Rebates

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Nearly 20,000 comments have been submitted in response to the Department of Health and Human Services January 31, 2019 notice of proposed rulemaking eliminating discount safe harbor protection for reductions in price to prescription pharmaceutical products (or rebates) provided by manufacturers to plan sponsors under Medicare Part D and Medicaid managed care organizations (MCOs), whether negotiated by the plan or by pharmacy benefit managers (PBM) or paid through a PBM to the plan or Medicaid MCO. Most of the comments appear to be relatively short, text box comments submitted by individuals through patient or business advocacy groups.  The following is a very high level summary of the several hundred comments posted (so far) from health plans, manufacturers, pharmacies, their respective associations, and policy oriented groups:
Continue Reading Highlights from the Comments on the Proposed Elimination of Discount Safe Harbors for Rebates

The President’s proposed budget, released February 2, includes a number of provisions that will impact the health care industry. Most prominently, the budget would seek savings through modifications to Medicare prescription drug coverage, extend the Children’s Health Insurance Program (CHIP), and continue to push Medicare delivery system reforms.
Continue Reading FY 2016 Proposed Federal Budget’s Potential Impact on Healthcare Industry

The Centers for Medicare & Medicaid Services (CMS) reports that consumers will receive more than $330 million from insurers that did not meet the medical loss ratio requirement for the 2013 policy year. Rebates must be paid by August 1, 2014. The report touts the success of the MLR rule, showing more consumers are insured…