All Articles In 'Medicare Drug Benefit'
Medicare Special Needs Plans: MedPAC Recommendations on Future of Special Needs Plans
Special Needs Plans (SNP) are part of the Medicare Advantage program and were created by the Medicare Modernization Act of 2003 (MMA). There are three types of SNPs, each intended to provide coordinated care for Medicare [...]
Medicare Drug Benefit: Formulary Oversight in Medicare Part D
Medicare Part D, the Medicare drug benefit, served roughly 31 million seniors last year. Medicare Part D is more similar to Medicare Advantage than to traditional Medicare in that enrollees can choose among several private health [...]
Legality of Pay for Delay Settlements: SCOTUS Pharma and Biotech Case Preview
The 2012 Supreme Court got a lot of attention for its decision to uphold most of the Affordable Care Act (ACA) health reform law in NFIB v. Sebelius. But this year’s court docket will be no [...]
Medicare Part D Spending: Key Drivers of Reduced Drug Benefit Costs
When Congress enacted the Medicare Modernization Act of 2003 (MMA), it set a spending target of about $400 billion over 10 years for the Medicare Part D drug benefit, after accounting for revenues from premiums and [...]
Medicare Drug Use and Medical Spending: Increased Rx Drug Use Reduces Medical Costs
Prescription drugs often play an important role in keeping people healthy, especially for people with chronic conditions. Medicare beneficiaries with diabetes or asthma, for example, might take regular medicines to prevent emergencies that would put them [...]
Patient Safety in Pharmacies: Toolkit to Improve Pharmacy Quality
Health care quality and patient safety have become increasingly important in recent years, particularly as part of efforts to prevent wasteful spending, hospital readmissions, and medical errors. Accountable Care Organizations (ACO), health information technology (HIT), electronic [...]
Medicare Reimbursement Explained: MedPAC Briefings on Medicare Payment Methods for Providers, Medicare Advantage, and Drug Plans
Medicare program payment methods are highly complex and change constantly. The Affordable Care Act (ACA) makes further, very significant changes to how Medicare pays hospitals, physicians, post-acute providers, and Medicare Advantage health plans. In a series of excellent briefs, [...]
Employee Retirement Health Benefits: Workers Increasingly Do Not Expect Retiree Health Coverage
Employers have made major changes to their health benefits in the past decade. Premiums for employer-sponsored health insurance increased more than 60 percent from 2001 to 2009, and the employee’s share of premiums went up more [...]
Medicare Part D and Dual Eligibles: Prescription Drug Formularies and Drugs Used by Dual Eligibles
Medicare Part D prescription drug plan formularies in 2012 covered 96 percent of the drugs most used by people eligible for both full Medicare benefits and Medicaid – full benefit dual eligibles - according to the Department [...]
Pharmaceutical Payment: Pharma and Biotech Market Shifting to Value or Outcomes-Based Drug Revenue Model
Pharmaceutical manufacturers face an economic transformation as payors look more toward value-based – as opposed to transactional, unit-based – models for drug reimbursement. This value-based revenue model presents enormous implications for the future of pharma and biotech, impacting everything [...]
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