Last Tuesday, the Trump administration announced the prices for the second round of Medicare negotiated drug prices, including semaglutide products from Novo Nordisk.
The new drug prices will go into effect in 2027 and are projected to cut between 38% to 85% off of the list price of the drugs individually, and net a 44% reduction in...
As one of the last acts of President Joe Biden's term, the administration listed the prescription pharmaceuticals that would be included in the second round of the program that allows the Centers for Medicare and Medicaid Services (CMS) to negotiate what it pays for certain drugs.
The announcement was made earlier than the...
The Department of Health and Human Services (HHS) Assistant Secretary for Planning and Evaluation (ASPE) continued its research series on the Inflation Reduction Act this week with a look at the impact of the $2,000 Part D out-of-pocket cap on prescription drugs.
Under the Inflation Reduction Act (IRA), 11 million Medicare Part D...
Rising consumer healthcare costs and increasing commercial reimbursement rates, impacts of the IRA, along with MSSP & REACH ACO shadow bundles and MA agent compensation data - if you can measure it, Milliman had an article, news brief or white paper on it in 2023; we're highlighting a few of our newsroom favorites.
Milliman is a...
The Centers for Medicare and Medicaid Services (CMS) has published new data from the 2025 Health Insurance Marketplace Open Enrollment Period (OEP). The OEP on HealthCare.gov runs from November 1 to January 15. The pace of enrollment is slower year-over-year.
Last year, 21.4 million signed up for health insurance through the ACA...
The Centers for Disease Control and Prevention (CDC) published its early release of quarterly estimates from the National Health Interview Survey which found relatively low uninsured rates across the country from 2023 to June 2024.
The report included select estimates of healthcare statistics for the non-institutionalized U.S....News
As part of the ongoing Inflation Reduction Act Research Series, the Assistant Secretary for Planning and Education (APSE) Office of Health Policy published an issue brief on the number of Medicare Part D enrollees who reached the out-of-pocket cap on prescription drugs by June 2024.
The issue brief found that 1.5 million enrollees...Arizona News
Vice President Kamala Harris and former President Donald Trump delivered their final pitches to the American public this week ahead of election day on November 5. Both candidates refined their positions on healthcare policy and the people they'd entrust with health matters should they win the White House.
Throughout the campaign...National News
One of the main provisions of the Inflation Reduction Act's Medicare reform package directly lowers out-of-pocket costs for beneficiaries by capping total individual spending at $2,000 per year. This is causing some issues in practice, which conservatives are seizing upon to criticize the program.
It also instructs insurers to cover...National News
The Health Resources and Services Administration (HRSA) said Johnson & Johnson has until September 30 to respond to the government's notice which argues J&J's plan to begin issuing rebates to DSH hospitals October 15, 2024 for two popular 340B covered outpatient drugs, a blood clot treatment drug Xarelto; and Stelara, a drug...
On August 15, the Biden administration announced new, lower prices for 10 drugs after the first cycle of negotiations under the new Medicare Drug Price Negotiation Program; prices are set to take effect in 2026.
The 2022 Inflation Reduction Act (IRA), aims to bring substantial savings for older Americans and Medicare. The law...
On Tuesday, the Biden administration released guidance on rules for the Medicare Prescription Payment Plan, a key aspect of the healthcare initiatives laid out in the Inflation Reduction Act of 2022 that aims to lower out-of-pocket costs for seniors with Medicare Part D prescription drug coverage.
The program is slated to launch in...Top of The Day
Congress will soon debate whether to extend the enhanced Premium Tax Credits (PTCs) again or potentially make them permanent. Since introduced in 2021, enhanced PTCs have driven record-high enrollment in the Marketplaces across all income levels. The report predicted that 7.2 million more people will enroll in 2025 Marketplace plans than...National News
In a ruling that is expected to be appealed, a fourth federal judge sided with the government against pharmaceutical companies in upholding the Medicare Drug Price Negotiation Program.
This lawsuit was brought by Bristol Myers Squibb and Johnson & Johnson against the law that will require them to negotiate the prices of blood clot...National News
The Republican Study Committee (RSC), of which most House Republicans are members, unveiled its budget proposal for fiscal year 2025 this week. The budget doubles down on the decade-and-a-half long campaign to repeal the Affordable Care Act (ACA) in addition to ending Medicare drug price negotiations, implementing block grants for...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) have taken the next step on the Medicare Prescription Payment Plan draft guidance, which is required by the Inflation Reduction Act of 2022 to advance President Joe Biden's plan to lower drug costs for seniors.
The draft guidance provides communication and education requirements for...
Last week the federal government began its initial pitch during its month-long negotiations with Johnson & Johnson, Merck, Bristol Myers, Squibb, Pfizer and other drug makers regarding how much Medicare is willing to pay for 10 costly cancer, diabetes and heart disease drugs.
The U.S. government gained authority to negotiate the...
From January 2022 to January 2023, 4,264 prescription drugs had price increases, of which 46% or 1,982 were increased above the inflation rate, according to ASPE researchers in a recent study.
Drug manufacturers make most of their prescription drug retail price changes in January and July annually and may change the list price at any...
All 10 drug companies whose drugs were selected for drug price negotiation with the Medicare program have elected to participate in negotiations.
President Joe Biden made the announcement on Tuesday in an online video. The first 10 companies were announced by the Centers for Medicare and Medicaid Services (CMS) in August and gave the...
Under the Inflation Reduction Act (IRA) people with Medicare may pay a lower coinsurance for some Part B drugs if the drug’s price increases faster than the rate of inflation.
The IRA, signed by President Biden in 2022, applied to Part D the same year, whereas Part B took effect in 2023. The Centers for Medicare & Medicaid...
