Policy and Legislation
States are required to get CMS approval for any changes they want to make to their Medicaid programs, no matter how simple.
Competition drives drug prices and results in higher rebates, insurance organization says.
OptumRx is changing its medication containers for temperature-sensitive prescriptions for home delivery to renewable cotton that is biodegradable, compostable, reusable and recyclable.
HRSA is distributing the funds to help boost the use of technology to improve efficiencies and outcomes among small hospitals.
Prosecutors for the 10 regional strike forces currently in operation have charged over 3,700 defendants in connection to more than $14 billion in false billings, DOJ says.
Site-neutral clinic payments, 340B drug program policy, adding procedures to covered list for ambulatory surgery centers all hit hospital margins.
Some drug companies pay less than what they would otherwise owe by introducing a new drug formulation, HHS Secretary Alex Azar says.
Administrator Seema Verma says it's time for ACOs to take on downside risk, in a proposal that would save Medicare $2.2 billion over 10 years.
The 2018 benefit year will now determine risk adjustment payments to insurers, using the statewide average premium.
Starting in 2019, insurers may use step therapy to choose the least expensive drug first before moving on to another prescription.