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CMS

ACA requirements relaxed by CMS

WASHINGTON — The Trump administration has shifted more control over the Affordable Care Act marketplaces to the states and given consumers more leeway to avoid participation this year. A new final rule issued recently by the Centers for Medicare and Medicaid Services (CMS) relaxes certain regulations regarding ACA health plans in order to drive competition

Rise in U.S. health care spending projected to accelerate

WASHINGTON — The pace of growth in U.S. health care spending is expected to quicken this year, increasing 5.4% over 2016, according to a report by the Centers for Medicare & Medicaid Services (CMS). Health care spending last year hit $3.4 trillion, an amount that represents a 4.8% increase from 2015, CMS said in a

Rise in U.S. health care spending outpaces economic growth

WASHINGTON — Health care spending in the United States grew 5.8% to $3.2 trillion during 2015, according to a new study by the Centers for Medicare & Medicaid ­Services (CMS). On a per capita basis, U.S. health care spending grew 5% to $9,990 per person. The overall increase exceeded the 5.5% rise projected by CMS

Trump chooses harsh critic of ACA to head HHS

Trump chooses harsh critic of ACA to head HHS

WASHINGTON — The choices of Tom Price and Seema Verma for top health positions under Donald Trump have reaffirmed the president-elect’s commitment to toppling the Affordable Care Act. Price, a six-term Republican congressman from Georgia and fierce critic of Obamacare, was picked as secretary of the Department of Health and Human Services (HHS), while Verma,

Health care spending tops $10,000 per person

WASHINGTON — A new study by personnel of the Centers for Medicare & Medicaid Services (CMS) projects that health care spending in the United States will exceed $10,000 per person this year. The report, published in the health policy journal Health Affairs, predicts that health care spending growth is accelerating after several years of unusually

Lawmakers urge CMS to act on DIR fees

Lawmakers urge CMS to act on DIR fees

ALEXANDRIA, Va. — Nearly 50 members of Congress have called on the Centers for Medicare & Medicaid Services (CMS) to finalize its proposed guidance on how Medicare Part D sponsors report pharmacy price concessions, also known as direct and indirect remuneration (DIR) fees. The National Community Pharmacists Association said that 16 senators and 30 representatives

NCPA leads call for more DIR fee transparency

NCPA leads call for more DIR fee transparency

ALEXANDRIA, Va. — The National Community Pharmacists Association has joined with a group of pharmacy industry stakeholders in calling for more clarity about direct and indirect (DIR) fees. NCPA said that this week it teamed up with 21 other organizations — including drug chains, drug suppliers, drug cooperatives and pharmacy associations, among others — in

CMS’ Medicaid managed care final rule addresses access

CMS’ Medicaid managed care final rule addresses access

ARLINGTON, Va. – The National Association of Chain Drug Stores hailed the Center for Medicare & Medicaid Services’ inclusion of network adequacy standards in the Medicaid and CHIP Managed Care final rule. NACDS said Wednesday that the final rule, released on April 21, would improve patient access to care in Medicaid and the Children’s Health

Final AMP-based FULs coming soon

Final AMP-based FULs coming soon

The National Association of Chain Drug Stores reports that final average manufacturer price (AMP)-based federal upper limits (FULs) are set to be published by the Centers for Medicare & Medicaid Services (CMS) late this month. Once instituted, the final AMP-based FULs will “significantly change” Medicaid pharmacy reimbursement for branded and generic drugs, according to NACDS.

NCPA gives heads-up on proposed Part D changes

NCPA gives heads-up on proposed Part D changes

The National Community Pharmacists Association has given a rundown of what it described as a “wide-ranging” 228-page call letter by the Centers for Medicare & Medicaid Services (CMS) concerning proposed revisions to Medicare Part D prescription drug plans in 2017. In a blog post this week, NCPA outlined some of the key changes that community

More work needed on preferred pharmacy access

More work needed on preferred pharmacy access

ALEXANDRIA, Va. — Though the Centers for Medicare & Medicaid Services (CMS) has improved Medicare Part D patient access to preferred pharmacies, more work needs to be done, according to the National Community Pharmacists Association. NCPA on Friday applauded a statement released by CMS that the agency’s efforts to boost access to preferred pharmacies across

Rx takes hard look at long-awaited Medicaid AMP rule

Rx takes hard look at long-awaited Medicaid AMP rule

ARLINGTON, Va. — The National Association of Chain Drug Stores was working with member companies at presstime to review the final rule on Medicaid prescription reimbursements. The Centers for Medicare & Medicaid Services (CMS) says the 658-page rule — which takes effect April 1 after a comment period — establishes a regulatory definition for average

AMP issue illustrates the pressure on Rx

AMP issue illustrates the pressure on Rx

After years of political and legal wrangling, the Centers for Medicare & Medicaid Services (CMS) has issued its final rule on Covered Outpatient Drugs, which governs reimbursement to retail pharmacies for generic medications dispensed under Medicaid. The history of the regulation goes all the way back to the Deficit Reduction Act of 2005 (DRA), which

Publix makes pitch for Part D customers

Publix makes pitch for Part D customers

With many seniors moving to new Medicare Part D coverage for next year, Publix Super Markets is urging them to switch their prescriptions to its pharmacies. An online video posted this week by the food and drug chain notes that Publix Pharmacy is a preferred pharmacy in a number of insurance plans, so Part D recipients could save more on