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CMS Releases Guidance on Implementation of Rebate Programs for Certain Medicare Part B and Part D Drugs

Sheppard Health Law

The Rebate Programs are administered as part of the prescription drug affordability provisions of the Inflation Reduction Act (the “IRA”), which is aimed at “lower[ing] out-of-pocket drug costs for people with Medicare and improv[ing] the sustainability of the Medicare program for current and future generations.” [1]

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NASHP Model Act to Limit Out-of-Network Provider Rates

NASHP

This model legislation limits out-of-network rates for inpatient and outpatient hospital services to the lesser of (a) the state’s median in-network commercial rate for the same service; or (b) [X]% of the Medicare rate for the same service in the same geographic area. 1) Definitions.

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Family Caregiver Services and Supports

NASHP

Family caregivers are the major providers of long-term services and supports (LTSS), with an estimated economic value of unpaid contributions totaling approximately $470 billion in 2017. Recent research indicates that unmet training needs of caregivers correlated to greater acute care utilization for Medicare home health beneficiaries.

Medicaid 115
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Major Questions about Vaccine Mandates, the Supreme Court, and the Major Questions Doctrine

Bill Of Health

This Friday, the Supreme Court will hear arguments about two federal vaccine mandates: the Centers for Medicare and Medicaid Services’ (CMS) mandate for health care workers, and the Occupational Safety and Health Administration’s (OSHA) vaccine-or-test mandate for employers with over 100 workers.

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HHS is prioritizing consumer experience, data exchange, explainable AI

Healthcare It News

Department of Health and Human Services, who outlined the ways HHS is tailoring its approach to better serve consumers with increased cross-departmental and interdepartmental cooperation. How are we thinking about the way Medicare and Social Security work together?" " And it's not just within HHS.

Medicaid 236
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Healthcare Reforms Under the IRA: Expanding Access to Care

Sheppard Health Law

The expansive legislation includes key health care provisions, including drug pricing reforms, inflationary rebates, Medicare Part D benefit redesign, as well as myriad other updates. Medicare Drug Price Negotiation Program. The Inflation Reduction Act (“IRA”) was signed into law by President Biden on August 16, 2022.

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HHS Issues Proposed Rule to Provide Clarity on Rights of Conscience in Healthcare

Sheppard Health Law

The provisions also prohibit entities that receive federal funds from denying admission or discriminating against any applicant for training or study based on their reluctance or willingness to counsel, recommend, perform, or assist in certain health services or research activities because of their religious beliefs or moral convictions.