DOJ Lambasts Chamber Of Commerce For Blocking Drug Price Negotiation
The Chamber of Commerce’s request for an injunction to block the Medicare drug price negotiation program has angered the DOJ, The Hill reports, arguing the organization has no standing to file the suit and pausing negotiation would harm the public. Also: a focus on how PBMs keep drug prices up.
The Hill:
DOJ Blasts Industry Attempt To Delay Medicare Drug Price Negotiations
The Department of Justice (DOJ) lambasted the Chamber of Commerce’s request for an injunction to block the Medicare drug price negotiation program, arguing in court filings that the organization had no standing to file the lawsuit and that pausing the program would harm the public. The rebuttal comes weeks before the federal government is expected to name the first 10 drugs chosen for price negotiation. (Choi, 8/14)
Axios:
Pharmacy Benefit Managers (PBMs) Start To Take Blame In High Drug Prices
The pharmaceutical industry has taken most of the heat in Congress and the public's mind for high drug prices. But increasingly, scrutiny is shifting to a different part of the supply chain: pharmacy benefit managers. PBMs may not resonate with the average person the way big drugmakers like Pfizer do, but they play an important role in determining how much people wind up paying for medicines. (Sullivan, 8/14)
In other Medicare and Medicaid news —
Axios:
Hospitals Push Back On Safety-Net Payment Cuts
Hospitals are scrambling to halt a nearly $1 billion cut the Biden administration made to their Medicare payments for treating low-income and uninsured patients. Why it matters: The reduction to fiscal year 2024 payments announced earlier this month was far larger than what Medicare had originally proposed, catching hospitals by surprise. And though Medicare already finalized the cuts, hospitals say the agency must reconsider its decision to avoid jeopardizing care for disadvantaged patients. (Goldman, 8/15)
Modern Healthcare:
CMS Unveils ACO REACH Makeover
The Centers for Medicare and Medicaid Services debuted a slate of changes to ACO REACH on Monday that are designed to boost participation in the value-based care program. The agency's Center for Medicare and Medicaid Innovation elevated financial reserve requirements and reduced enrollment minimums under the Accountable Care Organization Realizing Equity, Accountability and Community Health, or ACO REACH, program, the office announced via its website. (Tepper, 8/14)
Medical Economics:
CMS Creating Residencies To Focus On Primary Care, But They Have Not Expanded To Rural Areas
A federal plan to expand physician training in rural areas is geared toward primary care, but that training has not yet expanded according to Medicare plans. Congress approved money and a mandate for the U.S. Centers for Medicare and Medicaid Services (CMS) to create 1,000 new residency slots for physician training in rural and underserved areas. That happens in hopes of physicians staying to practice where they learn, said the research letter in JAMA. (Payerchin, 8/14)
Axios:
How Medicaid Disenrollments Could Squeeze Some Insurers
Big Medicaid-managed care plans that serve the majority of the program's beneficiaries are seeing membership slip as more states redetermine program eligibility — a trend that could eat into some of the insurers' bottom lines, according to Georgetown University's Center for Children and Families. If the remaining Medicaid enrollees as a group are sicker overall, plans may have to eat some of the higher cost of care unless states adjust their payment rates upward. (Bettelheim, 8/14)
