“Most favored nation” pricing model for certain drugs
According to a recent poll, three in four adults in the United States say the cost of medications is unaffordable.
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CMS
Should CMS monitor biosimilar coverage on formularies?
The U.S. Department of Health and Human Services Office of Inspector General (OIG) released a study that found many Medicare
Read MoreOriginal Medicare covers most but not all healthcare services
Medicare is the government health insurance program for adults 65 and older and individuals under 65 with certain disabilities. However,
Read MoreCMS weighing prior authorization reforms: Report
(By: Andrew Cass for Becker’s Hospital Review) CMS is considering proposals that would cut the number of procedures that are subject
Read MoreMedicare Advantage Insurers Often Use Rewards and Incentives to Encourage Enrollees to Complete Health Risk Assessments (HRAs)
(By Meredith Freed, Nolan Sroczynski, and Jeannie Fuglesten Biniek for The Kaiser Family Foundation Published: Apr 28, 2025) Beginning in
Read MoreCoverage of Breast Cancer Screening and Prevention Services
(Source – The Kaiser Family Foundation Published: Apr 24, 2025) Among women in the United States, breast cancer is the
Read MoreCMS fines 3 PACE organizations
(By: Jakob Emerson for Becker’s Hospital Review) On April 11, CMS fined three PACE organizations for failing to meet essential
Read MoreStand-Alone Drug Plans Cover a Larger Share of Medicare Part D Enrollees Living in the Most Rural Areas Than Medicare Advantage Plans
(By Juliette Cubanski, Tricia Neuman, and Anthony Damico for The Kaiser Family Foundation Published: Apr 23, 2025) The growing role
Read MoreA costly mistake for many Medicare Advantage enrollees
A recent study by a leading healthcare system found that people on Medicare Advantage plans are not utilizing dental and
Read MoreDOGE has access to 19 HHS systems: Report
(By: Mackenzie Bean for Becker’s Hospital Review) The U.S. Department of Government Efficiency has access to sensitive information in 19
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