Medicare Director Tries To Clarify Drug Pricing Policy, Penalties
Center for Medicare Director Meena Seshamani said Thursday the law will penalize drugmakers if they raise prices on medicines for patients who have private insurance, Stat reported.
Stat:
Drugmakers Will Be Penalized For Price Hikes On Privately Insured Patients
Democrats’ drug pricing law will still penalize drugmakers if they hike prices on medicines for patients who have private insurance, a top Medicare official said Thursday.
The penalties may factor into drugmakers’ decisions about how to price their medicines as the new law begins to take effect. Some experts and employers have been concerned that the drug pricing policy reforms that will save money in Medicare could incentivize drugmakers to try to charge more to patients with other forms of insurance coverage. (Cohrs, 10/6)
In related news —
Stat:
Medicare Tasks A Senior Adviser With Staffing Its New Drug Pricing Division
Medicare has tasked a senior adviser at the agency with assembling a small army of bureaucrats to get its new drug price negotiation program up and running. There are no job listings up on the federal government’s hiring website yet, but Medicare officials are already getting started with recruiting candidates. An organizational chart first obtained by STAT shows that the agency is aiming to hire 95 full-time employees. (Cohrs, 10/6)
In other Medicare news —
Modern Healthcare:
UnitedHealth, CVS, Centene To Lose Medicare Star Bonuses For 2023
Just half of Medicare Advantage plans with prescription drug coverage received ratings that will earn them bonuses for the 2023 plan year, down from nearly 70% in the current year, the Centers for Medicare and Medicaid Services revealed Thursday. (Tepper, 10/6)
Reuters:
CVS Health Expects Lower Medicare Performance Rating To Impact 2024
CVS Health Inc (CVS.N) said its largest health insurance plan for Medicare recipients received a lower performance rating from the Federal government program, sending shares of the company down around 5% in extended trade. In a regulatory filing late on Thursday, CVS said the newly-released Star Ratings for Medicare Advantage plans in 2023 lowered the rating for the company's Aetna National PPO plan to 3.5 stars from 4.5. (10/6)
MarketWatch:
Sticking With Your Medicare Plan This Open Enrollment Season? You Could Pay A Hefty Price.
Even Medicare beneficiaries happy with their plans should take the opportunity this open enrollment season to comparison shop — and review their current coverage. Medicare’s annual open enrollment period begins on Oct. 15 and ends on Dec. 7. This is the time when beneficiaries can switch their insurance plan, or at least review other options available. They may also switch to Medicare Advantage during this period (they can’t make changes to current Medicare Advantage plans — that is a separate enrollment period at the beginning of each year). (Malito, 10/7)
Health Affairs:
The New Medicare Part D Out-Of-Pocket Cap Will Have Unintended Consequences. Here’s How To Address Them
Signed into law in August 2022, the Inflation Reduction Act capped yearly out-of-pocket costs for Medicare Part D beneficiaries at $2,000. When the cap takes effect in 2025, it will be a significant benefit to an estimated 1.4 million beneficiaries per year who have annual Medicare Part D out-of-pocket costs exceeding the $2,000 threshold. But the policy may have unintended consequences that should be considered. (Socal, Crane, Ballreich and Anderson, 10/6)
The Motley Fool:
Social Security And Medicare Retirees Are About To Experience A Once-In-A-Lifetime Event
It has been well documented at this point that retirees are about to receive the largest increase to their Social Security benefits in about four decades. That's because inflation has been sky high this year and Social Security calculates an annual cost-of-living-adjustment (COLA). While the COLA increase is certainly a big deal, many retirees who claim Social Security are also enrolled in Medicare, the federal health insurance program for those that are 65 and older. Medicare enrollees are also expected to see some nice adjustments made for next year. (Berkowitz, 10/4)
KHN:
KHN’s ‘What The Health?’: Looking Ahead To The Lame-Duck Session
When the lame-duck Congress returns to Washington after Election Day, it will face a long list of health items needing attention before the end of the year, including setting overall spending for health programs and averting a series of Medicare payment cuts to health care providers. Meanwhile, in California, Democratic Gov. Gavin Newsom has signed a first-in-the-nation bill aimed at curbing covid-19 misinformation and disinformation by doctors. (10/6)
