AMCP Regulatory NewsBreaks
Regulatory NewsBREAK

CMS, EBSA, and IRS Releases Final Rule on Requirements Related to the Mental Health Parity and Addiction Equity Act

On Sept. 13, 2024, the Internal Revenue Service (IRS), Employee Benefits Security Administration (EBSA), and Centers for Medicare & Medicaid Services (CMS) (collectively, the Departments) released a Final Rule on Requirements Related to the Mental Health Parity and Addiction Equity Act (Final Rule). The Final Rule will be published in the Federal Register on Sept. 23, 2024. Access the Regulatory NewsBREAK to learn more.
Legislation & Regulation
Capitol Hill, U.S. Capitol, IRA Workshop
Letters, Statements & Analysis

AMCP Comments on the 2025 Medicare Physician Fee Schedule

On September 9, AMCP submitted comments praising CMS’s proposal to cover Digital Mental Health Treatment devices (DMHTs) under Medicare Part B. AMCP urges CMS to use its authority to cover all FDA-cleared, prescription only digital health products and develop appropriate coding and payment methodologies to promote adoption of these innovative technologies.
Medicare
Health Care Innovation: AMCP’s CEO Looks at the Complex Landscape Around Prescription Drug Costs
AMCP In The News https://www.hcinnovationgroup.com/

AMCP’s CEO Looks at the Complex Landscape Around Prescription Drug Costs

AMCP CEO Susan Cantrell stresses how collaboration is key in addressing challenges such as high drug prices and healthcare disparities. While there’s no silver bullet, solutions such as tailored population benefit design and value-based contracting can play an important role in making a difference for ordinary Americans looking for affordable access to prescriptions.
Formulary & Utilization Management, Drug Pricing, Legislation & Regulation
JMCP Bloomberg Article: Drugmakers, Medicare Conclude Talks to Slash Spiraling Costs
AMCP In The News Bloomberg Law

Drugmakers, Medicare Conclude Talks to Slash Spiraling Costs

Hernandez co-authored a June study in the Journal of Managed Care & Specialty Pharmacy (JMCP) on price benchmarks for selected drugs and their therapeutic alternatives, which concluded different negotiation scenarios for the first 10 drugs. If a drug has a therapeutic alternative, that likely guided the initial price offer from the CMS.
Legislation & Regulation, Inflation Reduction Act (IRA)
JMCP Mention: Negotiated Drug Prices Will Help Medicare Beneficiaries; Unclear If And By How Much Government Saves And Industry Loses
AMCP In The News Forbes.com

Negotiated Drug Prices Will Help Medicare Beneficiaries; Unclear If And By How Much Government Saves And Industry Loses

Because most prescription drugs selected for negotiation are highly rebated and discounted—prior to the federal government negotiations—comparisons of MFPs with list prices are somewhat misleading. Many of the ten drugs chosen already had significant rebates, in some cases as high as 68% off of the wholesale acquisition cost.
Legislation & Regulation, Inflation Reduction Act (IRA)