Medicare
Will the IRA Harm the Financial Integrity of LTCs?
Changes to Medicare Part D reimbursement policies could lower operating margins for long-term care pharmacies.
AUGUST 12, 2025
IRA Reduces Specialty Pharmacy Reliance on Patient Assistance Programs
The Inflation Reduction Act (IRA), which has made brand-name medications more affordable, also has yielded a key ...
JANUARY 2, 2025
NASP Urges Action on 'Abysmal' Medicare Reimbursement
Medicare Part D contract rates for specialty pharmacies for 2024 and again in 2025 are “abysmal,” Julie ...
OCTOBER 11, 2024
Why Health Plans Need a High Health Equity Index to Prosper
Medicare Advantage and other health plans are giving more attention to medication adherence, social determinants or ...
AUGUST 16, 2024
CMS Fee Schedule Proposes New Add-on Code for ID Docs
CMS released its 2025 Medicare Physician Fee Schedule proposed rule, which included a new “add-on” code ...
JULY 16, 2024
CMS Incentivizes Payor Health Disparity Performance
Medicare Advantage and other health plans are starting to pay more attention to medication adherence, social ...
JUNE 24, 2024
New CMS Rules Aim to Help Patients to Afford, and Stick to, Medications
CMS has released the final part 1 guidance for the new Medicare Prescription Payment Plan, part of President Joe ...
APRIL 19, 2024
AI May Not Be So Smart When Payors Use It To Deny Medical Claims
Concerns are growing about the increasing use of artificial intelligence to review—and in many cases ...
FEBRUARY 23, 2024
Why Do So Few Medicare Patients Have Access to Home Infusions?
A webinar hosted by the NHIA in response to the Senate introduction of the bipartisan Preserving Patient Access to ...
AUGUST 24, 2023
CMS Will Cover 80% Of Leqembi Cost; No Trial Entry Needed
With the FDA having granted full traditional approval to the anti-amyloid Alzheimer’s disease drug ...
AUGUST 17, 2023
Mark Cuban’s MCCPDC Could Save Medicare 78.8% On 7 Top Oncology Drugs
Medicare Part D beneficiaries and the U.S. government have the potential to save tens of millions of dollars if ...
JULY 27, 2023
CMS Proposes One-Time $9 Billion Restitution To Fix Years of 340B Underpayments
One year after a 2022 Supreme Court decision that the CMS did not have the authority to lower reimbursement rates ...
JULY 14, 2023
