Though negotiated prices won't appear until 2026, CMS is starting to implement the first-ever negotiated prices for drugs paid for by Medicare.
Policy Updates
HHS has extended the COVID-19 public health emergency until April 11.
CMS needs better strategies to ensure proper oversight of Medicare Part B drug payment calculations, according to a Dec. 3 report from HHS' Office of the Inspector General.
New Jersey has become the eighth state to require state-regulated health plans to cover abortion services.
New Mexico is planning several changes to its Medicaid program, focused on equity and whole-person care.
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Prime Therapeutics will add Humira biosimilars in the same position in its formulary as the original drug, joining other pharmaceutical benefit managers in announcing similar policies.
New requirements for payers under CMS' Transparency in Coverage rule take effect Jan. 1.
Washington is the nation's first state to be approved by HHS to offer health and dental ACA coverage to any resident, regardless of immigration status, The Hill reported Dec. 12.
CMS issued a proposed rule Dec. 14 to continue its efforts to overhaul prior authorization and marketing practices around Medicare Advantage and Part D plans, along with adding health equity measures to star ratings and boosting behavioral health network adequacy…
CMS is proposing a new rule to streamline options on the ACA marketplace and add more provider network requirements.