Month: March 2023

The Biden administration on Wednesday began fleshing out how it will implement drug-pricing provisions in the Inflation Reduction Act, including a multi-step negotiation process for selected Medicare drugs starting next year. Why it matters: The law gave the administration discretion to work out many details of the first-ever drug price talks, which will initially cover 10 ...

Nearly 30% of all patients who received medical services between 2016 and 2022 did not see a primary care physician, a FAIR Health analysis provided first to Axios shows. Why it matters: Primary care providers are supposed to manage patients’ day-to-day health needs and provide preventative care, and evidence shows it can drive down costs and improve outcomes. ...

Another major insulin maker has promised steep price cuts, as pressure grows on drugmakers and insurers to trim the cost of a medication that millions of Americans need. Novo Nordisk said Tuesday that it will slash some of its U.S. insulin prices up to 75% starting next year. The announcement comes less than two weeks ...

President Joe Biden released his budget for the 2024 federal fiscal year, outlining new investments to expand Medicaid, drug price reforms and other new policies. While the budget itself is unlikely to get enacted by a divided Congress, the document does outline key health priorities for the administration.

The Consolidated Appropriations Act (CAA) Rx Data Collection (RxDC) component requires health plans/issuers to produce and file reports on prescription drug and health care spending for the 2022 calendar year by 6/1/2023. These reports are due annually and will be due by June 1st each year thereafter. The Centers for Medicare & Medicaid Services (CMS) has released a RxDC Reporting Instructions Guide to help facilitate reporting.

Few things about the American health care system infuriate patients and doctors more than prior authorization, a common tool whose use by insurers has exploded in recent years.

The Word & Brown Companies today announced that key operating systems in use by Word & Brown® General Agency and CHOICE Administrators® have earned Certified status for information security by HITRUST.

When Paula Chestnut needed hip replacement surgery last year, a pre-operative X-ray found irregularities in her chest. As a smoker for 40 years, Chestnut was at high risk for lung cancer. A specialist in Los Angeles recommended the 67-year-old undergo an MRI, a high-resolution image that could help spot the disease. But her MRI appointment ...

Two top senators are urging the Biden administration to address “loopholes” that they said allow insurers to skirt price transparency requirements. Sens. Maggie Hassan, D-New Hampshire, and Mike Braun, R-Indiana, wrote in a letter (PDF) to Centers for Medicare & Medicaid Services Administrator Chiquita Brooks-LaSure that the agency should update its regulations to “ensure that there is ...

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