Carrots Or Sticks: Which Way Might Medicare's Protected Classes Reforms Go?
UnitedHealthcare program for commercial members offers some implications. MyScripRewards encourages less costly HIV treatments using financial rewards, underscoring insurers’ tendency to favor carrots over sticks when it comes to coverage policies for such drugs.
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Gilead faces two-pronged policy challenge in its core HIV business: its Part D product line could lose protections, but prophylactic prescriptions could dramatically expand under the Trump Administration's plan to eliminate HIV transmission.
O’Brien assumes role from his late colleague and friend Dan Best as HHS closes out administrative items in the blueprint.
CMS proposed rule would not eliminate any protected classes but would allow plans to impose additional restrictions on drugs in those classes. Proposal also codifies step therapy for Part B drugs.