Lower Medicare Drug Costs Could Pose Serious Challenge To Providers
But Modern Healthcare points out the new Trump administration rule seeking to benefit patients will likely be challenged in the courts.
Trump Drug Plan Would Make Providers Responsible For Negotiating Discounts
The Trump administration's plan to tie Medicare payment for outpatient drugs to prices charged in foreign countries depends on providers negotiating drugmakers' prices down to meet reduced reimbursement levels. While the administration pitches the Center for Medicare and Medicaid Innovation demonstration as an effort to lower drug prices, it's unclear whether or by how much drugmakers would actually lower the prices they charge healthcare providers. If they don't, providers have to choose whether to offer the drugs at a financial loss. (Cohrs, 11/25)
CMS Releases Proposed Regulations For 2022 ACA Insurance Exchange Issuers, Including Lower User Fees
The Trump administration proposed lowering the user fee for Affordable Care Act insurers from 3% to 2.25% of the premium for the 2022 coverage year. The Centers for Medicare & Medicaid Services released late Wednesday the proposed Notice of Benefit Payment Parameters for the 2022 coverage year. The rule also proposes enabling states to partner with the private sector to create a website that competes with the state-run exchange website or HealthCare.gov. (King, 11/25)
Little Change In Regional Medicare Spending Differences, Despite Attention
Just over a decade ago, celebrated surgeon and writer Dr. Atul Gawande penned a New Yorker article that called out certain areas of the country for their high Medicare spending. But despite the public lashing some regions endured, the most recent data from the Dartmouth Atlas show little has changed since then with respect to the communities atop the Medicare spending tower and those at the bottom. Miami was highest among hospital referral regions in the latest price-adjusted data, from 2017, followed by two smaller cities that were also near the top in 2010: Munster, Ind., and Monroe, La. Grand Junction, Colo., Anchorage, Alaska, and Honolulu had among the lowest spending in both years. (Bannow, 11/28)