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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

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 proposes Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System changes for 2019 (CMS-1695-P)

On July 25, 2018, CMS proposed changes that would encourage site-neutral payment between sites of services and make healthcare prices more transparent for patients so that they can be more informed about out-of-pocket costs.
Fact sheet

The Medicare Advantage Qualifying Payment Arrangement Incentive Demonstration

CMS is announcing the Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) Demonstration. The MAQI Demonstration will be tested under the authority of Section 402 of the Social Security Amendments of 1967 (as amended).
Fact sheet

CMS Announces Agency’s First Blue Button 2.0 Developer Conference

Today, the Centers for Medicare & Medicaid Services (CMS) announced it is hosting the first-ever Blue Button® 2.0 Developer Conference. This event is being held in Washington, D.C. at the General Services Administration national headquarters on Monday, August 13, 2018.
Press release

Medicare Trustees Report shows lower spending projections for Medicare Part D

Today, the Medicare Board of Trustees released their annual report for Medicare’s two separate trust funds -- the Hospital Insurance (HI) Trust Fund and the Supplementary Medical Insurance (SMI) Trust Fund.
Press release

Speech: Remarks by CMS Administrator Seema Verma at the Pharmacy Quality Alliance Annual Meeting

Good afternoon, it’s a pleasure to be with you today. Pharmacists are on the front lines of patient care and have keen insight to the issues that patients face. We appreciate your hard work, and we look forward to working with you on a goal that I’m sure we share – ensuring that all patients can access their medications at an affordable price.
Fact sheet

CMS Unveils Enhanced “Drug Dashboards” to Increase Transparency on Drug Prices

Today, the Centers for Medicare & Medicaid Services released a redesigned version of the Drug Spending Dashboards. For the first time, the dashboards include year-over-year information on drug pricing and highlight which manufactures have been increasing their prices.
Press release

Drug Spending Information Products Fact Sheet

Today, the Centers for Medicare & Medicaid Services announced the release of updated information products that provide greater transparency on drug spending in the Medicare and Medicaid programs.
Fact sheet