Crab cakes and … horse racing. That’s what Maryland does. Mine will come with a side of Smith Island cake which I’m making tomorrow morning. Wish me luck. Odds aren’t stacked. The Centers for Medicare & Medicaid Services (CMS) announced that the Medicaid rule won’t contain the stacking provision. A little odd to pre-announce it,…
Back to back. Arnold Ventures put out the latest anti-pharma talking points (h/t Brian Reid) and here were two back to back – Here’s the problem, it really isn’t about the cost of drugs. I mean you could take that drug price and reduce it 98% and the 25% cost share would still be too…
LDT. Not a sandwich, not a drink but laboratory developed tests. On Monday, the Food and Drug Administration (FDA) put out the long anticipated final rule on LDTs. If you’re more of a prescription drug policy person, get used to following LDT policy. We’ve moved from tests that are nice but, even if you have…
What the math. Yesterday afternoon CMS released a technical memo on the changes to True Out-of-Pocket (TrOOP) Costs and the maximum monthly cap for the Medicare prescription payment plan (MP3.) Simply put, they put out a memo that shows the math for the smoothing program. I need to work through some of the examples because,…
Last week MedPAC, the Medicare advisory committee to Congress, had a really interesting session on generic drug pricing in the Medicare prescription drug program (Part D.) There is always so much focus on branded drugs that an opportunity to flip the script and learn about the 90% of prescription drug utilization in Part D (and…
Ruling It. Yesterday afternoon, the Centers for Medicare & Medicaid Services released the MA/Part D final rule. Personally, most of it was not up my alley but I did read over the changes to the changes to an approved formulary sections. In December 2022, CMS proposed allowing immediate substitution of interchangeable biosimilars or branded biologics…
It has been a week of odds and ends so if you’re catching up after ignoring your emails, you didn’t miss a ton. Honestly, it seems like a good time to be a DC law firm working on pharmaceutical issues. You have the usual Inflation Reduction Act submissions, comment letters (which, for what it is…
Happy International Women’s Day. Best display of International Women’s day I’ve ever seen was in Russia when I was studying abroad. They took it SERIOUSLY. Not just a LinkedIn Holiday. Cat-astrophe? No, just a political speech – not reality. President Biden talked about increasing the number of negotiated drugs up to 50 a year. Not…
A whirlwind of a week. I regrouped on Wednesday and got a run in and some pottery wheel time and then it all fell apart again (in a good way) on Thursday where I forgot to leave my desk for hours and hours. One of those “I love working” and forget time exists. So much…
It is a dumb bucket list thing but one day I will go experience the Groundhog Day festivities. Dream big, I know. Cell and Gene Update. This week the Centers for Medicare and Medicaid Innovation (CMMI) released the Cell and Gene Therapy (CGT) Access model which will initially focus on sickle cell disease. It is…