This week's Regs & Eggs from McDermott+Consulting is out!!

This week, my colleague, Leigh Feldman, and I explore a new proposal from HHS.gov to address drug shortages.

Also, in some late breaking news, CMSGov just issued another proposal in the FY 2025 Inpatient Prospective Payment…

It’s a very interesting choice that CMSGov chose to include a mandatory episode based payment model in the IPPS.

I thought it would be a separate rule…

Also, a mandatory model puts a lot of pressure on hospitals that are already extremely strained…

Why do people feel the need to put down Duke all the time!!

Just say that UConn is a great team! UConn was clearly the best team this year— and back to back national championships is quite an accomplishment!!

You can say that without saying anything negative about Duke! It’s…

Yes, I definitely recommend that folks read the Chris Hamby article from the The New York Times.

nytimes.com//2024/04/07/us…

Also, as Ed Gaines notes, the article notes that U.S. Department of Labor only has one investigator for every 8,800 employer-based health plans. Proper oversight of these plans is…

Great summary of the MA and Part D final rule by Bridget Early at InsideHealthPolicy !

CMS Brings Back 2024 Proposal To Crack Down On 3rd-Party Marketers In 2025 MA Rule | InsideHealthPolicy.com insidehealthpolicy.com/daily-news/cms…

Very very busy week in health policy land! Get a run-down here!

I was about done checking the Federal Register, and then it appeared! So weird…

I was freaking out because I checked at 4:15 and nothing and then all of a sudden I saw that CMS release. What is going on?!?!?

Today, April 4, 2024, CMSGov issued a final rule that institutes changes to the Medicare Advantage (MA) and the Medicare Prescription Drug (Part D) Programs.

· The Final Rule can be found here: public-inspection.federalregister.gov/2024-07105.pdf
· A fact sheet highlighting the policies in the rule is…

Regs & Eggs is out!! This week, my colleague Kristen O'Brien and I discuss the implications of the the Medicare Advantage final rate announcement that establishes payment rates for calendar year (CY) 2025. mcdermottplus.com/blog/regs-eggs……

CMSGov has taken its final position with…

Regs & Eggs is out!!

This week, my colleague Kristen O'Brien and I discuss the implications of the the Medicare Advantage final rate announcement that establishes payment rates for calendar year (CY) 2025.
mcdermottplus.com/blog/regs-eggs…

CMSGov has taken its final position with…

What updates should Medicare Advantage and Part D stakeholders expect in 2025? Read our alert for a summary of CMS's CY 2025 Rate Announcement. mcdermott.shp.so/a/rzULVa

It's out!!

LINKS

· The final rule is available here: cms.gov/files/document…
· A fact sheet for the final rule is available here: cms.gov/newsroom/fact-…
· A press release for the final rule is available here: cms.gov/newsroom/press…

KEY TAKE AWAYS

Overall, the final policies…

Interesting... CMSGov released a fact sheet on a new final rule: the Final Notice of Benefits and Payment Parameters for 2025.

However... I can't find the rule itself!!

Anyone find it?

It's a regulatory mystery!

cms.gov/newsroom/fact-…

Here is an article from NBC News regarding Medicare's decision to cover Wegovy, and the effect the decision may have on drug costs and premiums in the long-run.

“This drug is expensive,” Jeffrey Davis from McDermott+Consulting said. “If millions of people are covered, it could…

“This drug is expensive,” Jeffrey Davis from McDermott+Consulting said. “If millions of people are covered, it could increase premiums going forward.”

Experts warn of Medicare premium hikes to cover Wegovy for heart risks nbcnews.com/health/health-… via @nbcnews

Here is a statement from AHIP: ahip.org/news/press-rel…

“These policies will put even more pressure on the benefits and premiums of 33 million Medicare Advantage beneficiaries who will be renewing their coverage this fall. It is important to note that the Medicare…