Heating Up the Debate: The Latest on Medicare Advantage Plans from Washington, D.C.
Greetings from Washington, While temperatures are dropping here in D.C., the Administration and some members of Congress are doing their best to heat it right back up by putting Medicare Advantage (MA) plans on blast. However, the Medicare Payment Advisory Commission (MedPAC) must’ve thought those changes weren’t enough as they thoroughly fanned the flames during […]
MedPAC Payment Basics – Our Christmas in October
It’s Christmas in October! For policy geeks like us, the release of the Medicare Payment Advisory Commission’s (MedPAC) payment basics are like a gift that keeps on giving. Not familiar with these beauties? Well, read on, my friend. MedPAC’s payment basics are a Medicare 101 for every payment system within Medicare. They cover all players in the […]
What Happened, What You Missed: October 2-6, 2023
Makers of 10 Drugs Agree to Participate in Medicare Price Negotiations The manufacturers of all 10 drugs selected for Medicare drug price negotiations have agreed to participate in the program, according to a White House announcement. The announcement comes as several drugmakers have filed lawsuits against the Biden administration to stop the drug price negotiation program, including […]
What Happened, What You Missed: May 1-5, 2023
Study: 340B Suppresses Uptake of Biosimilars Hospitals that participate in the 340B Drug Pricing Program see lower adoption of biosimilar drugs, according to a new study from Health Affairs. Roughly a third of the nation’s hospitals participate in the 340B program, which requires manufacturers to provide discounts on most drugs administered in the outpatient setting […]
The Calculations Change – But the Insolvency Dilemma for Medicare and Social Security Remains the Same
The 2023 Medicare Trustees Report showed a positive trend for the Hospital trust fund (Part A) but the Social Security Trustees noted a worsening trend for in their report. For Social Security, insolvency is coming 1 year earlier than last year (in CY 2032, rather than CY 2033), due to inflation, lowering of the GDP, and labor productivity. For Medicare, […]
What Happened, What You Missed: April 3-7, 2023
Final Rule Prohibits Deceptive Marketing of MA Plans Medicare Advantage (MA) plans and Medicare prescription drug plans will face tougher requirements on marketing plans, according to a rule finalized by the Centers for Medicare and Medicaid Services (CMS) on Wednesday. The final rule is part of an overarching effort by the administration to crack down on deceptive […]
Fixing Medicare’s Insolvency Requires Both the Administration and Congress – So Where Are They?
The 2022 Medicare Trustees Report was full of grim news – namely, that the Hospital Insurance (HI) Trust Fund is projected to hit insolvency by 2028. Given the serious implications insolvency could have on access to care, stakeholders have been begging Congress and the administration to do something. However, Washington has avoided serious attempts to address the HI Trust Fund’s insolvency for years, […]
The Medicare Trustees Report Is Still Bad News
The Medicare Hospital Insurance (HI) Trust Fund will become insolvent in 2028, according to the latest report by the Medicare Board of Trustees in June 2022. Last year’s report projected the HI Trust Fund’s insolvency date to 2026, which means the fund now has just two additional years of breathing room. In brief, the HI Trust Fund funds […]
Is the Future Now for a Lower Medicare Eligibility Age?
Some birthdays are more special than others. Turning 16 means a drivers license is within reach and turning 18 grants the ability to cast a ballot. For many Americans, turning 65 means they are finally eligible for Medicare coverage. However, this milestone for turning 65 could soon change, as top Democrats weigh the possibility of […]
Despite Reintroduction, Medicare for All, Medicare-X Proposals Face Limited Odds
With control of the White House and both chambers of Congress, Democrats are newly emboldened to expand access to health care coverage. A group of progressives in the House are making another attempt at Medicare for All, while moderates in the House and Senate want to expand coverage via a public option. However, lack of […]