of Health and Human Services Alex Azar expressing opposition to the CMS proposed rule changing the six protected classes of drugs in Medicare Part D.

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Prescription Drug: Other

CMS Updates Drug Spending Dashboards

CMS updated its drug spending dashboards with data for 2017.

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Payment Innovation: Innovation Center

CMS Hosts Webinar on the VBID and Part D Payment Modernization Model

CMMI will hold a webinar on February 28, 2019, at 3 pm ET. It will provide a deep dive into the application processes and information about model designs for the Part D Payment Modernization Model and the Medicare Advantage Value-Based Insurance Design model for interested Part D sponsors and MA organizations.

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Payment Innovation: Other

HHS and OIG Releases Proposal Targeting PBMs

HHS and OIG release proposed rule targeting pharmacy benefits managers.

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Payment Innovation: Other

CMS Proposes Changes for MA and Part D Plans: Coverage Changes for Protected Class Drugs, Step Therapy Requirements and Greater Price Transparency for Medicare Beneficiaries

On November 26, 2018, CMS released a proposed rule that would allow for changes in 2020 to coverage of protected class drugs, establish new requirements for when MA plans may apply step therapy as a utilization management tool for Part B drugs and implement electronic tools to increase drug price transparency for Medicare beneficiaries.

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Payment Innovation: Other

CMS Releases 2019 Medicare Advantage and Part D Prescription Drug Quality Program Star Ratings

CMS has released Part C and Part D Star Ratings; providing information about the quality of plan choices.

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