July Goal Set For Final U.S. Medicare Drug Negotiation Guidance

The U.S. government aims to publish the final guidance for its Medicare drug price negotiation program in early July and is currently talking to companies about its contents, a top health official said on Wednesday. The guidance will finalize the details of how President Joe Biden’s signature drug pricing reform will be carried out. The ...

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A Majority Of Payers Used Outcomes-Based Contracting Last Year: Survey

A majority of payers are using outcomes-based contracts for drugs, according to a recent analysis from Avalere. The researchers surveyed 46 health plans based in the U.S. and found that 58% had at least one outcomes-based contract in place in the 2022 plan year. More than a third (35%) said they had at least 10 such contracts ...

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Medication Prices Could Be Capped Under Proposed Nevada Bill

Assembly Bill 250, sponsored by Assemblywoman Venicia Considine, D-Las Vegas, and Assemblywoman Natha C. Anderson, D-Sparks, would cap the price of certain drugs to rates negotiated by the federal Department of Health and Human Services.

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Employee Navigator Announces Acquisition of Ease

Employee Navigator, the leading benefits administration and HR software solution for insurance brokers and employers, today announced the acquisition of Ease, the leading broker centric HR and benefits software solution for small businesses.

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Study Finds Half Of Cash Prices Below Commercial Rates In More Than 2,000 Hospitals

Cash prices for certain hospital services were lower than the average insurance rate in nearly half of the facilities examined in a new study, which could influence rate negotiations between payers and providers.

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U.S. Patients Blindsided By Telehealth Appointments That Charge A Facility Fee

U.S. patients are being blindsided by telehealth costs and many are facing facility fees even though they haven't stepped foot in a hospital or physician's office, The Washington Post reported April 1.

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What Lies Ahead for ACA’s Preventive Care Coverage Mandate?

On March 30, a single federal judge in Texas struck down a provision of the Affordable Care Act (ACA) that required free coverage for a host of preventive health services for people with private insurance. Under this decision, private health plans are no longer required to cover certain cancer screenings, services or medications to prevent heart disease, or perinatal depression preventive interventions, among others, with no cost sharing.

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Medi-Cal Will Soon End Some People’s Benefits. What This Means For You

Since the COVID-19 pandemic began in earnest, low-income Californians who enrolled in Medi-Cal — California’s version of the government-funded Medicaid health insurance program — have been able to keep their coverage without having to prove every year that they still qualified for it. That’s because the Families First Coronavirus Response Act, which President Trump signed ...

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HHS Quietly Trims Inaugural List Of Price Capped Medicare Drugs From 27 To 20

The Department of Health and Human Services’ (HHS’) highly publicized list of the first Medicare Part B prescription drugs hit with rebates under the Inflation Reduction Act discreetly dropped from 27 to 20, prompting critiques from the pharma lobby over the Biden administration’s swift implementation of the legislation’s drug controls. As spotted by Endpoints, the press release and ...

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WTW Expert: How Employers Can Protect Themselves Against Rising Healthcare Costs

Last June, the major tracker of inflation—the Consumer Price Index—hit 9.1% but has been receding ever since. Employers should be aware that the healthcare industry will not see a similar reduction in prices and, in fact, should expect costs to rise substantially, according to an expert at Willis Towers Watson. Tim Stawicki, a WTW senior ...

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