Late Monday, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2025 Rate Announcement for Medicare Advantage and the Medicare Prescription Drug Program (Part D) as well as the CY25 Part D Redesign Program Instructions. I was about to get on an airplane and instead of watching a movie, I figured what sounds like a…
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…
Patients driving change. I love this story because it involves Carl Schmid, patient groups and copay accumulators. Copay accumulators are when insurance does not allow pharmaceutical manufacturer contributions to count towards patient out-of-pocket spending calculations. Thanks to the HIV+Hepatitis Policy Institute, the Diabetes Leadership Council and the Diabetes Patient Advocacy Coalition and their suit against…
Yesterday the Centers for Medicare & Medicaid Services (CMS) released the list of drugs that they have selected as part of the initial year of Medicare drug price negotiation under the Inflation Reduction Act (IRA). These drugs will be negotiated over the next year with implementation of the prices to begin in 2026. And there…