April 29th 2025
At Asembia’s AXS25 Summit, industry experts explored how pharmacy is evolving to meet rising patient expectations and navigate a shifting health care environment.
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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Dr Dennis Scanlon Discusses the Impact of the COVID-19 Pandemic on Medicaid Coverage
February 1st 2023With the public health emergency soon coming to an end, people covered by Medicaid will encounter new barriers, discusses Dennis Scanlon, PhD, professor of health policy and administration, Penn State University.
Watch
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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Targeted Therapies for NSCLC May Be Underused in Medicaid Programs, Study Suggests
January 29th 2023A new study estimates that prescription of standard-of-care non–small-cell lung cancer (NSCLC) therapies is lower than expected in Medicaid programs, with significant variation between states.
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Associations Between Physician Practice Models and Health Information Exchange
January 11th 2023A survey of all Arizona physicians found that accountable care organization, clinically integrated network, or integrated delivery network participation was associated with higher use of health information exchange. However, there are exceptions and important barriers noted.
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What We’re Reading: Biden to Extend PHE Once More; High Court Rejects Pharma Suits; 988 Calls Soar
January 10th 2023President Joe Biden expected to renew COVID-19 public health emergency (PHE) one more time; Bristol Myers Squibb and Pfizer are denied by the Supreme Court; funding for the 988 mental health helpline expands inclusivity efforts.
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HHS updated guidance for states using Medicaid managed care to manage nonmedical needs; anxieties surrounding new variants rise amidst underreported COVID-19 cases in China, which defended its counts; public health campaigns try new strategies to increase trust and promote immunizations.
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PBMs Announce 2023 Coverage Plans for Adalimumab Biosimilars
January 1st 2023The addition of adalimumab biosimilars to formularies can help accelerate realized savings as the blockbuster drug Humira faces competition from multiple biosimilars, including 1 approved interchangeable biosimilar.
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COVID-19 vaccines have prevented more than 3.2 million deaths, but the US death rate this year has not declined to prepandemic numbers; Texas Attorney General (AG) Ken Paxton’s office has requested driver’s license records with sex changes from the past 2 years, among other documents, from the Texas Department of Public Safety; even though hepatitis C virus (HCV) is curable, some people who are incarcerated are going without treatment and dying.
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