Medicare & Medicaid

Bill would prohibit PBM compensation in Medicare Part D from being tied to the manufacturer’s list price of a drug.

MA payments are $76B above what spending would have been in Medicare fee-for-service in 2026, says MedPAC report.

DOJ had alleged that the Kaiser affiliates violated the False Claims Act by submitting invalid diagnosis codes to get higher government payments.

The deadline is today for MA plans to volunteer for a pilot related to data and coverage decisions.

The CMS program known as the Wasteful and Inappropriate Service Reduction (WISeR) model requires PA for 17 services, but Carol Howard, VP of innovation and adoption at Janus Health, says she can see it expanding before the end of the pilot period.

This is Cityblock's fourth partnership with a Centene regional plan.

Solicitor General D. John Sauer is urging the Supreme Court to deny AstraZeneca’s petition to hear the constitutionality of the case.

Model enables state Medicaid agencies and Medicare Part D  to cover GLP-1 drugs.

HHS has appealed and has been joined by several pharmaceutical companies that want intervenor status.

Proposed rule increases requirements for price comparison tools by aligning them with consumer protections established under the No Surprises Act.