Newsletters

08.07.24

340B Hospitals Sue HRSA for Authorizing Audits of 340B Records

On July 24, two hospitals that participate in the Section 340B drug discount program—Oregon Health & Science University and Maine General Medical Center—filed separate lawsuits against the Health Resources and Services Administration (HRSA), alleging that HRSA had unlawfully ...


08.01.24

OIG Concludes Gene Therapy Manufacturers Could Violate Law By Providing Fertility Support to Patient

On July 22 and July 23, HHS OIG published two advisory opinions for proposals by pharmaceutical manufacturers to provide fertility support to patients receiving their gene therapies.


08.01.24

House Oversight Committee Focuses on PBMs

During a July 23 hearing with executives of the nation’s three largest pharmacy benefit managers (PBMs) members of the House Committee on Oversight and Accountability made clear their concern over the role of PBMs in drug pricing and the future of independent retail pharmacies.  


07.24.24

CMS Finalizes Part D Cost-Sharing Smoothing Guidance

The Centers for Medicare & Medicaid Services (CMS) finalized the second part of its guidance on implementation of the IRA’s Medicare Prescription Payment Plan (MPPP), known informally as Part D monthly out of-pocket “smoothing”.


07.24.24

CMS Releases Technical Guidance to States on Complying with Medicaid Access Final Rule

On July 12, CMS released a companion guide to the Ensuring Access to Medicaid Services final rule (the “Access Final Rule”).


07.24.24

Oregon Launches a Basic Health Program

On July 1, Oregon launched a Basic Health Program (BHP) that offers comprehensive health care coverage, including medical, dental, and behavioral health care, with zero premiums and zero cost-sharing for eligible individuals with income between 138–200 percent of the federal poverty level ...


07.17.24

Media Reports FTC Poised to Sue PBMs

In the wake of the FTC’s July 9 vote to release an interim staff report on PBMs, several media outlets are reporting that the Commission is poised to sue large PBMs.


07.17.24

D.C. Court Strikes Down Indiana 1115 with Premiums and Coverage Restrictions

On June 27, the D.C. District Court struck down CMS’ 2020 approval of a 10-year renewal for the Healthy Indiana Plan (HIP) 2.0 Medicaid Section 1115 demonstration (Rose v. Becerra).


07.17.24

North Carolina’s New Plan to Relieve Medical Debt

On July 1, North Carolina announced a new plan to relieve past medical debt for low- and middle-income consumers and mitigate the impact of medical debt going forward.


07.17.24

Biden Administration Launches Dementia Care Model

The CMS Innovation Center has officially launched the Guiding an Improved Dementia Experience (GUIDE) Model, in which 390 participating academic medical systems, small group practices and clinics, hospice agencies, community-based organizations, and other health care providers will develop Dementia ...