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Medicare
CMS Set to Scrutinize Medicare Advantage Marketing
In a May 10 letter to Medicare Advantage organizations and prescription drug plans, CMS said it will more closely scrutinize more…
CMS Issues Final Rule, Making changes to MA and Part D
In April, the Centers for Medicare & Medicaid Services (CMS) issued a Final Rule regarding the Medicare Advantage (MA) and…
CMS Outlines Medicare Drug Price Negotiation Program for 2026
On March 15, 2023, CMS released initial guidance detailing the requirements and parameters on key elements of the new Medicare…
CMS Releases 2024 MA Capitation Rates and Part C and D Payment Policies
On Friday, March 31, 2023, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year 2024 Medicare…
Medical Societies Support Legislation Aimed at Updating Medicare
The American Medical Association (AMA) led a coalition of more than 120 state medical societies and medical specialties in…
Part D Changes Included in the Inflation Reduction Act May be Helpful, But…
The Inflation Reduction Act (IRA) passed in 2022 included several changes to the Medicare Part D benefits, aimed at improving…
Program Safeguards Would Have Saved Medicare Money on Drug Testing Services…
From 2016 through 2020, Medicare Part B paid roughly $3 billion for 17.1 million definitive drug testing services to 3.3 million…
MGMA Submits Comments to CMS in Support of Prior Authorization Reforms
The Medical Group Management Association (MGMA) submitted comments to Centers for Medicare and Medicaid Services (CMS)…
CMS Lost $2.8 Million in Savings from 2016 to 2020
The Department of Health and Human Services Office of Inspector General (HHS OIG) published a report that found while the Centers…
Health Affairs Releases Research on Value-Based Payment Models
Health Affairs recently published a research brief, Value-Based Payment As A Tool To Address Excess US Health Spending. The brief…