The Social Security Act permits Medicare Part B to pay for drugs and biologicals that are not usually self-administered by the patient and furnished as “incident to” a physician's service. As a result, drugs that are “usually self-administered” are … [Read more...] about CMS Request for Information Regarding Self-Administered Drugs – Center for Medicare Advocacy Calls for Reform
Medicare Part D / Prescription Drugs
Inflation Reduction Act (Medicare Drug Law) Updates – Including Part D Low Income Subsidy
HHS Actions to Increase LIS EnrollmentAmong other changes aimed at reducing drug costs for both Medicare beneficiaries and the Medicare program at large, a provision of the Inflation Reduction Act of 2022 (IRA) expands access to the Part D Low … [Read more...] about Inflation Reduction Act (Medicare Drug Law) Updates – Including Part D Low Income Subsidy
Lawsuit Settlement Allows Medicare Coverage for “Off-Label” Medication
Medicare has agreed to cover an essential medication for a retired public school teacher in New Jersey who needs the drug to control debilitating symptoms of a digestive system disorder.Cheryl Hough experiences extreme nausea, vomiting, and … [Read more...] about Lawsuit Settlement Allows Medicare Coverage for “Off-Label” Medication
Drug Company Sues Medicare to Reverse Gains Being Made in Reining in Drug Costs
June 6, 2023WASHINGTON, D.C. - Today, pharmaceutical company Merck filed a lawsuit against the Medicare program in an effort to stop progress being made on drug pricing in Medicare through the Inflation Reduction Act (IRA), signed into law by … [Read more...] about Drug Company Sues Medicare to Reverse Gains Being Made in Reining in Drug Costs
Special Report | Recent Medicare Advantage (MA) and Part D Rule – Important Consumer Protections re: MA Prior Authorization and Marketing
On April 12, 2023, the Centers for Medicare and Medicaid Services (CMS) published a final rule for 2024 regarding Medicare Advantage (MA) and Part D. The final rule is available in the Federal Register at 88 Fed Reg 22120 (April 12, 2023) here, … [Read more...] about Special Report | Recent Medicare Advantage (MA) and Part D Rule – Important Consumer Protections re: MA Prior Authorization and Marketing
Implementation of Medicare Drug Bill Proceeds – This Progress Must be Defended
As discussed in a previous CMA Alert (Aug. 18, 2022), President Biden signed into law the Inflation Reduction Act (IRA) of 2022 on August 16, 2022. This bill includes historic prescription drug provisions that are already providing significant … [Read more...] about Implementation of Medicare Drug Bill Proceeds – This Progress Must be Defended
Center for Medicare Advocacy Comments on Proposed Part C & D Rule
As noted in this December 2022 CMA Alert, CMS released a proposed rule for Medicare Advantage and Part D for 2024 available here (87 Fed Register 79452, December 27, 2022). CMS also published a press release and accompanying fact sheet … [Read more...] about Center for Medicare Advocacy Comments on Proposed Part C & D Rule
Critical Provisions of Medicare Drug Bill Already Taking Effect
As discussed in a recent CMA Alert (Dec. 8, 2022), provisions of the Inflation Reduction Act (IRA) have begun to take effect, and other provisions are soon to follow. However, these historic changes are already being threatened by the pharmaceutical … [Read more...] about Critical Provisions of Medicare Drug Bill Already Taking Effect
CMS Issues Proposed Rules Impacting Medicare Advantage – Part C & D Rule for 2024, and Separate Prior Authorization Rule
As the Center for Medicare Advocacy has long noted, the Medicare Advantage (MA) program is in significant need of heighted regulation and oversight, not just for the sake of the Medicare program’s financial footing, but for the sake of the … [Read more...] about CMS Issues Proposed Rules Impacting Medicare Advantage – Part C & D Rule for 2024, and Separate Prior Authorization Rule
Provisions of Recently Passed Medicare Drug Bill in Effect Next Month – January 2023
As discussed in a recent CMA Alert (Aug. 18, 2022), President Biden signed into law the Inflation Reduction Act (IRA) of 2022 on August 16, 2022. This bill includes historic prescription drug provisions that will soon be of significant benefit to … [Read more...] about Provisions of Recently Passed Medicare Drug Bill in Effect Next Month – January 2023