On April 5, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a Final Rule,
titled “Medicare Program; Contract Year 2024 Policy and Technical Changes to the Medicare
Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan
Program, and Programs of All-Inclusive Care for the Elderly” (Final Rule).
Substance Abuse and Mental Health Services Administration (SAMHSA) within
the Department of Health and Human Services (“HHS”) issued a final rule on
Medications for the Treatment of Opioid Use Disorder (Final Rule), to be published
on Feb. 2, 2024.
Health care expert Fred Goldstein sits down with Melissa Andel, principal and founder of CommonHealth Solutions, to discuss the long-awaited launch of Humira biosimilars and what Amgen’s pricing strategy means for patients and payers.
On March 15, the Centers for Medicare & Medicaid Services (CMS) released initial guidance
for key elements of the new Medicare Drug Price Negotiation Program. This guidance
describes how CMS intends to implement the Negotiation Program for initial price applicability
year 2026 (Jan. 1, 2026 to Dec. 31, 2026), the first year the negotiated prices will apply.
Under the Medicare Drug Rebate provisions of the Inflation Reduction Act (IRA), beneficiary
coinsurance will be 20% of the inflation-adjusted payment amount for certain Part B drugs and
biologicals with prices that have increased faster than the rate of inflation.