cms

Price Transparency Updates

Update to Regulations for Price Transparency

Over the summer we discussed in a blogpost, “Executive Order Reduces HHS Time for Transparency,” the order issues from the current administration to make pricing more accessible for patients to be able to shop around for common outpatient procedures. November 15th, CMS announced two proposed regulations intended to follow through on this order. One is …

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Prescription Benefits

CMS Final Rule for Drug Prices in Advertising

A rule proposed in October of last year has become final on May 8, 2019. This rule would mandate that pharmaceutical companies publish the prices of any medication with a list price greater than $35 during television ads. Pharmaceutical companies tried to push back on this rule stating that listing the prices would confuse patients …

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CMS Spending Growth

CMS Projects Exponential Growth of Healthcare Spending

A new report from CMS recently published in Health Affairs, states that the US is projected to spend $5.96 trillion on healthcare in 2027. This would be a 19.4 percent share of the gross domestic product (GDP). In 2017, healthcare spending accounted for 17.9 percent of the GDP. The largest catalyst behind this projected growth …

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Increased Spending

Private Insurers, not Medicare or Medicaid, are behind increased healthcare spending

A new study released this week by The Urban Institute shows that Medicare and Medicaid spending is increasing more slowly than with Private Insurers, contrary to some of the policy proposals that have been put forth in recent years. According to the study of CMS data between 2006 and 2017, “Medicare and Medicaid spending per …

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Prescription Benefits

CMS Proposed Changes to Prescription Benefits

At the end of last month, CMS proposed a rule to change some key components of prescription coverage for Medicare Part D and Medicare Advantage beneficiaries. The key change revolves around the six protected classes: antidepressants, antipsychotics, anticonvulsants, immunosuppressants for transplant rejections, antiretrovirals and antineoplastics (typically cancer treatment drugs). The six protected classes acknowledge that …

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