For Pharma, Unfamiliar Payers, Tight Cost Structures Ahead In State Exchanges
Medicaid managed care organizations are among the insurers moving into the individual insurance space with low-cost plans, although the more familiar Blues plans will also have a strong showing across the states.
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Report released as soon-to-be committee chair Ron Wyden, D-OR, assembles plans for drug pricing legislation in the new Democratic-controlled Senate.
Former CMS acting administrator Andy Slavitt says agency’s direction during Biden administration depends on nominee, but trust fund’s looming insolvency will be ‘an issue you can’t avoid.’ The president’s priorities around health equity, racial justice and mental health will make their way into CMS policy and demonstration models, Slavitt suggests.
Demonstration, which may not survive scrutiny from the Biden Administration, includes some protections, such as prohibiting Tennessee from excluding drugs described in the Medicare Part D protected classes policy.