As directed by President Trump’s Executive Order on Improving Price and Quality Transparency in American Healthcare, today the Department of Health and Human Services is announcing that the Centers for Medicare & Medicaid Services (CMS) is issuing two rules that take historic steps to increase price transparency to empower patients and increase competition among all hospitals, group health plans and health insurance issuers in the individual and group markets.
Coverage Leadership Legislation Quality
On May 28, 2019, the Centers for Medicare & Medicaid Services (CMS) is finalizing a rule to update and modernize the PACE program.
Delay in Final Chimeric Antigen Receptor (CAR) T-cell therapy National Coverage Determination
From a CMS spokesperson:
Today, the Trump Administration finalized improvements to Medicare Advantage and Medicare Part D, which provide seniors with medical and prescription drug coverage through competing private insurance plans.
The Centers for Medicare & Medicaid Services (CMS) issued a final rule on May 16, 2019 that modernizes and improves the Medicare Advantage and Part D programs. These changes will ensure that patients have greater transparency into the cost of prescription drugs in Part D and will also enable Medicare Advantage plans to negotiate better prices for physician-administered medicines in Part C.
Agency issues guidance for Medicaid Managed Care and CHIP health plans that clarifies how current regulations require “spread pricing” to be accounted in the calculation of Medical Loss Ratios (MLRs)
Remarks by Administrator Seema Verma at the National Rural Health Association Annual Conference (As prepared for delivery – May 8, 2019)