February 5, 2013

Money is a powerful motivator. Look no further than the sports world for validation. The PGA’s FedEx Cup encourages golfers to earn “points” towards participation in playoffs that offer a big season-ending payoff. Tennis has a similar format with the U.S. Open Series where performance in a series of events equates to a huge prize purse. Both instances use hefty prize money to help ensure the top performers participate and at high levels. The Centers for Medicare and Medicaid Services (CMS) have applied this sports theory to its rankings system of Medicare Advantage (MA) and Prescription Drug Plans (PDP) plans. And there’s billions of dollars up-for-grabs for healthcare plans.

August 20, 2014

Despite a rocky start, the full rollout of health reform under the Affordable Care Act has already brought major benefits to the nation’s troubled health system and affordable coverage to millions of formerly uninsured or underinsured Americans, one of the Obama administration’s top health officials asserted recently.

July 14, 2014

At the close of the Affordable Care Act’s first open enrollment period, an estimated 9.5 million fewer U.S. adults were uninsured, according to a new Commonwealth Fund survey released last week.

June 3, 2014

The Centers for Medicare and Medicaid Services has announced new timing to implement the Medicaid average manufacturer price-based federal upper limits for prescription medications, a move that has been applauded by the National Association of Chain Drug Stores. The FULs were expected to be finalized in July.

May 21, 2014

According to a report published Monday by JAMA Pediatrics, cost-related barriers to care among children with asthma are concentrated among low-income families with higher cost-sharing levels.

May 21, 2014

Citing the need for a one-year transition period for states to implement the July average manufacturer price-based federal upper limits, or FULs, nine Senators are urging Department of Health and Human Services Secretary Kathleen Sebelius to consider the challenges that states will face when the final Medicaid AMP-based FULs are published.

May 20, 2014

The Centers for Medicare & Medicaid Services on Monday issued final regulations for the Medicare Advantage and prescription drug benefit (Part D) programs.

April 24, 2014

More than two-thirds of the U.S. population now live in localities served by accountable care organizations, and more than 40% live in areas served by two or more.

April 22, 2014

This week, 49 members of the U.S. House of Representatives urged Health and Human Services Secretary Kathleen Sebelius to adopt a one-year transition period for states to implement the July 2014 average manufacturer price-based federal upper limits.

April 11, 2014

The New York State legislature recently wrapped up its 2015 budget negotiations with a favorable outcome for community pharmacy as it rejected an executive branch proposal to change how New York’s Medicaid program reimburses pharmacies for prescription medications.

April 9, 2014

Emphasizing implementation challenges that could impact patient access to pharmacy services, a coalition is urging Secretary of Health and Human Services Secretary Kathleen Sebelius to allow a one-year transition period for states to fully implement the Medicaid average manufacturer’s price-based federal upper limits for prescription medications.

April 2, 2014

Symphony Health Solutions on Wednesday released research on the affects of the Affordable Care Act on Medicaid drug spending.

March 28, 2014

More smokers would quit if state Medicaid programs covered more cessation treatments and removed barriers to coverage, according to a Centers for Disease Control and Prevention study published in Thursday's Morbidity and Mortality Weekly Report.

March 26, 2014

Message to federal health plan payers from community pharmacy: We have the systems in place and the professional expertise to help millions of patients to better their health outcomes at a lower cost. Message to pharmacy from the U.S. Department of Health and Human Services and its Centers for Medicare and Medicaid Services: Prove it.

March 18, 2014

Even as millions of Americans gain access to insurance coverage under the Affordable Care Act, there are an estimated 62 million people who remain without access to a primary heath care physician, according to a report by the National Association of Community Health Centers.

March 12, 2014

Citing pharmacist-administered medication therapy management, recognition of pharmacists as healthcare providers, the need for fair and accurate pharmacy reimbursement in state Medicaid programs and other pharmacy services, the National Association of Chain Drug Stores has sent a statement to lawmakers urging them to consider pharmacy provisions within the “Fiscal 2015 Budget,” released by the administration last week.

March 11, 2014

The Centers for Medicare and Medicaid Services has decided not to move forward on several of the proposed provisions of the Medicare Advantage and Part D prescription drug program, according to reports.

February 18, 2014

Now that most generics have declined in cost, plans will look for new ways to control health spend and ensure that generics are being used whenever possible.

February 12, 2014

A Medicare proposed rule change limiting the number of prescription drug plans that insurers may offer in the Part D market could require 39% of all enhanced plans to be eliminated in 2016, according to an analysis from Avalere Health that was released Wednesday.

February 12, 2014

Members of Congress are contacting the U.S. Centers for Medicare and Medicaid Services in support of pro-patient improvements the agency proposed for Medicare Part D prescription drug plans in 2015, a development applauded today by the National Community Pharmacists Association.

February 7, 2014

In a report released by the U.S. Government Accountability Office, the GAO found that the total draft federal upper limits amount based on the new formula under the Patient Protection and Affordable Care Act was about 1.4% lower than the total National Average Drug Acquisition Cost amount in aggregate for 1,035 outpatient drugs subject to the FUL in first quarter 2013.

January 31, 2014

Interim financial results for 114 ACOs that began work in 2012 show that they generated $128 million in savings for the Medicare trust fund in the first year, the Centers for Medicare and Medicaid Services reported in a blog posted Thursday.

January 23, 2014

When selecting an exchange health plan under the Affordable Care Act, consumers should be able to evaluate plans’ success in medication management, among other quality measures, the National Association of Chain Drug Stores stated in comments to the Centers for Medicare and Medicaid Services.

January 15, 2014

Reform of eligibility criteria for MTM services would improve access to care for seniors and boost medication adherence, according to an article co-authored by Laura Miller, senior economist with the National Association of Chain Drug Stores.