Medicare

Trump’s Blueprint on International Drug Pricing; What to Expect

The U.S. always stood out as a different healthcare system. Well, maybe not anymore. The Trump Administration released an International Drug Pricing blueprint in 2018 and it was received with…

Read Full Article

Discount Safe Harbor Proposed Rule: How Process Works and What does it mean?

July 2019 Update As first reported by The Wall Street Journal and Axios on July 11, 2019, the Trump Administration has decided to abandon implementation of the proposed Discount Safe…

Read Full Article

Challenges with Health Plan Re-accreditation

As NCQA Health Plan re-accreditation quickly approaches for many health plans this year, in addition to ensuring certain areas are accreditation ready, the quality and clinical teams at your health…

Read Full Article

CMS 2019 Final Rule and the Scope of the 340B Program

In its final rule for 2018, the Centers for Medicare and Medicaid Services (CMS) reduced Medicare Part B reimbursement for 340B-acquired drugs from Average Sales Price (ASP) plus 6% to…

Read Full Article

Refining Cost Sharing: Barriers to Outcome-Based Agreements in the U.S.

WHAT ARE OUTCOMES-BASED AGREEMENTS (OBA)? Currently, market forces, including volume, competition, and Research & Development expenditures, determine the prices for pharmaceutical therapies in the U.S. market. However, as prices for…

Read Full Article

Switch Operator – Current Role and Potential Impacts

Co-written by Catherine Trentini, Senior Consultant, Pricing, Contracting & Market Access As the healthcare industry is in a state of rapid change, the pharmaceutical supply chain and how consumers receive…

Read Full Article

Can Congress Delay the Safe Harbor Proposed Rule?

July 2019 Update As first reported by The Wall Street Journal and Axios on July 11, 2019, the Trump Administration has decided to abandon implementation of the proposed Discount Safe…

Read Full Article

Medicare Part D Bids and Discount Safe Harbor Timeline

For those whose only association with Medicare comes from being a participant in a health insurance plan, chances are individuals are not aware of the extensive path each plan takes…

Read Full Article

CMS message at HIMSS: Overhauling “meaningful use”, ensuring interoperability, and patient-ownership of data

Co-authored by Chris McShanag, VP Healthcare Provider Solutions Last week in Las Vegas, Nevada, senior representatives from the Trump Administration and the Centers for Medicare and Medicaid Services (CMS) spoke at…

Read Full Article