CMS Working With DOGE
CMS announced that it has assigned 2 industry veterans to lead its collaboration with the Department of Government Efficiency (DOGE), including ensuring appropriate access to CMS systems and technology. “We are taking a thoughtful approach to see where there may be opportunities for more effective and efficient use of resources in line with meeting the goals of President Trump,” said the agency. Read the announcement.
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HHS Delays NCPDP Standards
HHS delayed the effective date of a final rule on pharmacy standards – “Administrative Simplification: Modifications of Health Insurance Portability and Accountability Act of 1996 (HIPAA) National Council for Prescription Drug Programs (NCPDP) Retail Pharmacy Standards; and Modification of the Medicaid Pharmacy Subrogation Standard – until April 14. Read the announcement.
Report: MA Plans Serve Older, More Medically Complex Patients
A new report from America’s Health Insurance Plans (AHIP) found that Medicare Advantage plans serve increasingly diverse populations with lower incomes and more complex health needs than Fee-for-Service (FFS) Medicare. Based on 2022 beneficiary data, the report shows that MA plans have a higher percentage of enrollees over 75 years old (39% vs 37%); higher percentage of enrollees with annual incomes of less than $25,000 (36% vs 20%); and lower percentage of enrollees with self-described health status of “excellent” or “very good” (47% vs 54%). Download the report.
Cigna to Reform Prior Authorization
Cigna Group announced that it will spend up to $150 million to reform its prior authorization, patient advocacy, and provider services this year. The commitment comes a month after the assassination of a high-profile industry executive sparked loud, public conversations about payor services. Read more.