4月4日,美国医保局(CMS)发布了2025年的Medicare Advantage和Medicare Part D的最终版规则,其中对生物类似药替代的要求明显降低,Medicare Part D的所有生物类似药替换不再明确要求CMS的提前批准,而此前这一原则仅适用于可互换的(interchangeable)生物类似药。 在此之前,任何生物药处方的变更中,CMS规定保险公司、PBM或...
Ahead of the Medicare Open Enrollment Period, CMS hasannouncedthat Medicare Advantage premiums, benefits, and plan choices will remain relatively stable in 2024. “A top priority for CMS is to protect and strengthen the Medicare program for people with Medicare, their children, and ...
CMS issued new rules that would limit insurance agents' contact with the elderly and disabled when selling prescription drug plans or the Medicare Advantage. The changes made include no more unsolicited contacts with beneficiaries, no selling of other insurance products, no free meals at promotional ...
The Centers for Medicare & Medicaid Services (CMS)releasedits Advance Notice of Methodological Changes for Calendar Year (CY) 2025 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies on Jan. 31, 2024, that would update program policies for Medicare Advantage...
Additionally, the administration changes in the upcoming year and potential CMS leadership by Dr. Mehmet Oz, an eager advocate of Medicare Advantage, add an element of uncertainty regarding the future development of this proposed rule. In particular, the Congressional Revi...
AI and other algorithms can be used as part of making Medicare Advantage coverage decisions. CMS reminds Medicare Advantage organizations that coverage must be based on individualized determinations. AI and other algorithms should not perpetuate or create discriminatory and biased res...
Traditional Medicare (Parts A and B) and Medicare Advantage (Part C, including additional vision, dental, and hearing benefits) plans aim to provide comprehensive medical benefits to American Seniors and adults with...more The Federal Funding Freeze and its Effect on Health Equity Programs ...
CMS估计,Medicare Advantage计划将使保险金平均下降1.91至30美元,PartD计划平均月保险金下降1.20至33.50美元。CMS预测,MedicareAdvantage计划的参保人数将上升9茗,达到2040万人,占医疗保险计划参保人数的34%。 【总页数】1页(P4-4) 【关键词】CMS;美国;医疗保险计划;参保人数;服务中心;医疗补助;费用信息;保险金 【...
of health. Social determinants of health are the conditions in places where people live, learn, work and play that affect health risks and outcomes. The new definition opens the doors to coverage for new benefits for Medicare Advantage plans, which are projected to cover22.6 mil...
The federal government said it is giving Medicare Advantage plans the ability to require step therapy for Part B drugs, labeling it as a way to drive down drug costs by motivating pharmaceutical companies to come to the negotiating table. ...