Guidance on how to implement a new policy to permit Part D beneficiaries to pay high copays in monthly installments (rather than all at once at the pharmacy counter) shows that there is no such thing as a straight-forward change in the drug benefit program.
One of the many changes in the US Medicare Part D prescription drug program enacted as part of the Inflation Reduction Act is intended to make it easier for beneficiaries with very high-cost prescriptions to afford their co-pays by permitting monthly installments rather than demanding collection of the whole cost at the time of dispensing.
The provision for smoothing out monthly co-pays did not get a lot of attention as part of the broader bill,...
The Centers for Medicare and Medicaid Services is considering imposing price inflation rebates on Part B drugs furnished to enrollees in Medicare Advantage plans in addition to those covered by fee-for-service Medicare.
Doctors are increasingly falling victim to financial scams due to their high incomes, busy schedules, and trust in professional networks. Recognizing the tactics scammers use and the reasons behind physicians’ susceptibility is essential for protecting medical professionals.
US lawmakers will undoubtedly continue to work on pharmacy benefit manager reform legislation in 2025, given its bipartisan support. But policies impacting rebates that could lead to higher premiums in Part D may be a tough sell in the midst of the benefit redesign.
Medicare coverage with evidence development final guidance includes few substantive changes from the proposed version despite biopharma stakeholder concerns.
Congressional Budget Office responses to questions from US lawmakers on pharmacy benefit managers could add to the momentum for PBM reforms to go further than the current leading proposals.
Pink Sheet reporter and editors discuss the take-aways from the landmark first Medicare negotiated drug prices and what additional information remains outstanding.
But the amount of savings realized when the Medicare negotiated prices go into effect in 2026 remains the subject of debate.
