Specialty Pharma Journal Specialty, Precision & Technology
Today, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that includes a number of changes that, if finalized, will ensure that Part D Medicare enrollees have access to more affordable prescription drugs and more robust prescription drug coverage at the pharmacy they prefer. The rule also …
Tag Archives: Medicare
November, 2017
September, 2017
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20 September
Anthem, Inc. to Acquire HealthSun
INDIANAPOLIS–(BUSINESS WIRE)–Anthem, Inc. (NYSE:ANTM) today announced that the company has entered into an agreement to acquire HealthSun, one of the fastest-growing integrated Medicare Advantage health plans and healthcare delivery networks in Florida. “Anthem is committed to identifying opportunities for growth that will enable us to advance our goal of increasing …
November, 2016
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4 November
Both Providers and Patients Drive Health Care Spending, Study Finds
In Miami, health care providers spent about $14,423 per Medicare patient in 2010. But in Minneapolis, average spending on Medicare enrollees that year was $7,819, just over half as much. In fact, the U.S. is filled with regional disparities in medical spending. Why is this? One explanation focuses on providers: …
May, 2016
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9 May
Changes Needed to Increase Access to Colorectal Cancer Screening
PHILADELPHIA –– Colorectal cancer is the second highest cause of cancer death in the United States, expected to claim the lives of an estimated 49,190 people in 2016. The Affordable Care Act (ACA) aimed to increase access to CRC screening by not holding patients responsible for all costs of the …
July, 2015
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8 July
Aetna to Buy Rival Humana for $37 Billion
HARTFORD, Conn. & LOUISVILLE, Ky.–(BUSINESS WIRE)–Aetna (NYSE: AET) and Humana Inc. (NYSE: HUM) today announced that they have entered into a definitive agreement under which Aetna will acquire all outstanding shares of Humana for a combination of cash and stock valued at $37 billion or approximately $230 per Humana share …
June, 2015
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1 June
CMS Shares Medicare Data on Hospital and Physician Utilization
The Centers for Medicare & Medicaid Services (CMS) announced today that it is posting new Medicare data to increase transparency on hospital and physician utilization. The Administration said that it is posting its third annual release of the Medicare hospital utilization and payment data, as well as the second annual …
April, 2015
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22 April
Even After the Introduction of Biosimilars in the US, RA Patients May Still Face High Cost Burden
An investigation of Medicare coverage of biologic disease modifying drugs (DMARDs) found that starting these drugs can cost Medicare patients more than $2,700 in co-payments a year, and patients may continue to face a high cost burden even with the introduction of biosimilars. Results from a new study, published in …
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7 April
CMS Guidance on Biosimilar Reimbursement is One of Many Expected in 2015
By Kathleen P. Wolff, MBA On Mar. 30, 2015, the Centers for Medicare & Medicaid Services (CMS) issued important new guidance on biosimilar reimbursement. Not only was the guidance itself noteworthy, it comes less than a month from the decision to approve the first biosimilar in the U.S. and is …
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6 April
HIV-Infected Veterans Have Higher Rates of Medicare/Medicaid Enrollment
A substantial proportion of veterans are dually enrolled in the Veterans Affairs (VA) healthcare system as well as Medicare and/or Medicaid, which leads to care received inside and outside of the VA. However, the use of non-VA healthcare among this population can lead to fragmented, inefficient, and lower quality of …
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2 April
CMS Issues Guidance on Biosimilar Reimbursement and Formulary Policies
The Centers for Medicare & Medicaid Services (CMS) issued documents with guidance on reimbursement and formulary policies for biosimilars. The company issued documents on reimbursement of biosimilars that will remove the benefit from physicians to prescribe higher cost, branded innovator products over biosimilars. Typically, Part B physician-administered drugs are reimbursed …