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Morning Briefing

Summaries of health policy coverage from major news organizations

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Monday, Jul 31 2023

Full Issue

List Of Initial Drugs For Medicare Price Negotiations Will Be Unveiled By Sept.

NPR explores a major question that could have ripple effects on both the affordability and availability of prescription drugs: What makes a drug price fair?

The Hill: Which Drugs Will Be Selected For Medicare Negotiations? Here’s What We Know 

The first 10 drugs selected for Medicare price negotiation will be announced by Sep. 1 and will set the stage for unprecedented government action regulating drug costs, with billions of dollars at stake and scores of patients standing to benefit. Once the initial batch of drugs chosen for negotiations are announced, the years-long negotiation process — currently being challenged in courts — will kick off. The manufacturers of the Medicare Part D-covered drugs picked by the Centers for Medicare and Medicaid Services (CMS) will have one month to send in their agreements saying they will engage in the negotiation process. (Choi, 7/28)

NPR: Medicare Drug Price Negotiations Raise The Question: What's A Fair Price?

Drugmakers around the globe are bracing for a major shakeup in how one of their largest customers does business. On Sept. 1, Medicare will target its first 10 drugs for historic price negotiations. The medications are sure to be among the country's costliest and will likely include common treatments for cancer and diabetes. (Walker and Gorenstein, 7/28)

Reuters: Focus: Drugmakers Go Under The Skin, Skirting Early US Medicare Price Negotiations 

Injectable versions of some widely-used cancer drugs including Johnson & Johnson's blockbuster multiple myeloma treatment Darzalex are likely to be excluded from new U.S. government price negotiations for years, drugmakers told Reuters, protecting billions in revenue. (Erman, 7/28)

Barrons: Pharma Companies Want To Crush Medicare's Ability To Negotiate Costs

The pharmaceutical industry is launching a major legal assault against a new law that will allow Medicare to pay less for some high-price drugs, in an all-out effort to kill the program. (Nathan-Kazis, 7/28)

More Medicare developments —

Modern Healthcare: CMS Hospice Payment Final Rule Boosts Medicare Fees For 2024

Hospice providers will receive a 3.1% Medicare payment increase next fiscal year under a final rule the Centers for Medicare and Medicaid Services issued Friday. That's higher than the 2.8% reimbursement increase CMS proposed in a draft regulation published in March. The final rate for fiscal 2024 is the product of a 3.3% market basket increase adjusted for productivity. Beginning next year, hospice providers that fail to meet quality reporting requirements will be subject to a four-percentage-point penalty. The final rule raises the aggregate amount hospices can be paid per patient per year by 3.1% to $33,491. (Eastabrook, 7/28)

Modern Healthcare: Centene CEO Sarah London: Medicare Advantage Star Ratings May Drop

Centene’s standing in the Medicare Advantage market may further deteriorate as the company anticipates losing its sole four-star quality rating, CEO Sarah London told investors Friday. The insurer reported the greatest drop in star ratings among Medicare Advantage carriers last year after the Centers for Medicare and Medicaid resumed stringent reviews it had paused during the COVID-19 public health emergency. Insurers strive to achieve at least four out of five stars in order to qualify for the biggest bonuses, which they use to offer supplemental benefits and zero-premium plans. (Tepper, 7/28)

Fierce Healthcare: Medicare Patients More Likely To Get Cancer Screenings: Study

Researchers found that once joining Medicare, patients are 50% more likely to get health screenings for breast cancer and colorectal cancer. Patients with other undiagnosed diseases, such as depression, COPD, type 2 diabetes, lung or prostate cancer, hypertension and hyperlipidemia, are also more likely to discover their condition in their first year of being on Medicare coverage. (Tong, 7/28)

KFF Health News: Sen. Sanders Says Millions Of People Can’t Find A Doctor. He’s Mostly Right

Sen. Bernie Sanders (I-Vt.) has long been a champion of a government-sponsored “Medicare for All” health program to solve long-standing problems in the United States, where we pay much more for health care than people in other countries but are often sicker and have a shorter average life expectancy. Still, he realizes his passion project has little chance in today’s political environment. “We are far from a majority in the Senate. We have no Republican support … and I’m not sure that I could get half of the Democrats on that bill,” Sanders said in recent remarks to community health advocates. (Andrews, 7/31)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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