Keeping you updated on the latest Medicare and Part D news

Leave a comment

Tom Price confirmed as HHS secretary

Tom Price was confirmed overnight by the US Senate to become the next secretary of health of human services.  The vote along party lines was largely expected and one of Mr. Price’s first responsibilities will be to head President Trump’s push to dismantle the Affordable Care Act.  Mr. Price is expected to work to limit the growth of Medicare and Medicaid.  Details regarding possible changes to the programs, which insure more than 100 million Americans remain unclear, but Democrats are worried about what they see as the secretary’s desire to dismantle Medicare.  A 2009 op-ed article penned by Mr. Price included the following, “Nothing has had a greater negative effect on the delivery of health care than the federal government’s intrusion into medicine through Medicare.”

New York Times

Tom Price op-ed


Leave a comment

The Opioid Epidemic and Medicare Beneficiaries

CMS recently outlined it’s strategy for combating the opioid epidemic that is impacting a large numbers of Medicare and Medicaid beneficiaries and their families.  CMS identified the following areas as priorities to reduce opioid overuse and misuse in Medicare and Medicaid:

  • Implement more effective person-centered and population-based strategies to reduce the risk of opioid use disorders, overdoses, inappropriate prescribing, and drug diversion
  • Expand naloxone use, distribution, and access
  • Expand screening, diagnosis, and treatment of opioid use disorders, with an emphasis on increasing access to medication-assisted treatment
  • Increase the use of evidence-based practices for acute and chronic pain management

The success of CMS’ strategy relies on successful coordination and cooperation between Medicare and Medicaid beneficiaries, their families and caregivers, health care providers, health insurance plans, and states.  Acumen’s work on the Overutilization Monitoring System (OMS) is described as one example of the work CMS already does with health insurance plans to improve how opioids are prescribed by providers and used by beneficiaries.

Leave a comment

EpiPen designation as a generic medication reinvigorates criticism of Mylan’s practices

A new development in the ongoing EpiPen controversy – drug maker Mylan has been telling the federal government the product is a generic. This classification likely resulted in individual state Medicaid programs paying more for the product, since the company provides smaller discounts to states for generic drugs. The generic designation seems to predate Mylan’s ownership of the EpiPen product though the company objected to new government rules which will require requesting a waiver instead of reclassifying some older products as brand name. Much has been made recently of Mylan’s repeated increase of the price of the EpiPen product and the recent announcement that it will offer a generic version of the product at a reduced cost in an attempt to mollify critics.