Although bills that would make comprehensive changes to the PBM industry have advanced in Congress, Paul Kelly, a veteran healthcare lobbyist, says a limited version that saves Medicare money may pass as an offsetting "pay for" for extension of more liberal rules for telehealth services that Medicare covers.
Paul Kelly, of Capitol Advocacy & Government Affairs, LLC and a veteran healthcare lobbyist in Washington, D.C., says that a limited version of PBM reform may pass Congress after the November election that serves as a "pay for" for the extension of the Medicare telehealth flexibilities that were permitted during the COVID-19 public health emergency.
Kelly says the House Ways and Means has OKed a two-year extension of the telehealth flexibilities that includes some limited PBM reform provisions as a way of offsetting the costs of liberalizing the rules for telehealth services that Medicare will cover.
Breaking Down Health Plans, HSAs, AI With Paul Fronstin of EBRI
November 19th 2024Featured in this latest episode of Tuning In to the C-Suite podcast is Paul Fronstin, director of health benefits research at EBRI, who shed light on the evolving landscape of health benefits with editors of Managed Healthcare Executive.
Listen
In this latest episode of Tuning In to the C-Suite podcast, Briana Contreras, an editor with MHE had the pleasure of meeting Loren McCaghy, director of consulting, health and consumer engagement and product insight at Accenture, to discuss the organization's latest report on U.S. consumers switching healthcare providers and insurance payers.
Listen
ICER Identifies 5 Drugs with Unsupported Price Increases
December 12th 2024The Institute for Clinical and Economic Review has identified five drugs — Biktarvy, Darzalex, Entresto, Cabometyx, and Xeljanz — with prices increases that are not supported by new clinical evidence, with a total of $815 million in added costs to U.S. payers in 2023.
Read More