June 5th 2023
The authors find that 340B-covered hospitals and grantees are contracting mainly with pharmacies in significantly more affluent neighborhoods than their own.
Biden Administration Releases Drug Rebate List, Promotes End of Vaccine Cost Sharing
March 15th 2023The Biden administration released the list of 27 Medicare Part B drugs that are subject to rebates back to the government for having price increases that rose faster than inflation as well as the removal of out-of-pocket costs for some vaccines covered under Part D.
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Community social determinants of health such as rurality and low socioeconomic status moderate the association between an individual’s race and emergency care use.
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Development of a Medicare Plan Dashboard to Promote Health Equity
Health plans use data to decide on quality improvement initiatives. Having a dashboard that characterizes how equitably plans are serving their enrollees would promote health equity.
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What We’re Reading: Rare Disease Drug Approved; Congress and PBMs; FDA Panel Splits on RSV Shot
March 1st 2023The FDA approved the first drug for the rare disease Friedreich’s ataxia; House Republicans seek information from pharmacy benefit managers (PBMs); FDA panel narrowly supports respiratory syncytial virus (RSV) vaccine for older adults.
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Association Between Use of Clinician Performance Information and Patient Experience
High patient experience scores were associated with the collection and use of any clinician performance information, especially with whether the practice shared this information internally to compare.
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Social Security and Medicare spending could double by 2023; FDA panel experts want naloxone to be available over the counter after the drug information is revised; Moderna announced its COVID-19 vaccines will stay free, and the Biden administration might keep tests and treatments free for the uninsured.
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CMS Practice Assessment Tool Validity for Alternative Payment Models
Using data from 632 primary care practices, the authors show that the CMS Practice Assessment Tool has adequate predictive validity for participation in alternative payment models.
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HHS wants to require nursing homes to disclose more ownership and management information; privacy advocates warn that mental health data can legally be sold from certain platforms not covered by the Health Insurance Portability and Accountability Act; the FDA won’t review Soligenix’s cancer drug proposal because of an insufficient application.
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Pediatric Oral Health Services in Medicaid Managed Care and Fee for Service
Rates of preventive oral health services among pediatric medical visits in Florida were similar whether visits were paid via Medicaid comprehensive managed care or fee for service.
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CMS Releases Guidance on the Math Behind Part B, Part D Drug Rebates
February 10th 2023The Biden administration released 2 sets of guidance documents for pharmaceutical manufacturers about how it plans to implement the new Medicare Prescription Drug Inflation Rebate Program as required under the Inflation Reduction Act, and said some beneficiaries could see lower coinsurance for some Part B drugs as soon as April 1.
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What We’re Reading: Child RSV Shot Disparities; Hospital Transparency Compliance; Abortion Pill Bans
February 6th 2023A pediatric shot for respiratory syncytial virus (RSV) may not be covered as a free routine vaccine; hospitals fail to comply with payment transparency rules; the fate of abortion pills is in the hands of conservative judges
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What We’re Reading: Eyedrops Recalled; Inaccessible Weight Loss Drugs; Doctor, GOP Governor Spar
February 3rd 2023CDC warns against EzriCare Artificial Tears, which were recalled by the manufacturer; certain weight loss drugs not covered by most payers; Mississippi's Republican governor denies being privately in support of Medicaid expansion.
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The government is allowing Medicare Advantage (MA) plans to delay returning hundreds of millions of dollars or more in government overpayments; a proposed new extension of the Affordable Care Act (ACA) might make birth control coverage more accessible for certain private insurance plans; a study found that students lost around 33% of their school year because of the pandemic’s educational barriers and are struggling to regain that lost time.
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IRA Insulin Cap Could Have Saved Medicare Beneficiaries Millions in 2020
January 30th 2023An HHS report said that if the Inflation Reduction Act (IRA) had been implemented in 2020, Medicare Part D beneficiaries could have saved a total of $734 million, averaging out to about $500 per member.
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