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May 24

2019

Key House Committee Leadership Introduces Draft Medicare Part D Bill Capping Seniors’ Out-of-Pocket Costs

Ways and Means and Energy and Commerce leadership bill aimed at reducing the Medicare Part D reinsurance subsidies and eliminate beneficiary out-of-pocket costs above the Medicare part D catastrophic  threshold.  

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May 24

2019

Senate Health Committee Leaders Release Bipartisan Discussion Draft Legislation to Reduce Health Care Costs

Senate health committee Chairman Lamar Alexander (R-Tenn.) and Ranking Member Patty Murray (D-Wash.) today released the Lower Health Care Costs Act of 2019—bipartisan discussion draft legislation to reduce health care costs. “There's one issue I hear a lot about from Tennesseans, and it is, ‘What are you going to do about the health care

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May 24

2019

Congress Wants to Stop Surprise Medical Bills. But they Have One Big Problem Left to Solve.

President Trump and Democrats want to fix an important health care problem, but lawmakers still have one very difficult question to figure out before they can move forward. Congress suddenly has a bunch of bills to stop surprise medical bills, which can leave even some insured people with tens of thousands of dollars in

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May 24

2019

Cancer & Blood Specialists of Louisville To Join the American Oncology Network, LLC

American Oncology Network, LLC (AON) is pleased to announce that Cancer & Blood Specialists of Louisville, a leading community oncology/hematology practice in Louisville, Kentucky will join AON on June 1, 2019. AON is an alliance of physicians and veteran healthcare leaders uniting to ensure the long-term success of community oncology.

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May 23

2019

More than Half of All OCM Providers Could Owe CMS Money if Required to Join in 2-Sided Risk Model

The Oncology Care Model (OCM), started in 2016, is a voluntary 5-year bundled-payment program developed by the Center for Medicare & Medicaid Innovation. The OCM encourages practices to improve care and lower costs through episode-based cost performance and quality measures. Currently, all OCM participants are enrolled in a 1-sided risk arrangement. Beginning in July

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May 23

2019

Governor Signs Revised Pharmacy Choice Bill

A second pharmacy choice bill was signed into law Tuesday, three weeks after Gov. Kevin Stitt vetoed the first one. House Bill 2632 prohibits restrictions on a patient's right to choose a pharmacy provider without paying a penalty and calls for an advisory committee to review complaints and administer fines.

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May 23

2019

A Drug with a Multi-Million Dollar Price Tag is Making a Mockery of Washington’s Efforts to Rein in Prices

Gilead Sciences, a California biopharmaceutical company, scored a major breakthrough in 2013 when the Food and Drug Administration approved Sovaldi, a pill that could cure hepatitis C when combined with another antiviral medication. And then Gilead delivered another breakthrough, albeit not a good one: It priced Sovaldi at $1,000 per pill, or $84,000 to

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May 23

2019

340B Rate Cuts: DC Court Enjoins and Remands CMS’ 2018 and 2019 Reductions for Hospital Outpatients

On May 6, 2019, a federal district court held that the Department of Health and Human Services’ (HHS) 2018 and 2019 rate reductions for 340B Program participants, including safety net hospitals and other providers, were unlawful.  Although the court found that the 340B rate cuts in both 2018 and 2019 were unlawful, it did

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May 23

2019

How Much U.S. Households with Employer Insurance Spend on Premiums and Out-of-Pocket Costs: A State-by-State Look

In the years since the Affordable Care Act (ACA) took effect, public debate over the cost and quality of insurance has focused primarily on health plans sold through the marketplaces established by the law. There has been less attention on the 158 million Americans who have employer-based coverage.

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May 22

2019

Which PBM Best Managed Drug Spending in 2018: CVS Health, Express Scripts, MedImpact, or Prime Therapeutics?

It’s time for our annual Drug Channels’ examination of drug spending reports. For 2018, we again aim our magnifying glass at the annual trend reports from four large pharmacy benefit managers (PBMs): CVS Health, Express Scripts, MedImpact, and Prime Therapeutics.

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