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Medicare Advantage Prior Authorization and Step Therapy for Part B Drugs

Today, the Centers for Medicare & Medicaid Services (CMS) introduced much-needed competition and negotiation into the market for physician-administered and other Part B medications that will result in better deals and lower drug costs for patients. As part of the agency’s ongoing activities to deliver on President Trump’s promises outlined in his American Patients First Blueprint, CMS will provide Medicare Advantage plans the option of applying step therapy for physician-administered and other Part B drugs in a way that lowers costs and improves the quality of care for Medicare beneficiaries.
Fact sheet

CMS empowers patients with more choices and takes action to lower drug prices

Agency is providing flexibility through private sector tools to negotiate lower prescription drug prices on behalf of beneficiaries.
Press release

SPEECH: Remarks by Administrator Seema Verma at the ONC Interoperability Forum in Washington, DC

(As prepared for delivery – August 6, 2018)
Press release

CMS Finalizes Changes to Empower Patients and Reduce Administrative Burden

Changes in the Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System final rule will advance price transparency and electronic health records.
Press release

Short-Term, Limited-Duration Insurance Final Rule

The Secretaries of the Treasury, Labor, and Health and Human Services published a proposed rule to consider allowing short-term, limited-duration insurance to cover longer periods.
Fact sheet

HHS News Release: Trump Administration Delivers on Promise of More Affordable Health Insurance Options

HHS final rule on short-term, limited-duration insurance brings more flexibility and choices to consumers.
Press release

Medicare Part D premiums continue to decline in 2019

Today, the Centers for Medicare & Medicaid Services (CMS) announced that, for the second year in a row, the average basic premium for a Medicare Part D prescription drug plan in 2019 is projected to decline.
Press release

Speech: Medicare Remarks by CMS Administrator Seema Verma at the Commonwealth Club of California

I’d like to talk to you about things on which we all agree, like the future of our healthcare system, and Medicare. And if we have time we can touch quickly on world peace before we all leave.
Press release

CMS Empowers Patients and Ensures Site-Neutral Payment in Proposed Rule

Outpatient Prospective Payment System (OPPS) & Ambulatory Surgical Center (ASC) proposed rule advances CMS commitment to increasing transparency and lowering drug prices.
Press release

CMS Adopts the Methodology for the Permanent Risk Adjustment Program under the Patient Protection and Affordable Care Act for the 2017 Benefit Year

Final rule addresses the collection of risk adjustment charges and making of payments for the 2017 benefit year.
Press release