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The specialty tier in Part D plans is for drugs that cost at least $670 per month & beneficiaries typically face the highest out-of-pocket costs for drugs on this tier. Adding a new specialty tier with a lower cost-sharing requirement could provide cost relief for some people.
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NEW from CMS: a proposal to allow Medicare Part D plans to have *2* specialty tiers. Right now plans have one specialty tier, with cost sharing ranging from 25%-33%. The proposal would allow for a new "preferred" specialty tier with lower cost sharing. https://s3.amazonaws.com/public-inspection.federalregister.gov/2020-02085.pdf …
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Juliette Cubanski proslijedio/la je Tweet
Our newest brief digs into CMS guidance inviting states to apply for
#Medicaid waivers that would cap federal financing & authorize adult coverage without many existing standards about eligibility, benefits, delivery systems, & oversight.https://www.kff.org/medicaid/issue-brief/implications-of-cmss-new-healthy-adult-opportunity-demonstrations-for-medicaid/ …Hvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
Juliette Cubanski proslijedio/la je Tweet
Today's congressional hearing on women's
#globalhealth was very informative! Great to learn more about work of@CARE,@WorldVisionUSA,@cehurduganda. Written testimony of@jenkatesdc on USG role in this area, inc. $ and challenges, is on@KFF site
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Unless stellar economic growth boosts payroll tax levels in such a way as to push the Medicare Part A trust fund insolvency date out for several years, whoever occupies the White House for the next four years is probably going to have to confront this issue (along with Congress).https://twitter.com/tricia_neuman/status/1225071888382287873 …
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And obviously there's other stuff going on in DC that people may be hearing more about than the House-passed legislation to lower drug costs.
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Of course, passing a bill through one chamber of Congress is not the same as actually lowering drug costs. Until people see their drug costs go down, perhaps they can be forgiven for not really taking notice of the legislative machinery at work that could help make that happen.
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According to the new
@KFF tracking poll, most people say that lowering drug costs is important for Congress to work on. At the same time, very few know that the House of Representatives passed a bill to lower drug costs in December 2019. https://www.kff.org/health-reform/poll-finding/kff-health-tracking-poll-january-2020/ …pic.twitter.com/nOh12oCQ2F
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Private plans were supposed to be a way of controlling costs, based on the idea that plan competition could drive down the cost of providing Medicare benefits. In reality, it’s more complicated than that, but based on the numbers from CBO, it’s not what sounds like is happening.
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CBO has revised upward its projections of Medicare spending in the coming decade, due in part to higher-than-expected spending on Medicare Advantage in 2019/2020, driven in part by higher payment rates to plans and coding intensity for MA enrollees. https://www.cbo.gov/publication/56020 …
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Juliette Cubanski proslijedio/la je Tweet
8.30 million people have signed up for ACA coverage through the federal marketplace for 2020, down just a bit from 8.45 million last year. The ACA is stable and resilient, not failing. However, it also has limited potential to grow without strengthening. https://www.cms.gov/newsroom/fact-sheets/federal-health-insurance-exchange-weekly-enrollment-snapshot-week-7 …pic.twitter.com/fpSHHGEUZf
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Nice rundown of what did and (mostly) didn't result from the legislative and regulatory push to lower drug prices in 2019. The article ends on a surprisingly hopeful tone for action in 2020, though - but it's unclear if election-year politics will help or hurt this policy agenda.https://twitter.com/statnews/status/1208065579841675264 …
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The FDA's impact analysis also suggests the potential interplay between the importation proposal and the pending international reference price proposal, with the potential for the latter to reduce the potential impact of the former. https://twitter.com/RESachs/status/1207376314824642560 …pic.twitter.com/1HTfzP79F7
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Anxiety & frustration abound about high insulin prices in the US, which are higher than in other countries. In theory, drug importation could mean savings for some insulin users, but insulin isn't allowed to be imported. (HR3 would include insulin in price negotiations, however.)
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Like allowing Medicare to negotiate prices, drug importation has been discussed for years & both ideas have advanced further in recent months. But there is much uncertainty about potential savings from importation. Notably, there are no cost/benefit
#s in today's proposed rule.pic.twitter.com/56u1ct7AOO
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Juliette Cubanski proslijedio/la je Tweet
Having reviewed HHS' drug importation proposal, it may have a hard time satisfying the statutory (21 U.S.C. 384) requirements to authorize such importation. Here's why. (1/7) https://www.hhs.gov/sites/default/files/nprm-importation-of-prescription-drugs_12-18-2019.pdf …
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Juliette Cubanski proslijedio/la je Tweet
NEW: KFF analysis on
#HIV Drug Price Increases: https://www.kff.org/hivaids/issue-brief/quick-look-antiretroviral-price-increases-in-medicare-part-d/ … with@LindseyH_Dawson@jcubanski We looked at antiretroviral (ARV) drug price increases in#Medicare Part D. ARVs are the mainstay of HIV treatment and, increasingly, prevention.Prikaži ovu nitHvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
None of these bills seems destined to land on the President’s desk, but it feels like progress that these proposals have advanced even this far in the policymaking process. Yet without changes being implemented, patients aren’t likely to see much relief from rising drug costs.
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Importantly, all three proposals include a cap on out of pocket drug spending for Part D enrollees and would allow enrollees to spread out their drug costs over time. This is noteworthy common ground in otherwise highly contentious policymaking territory.
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The Senate Finance proposal is something of a middle ground between House Democrats and House Republicans in terms of savings provisions, with drug price inflation limits but no Medicare drug price negotiation.pic.twitter.com/7Z8GeDGOFe
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