Content about Medicare

February 12, 2014

A Medicare proposed rule change limiting the number of prescription drug plans that insurers may offer in the Part D market could require 39% of all enhanced plans to be eliminated in 2016, according to an analysis from Avalere Health that was released Wednesday.

WASHINGTON — A Medicare proposed rule change limiting the number of prescription drug plans that insurers may offer in the Part D market could require 39% of all enhanced plans to be eliminated in 2016, according to an analysis from Avalere Health that was released Wednesday. The change, which limits standalone PDP sponsors to one basic and one enhanced plan per region, was proposed by the Centers for Medicare and Medicaid Services in a January proposed regulation. 

February 12, 2014

Members of Congress are contacting the U.S. Centers for Medicare and Medicaid Services in support of pro-patient improvements the agency proposed for Medicare Part D prescription drug plans in 2015, a development applauded today by the National Community Pharmacists Association.

ALEXANDRIA, Va. — Members of Congress are contacting the U.S. Centers for Medicare and Medicaid Services in support of pro-patient improvements the agency proposed for Medicare Part D prescription drug plans in 2015, a development applauded today by the National Community Pharmacists Association.

In response to problems with “preferred pharmacy” networks, CMS has proposed allowing any willing pharmacy to offer a plan’s lowest, or preferred, cost-sharing to give seniors more choice and to foster greater competition among pharmacies. 

February 7, 2014

In a report released by the U.S. Government Accountability Office, the GAO found that the total draft federal upper limits amount based on the new formula under the Patient Protection and Affordable Care Act was about 1.4% lower than the total National Average Drug Acquisition Cost amount in aggregate for 1,035 outpatient drugs subject to the FUL in first quarter 2013.

WASHINGTON — In a report publicly released Thursday by the U.S. Government Accountability Office, the GAO found that the total draft federal upper limits amount based on the new formula under the Patient Protection and Affordable Care Act was about 1.4% lower than the total National Average Drug Acquisition Cost amount in aggregate for 1,035 outpatient drugs subject to the FUL in first quarter 2013.

February 6, 2014

The Food and Drug Administration’s proposed rule on prescription drug labeling would add $4 billion annually to the nation’s healthcare costs, undercutting the cost savings that generic medicines have brought to America’s patients and healthcare system, according to an analysis released Wednesday by economic consulting firm Matrix Global Advisors.

WASHINGTON — The Food and Drug Administration’s proposed rule on prescription drug labeling would add $4 billion annually to the nation’s healthcare costs, undercutting the cost savings that generic medicines have brought to America’s patients and healthcare system, according to an analysis released Wednesday by economic consulting firm Matrix Global Advisors.

February 3, 2014

Leaders from the National Association of Chain Drug Stores set the stage Monday morning at the Regional Chain Conference for regional chain attendees to tackle issues ranging from the Affordable Care Act implementation to digital’s impact on shoppers and stores, to how to engage in interactive discussions and business meetings.

NAPLES, Fla. — Leaders from the National Association of Chain Drug Stores set the stage Monday morning at the Regional Chain Conference for regional chain attendees to tackle issues ranging from the Affordable Care Act implementation to digital’s impact on shoppers and stores, to how to engage in interactive discussions and business meetings.

January 31, 2014

Interim financial results for 114 ACOs that began work in 2012 show that they generated $128 million in savings for the Medicare trust fund in the first year, the Centers for Medicare and Medicaid Services reported in a blog posted Thursday.

WASHINGTON — Interim financial results for 114 ACOs that began work in 2012 show that they generated $128 million in savings for the Medicare trust fund in the first year, the Centers for Medicare and Medicaid Services reported in a blog posted Thursday. Additionally, initial results from an independent evaluation of 23 Pioneer ACOs, which are those that have more experience with coordinated care, show that they saved the Medicare program $147 million in their first year of operation.

January 23, 2014

When selecting an exchange health plan under the Affordable Care Act, consumers should be able to evaluate plans’ success in medication management, among other quality measures, the National Association of Chain Drug Stores stated in comments to the Centers for Medicare and Medicaid Services.

ARLINGTON, Va. — When selecting an exchange health plan under the Affordable Care Act, consumers should be able to evaluate plans’ success in medication management, among other quality measures, the National Association of Chain Drug Stores stated in comments to the Centers for Medicare and Medicaid Services.

Specifically, NACDS urged CMS to adopt measures related to medication adherence and appropriate medication use as part of its Quality Rating System for Qualified Health Plans, which are offered through health insurance exchanges.

January 17, 2014

The National Community Pharmacists Association on Thursday expressed its support behind the Diabetic Testing Supply Access Act (S. 1935).

ALEXANDRIA, Va. — The National Community Pharmacists Association on Thursday expressed its support behind the Diabetic Testing Supply Access Act (S. 1935). 

The legislation would allow independent community pharmacies to provide same-day delivery of diabetes testing supplies to Medicare beneficiaries and was introduced by Senss Jerry Moran, R-Kan., and John Thune, R-S.D. 

Since July 1, 2013 community pharmacies have been banned from delivering DTS to beneficiaries, including those who are homebound or in long-term care or assisted living facilities. 

January 17, 2014

The Medicare Part D program and taxpayers often pay more when prescription drugs are obtained through "preferred" pharmacies and mail order than they would if the same prescriptions were filled through other, "non-preferred" pharmacies, according to a cost comparison made by the National Community Pharmacists Association released Thursday using the Medicare Plan Finder website.

ALEXANDRIA, Va. — The Medicare Part D program and taxpayers often pay more when prescription drugs are obtained through "preferred" pharmacies and mail order than they would if the same prescriptions were filled through other, "non-preferred" pharmacies, according to a cost comparison made by the National Community Pharmacists Association released Thursday using the Medicare Plan Finder website. The findings come shortly after recently proposed requirements that officials with the U.S.

January 15, 2014

Reform of eligibility criteria for MTM services would improve access to care for seniors and boost medication adherence, according to an article co-authored by Laura Miller, senior economist with the National Association of Chain Drug Stores.

ARLINGTON, Va. — Reform of eligibility criteria for MTM services would improve access to care for seniors and boost medication adherence, according to an article co-authored by Laura Miller, senior economist with the National Association of Chain Drug Stores.

The article — titled “Should Eligibility for Medication Therapy Management be Based on Drug Adherence?” — is in the January 2014 Journal of Managed Care Pharmacy.

January 9, 2014

Rather than take vacation for Christmas and New Year’s, the editors of DSN worked to compile a list of the top 10 trends that will shake up the business in 2014.

Rather than take vacation for Christmas and New Year’s, the editors of DSN worked to compile a list of the top 10 trends that will shake up the business in 2014.

Clinics explode onto scene

Keep a close eye on retail-based health clinics come 2014.

The convenient care industry has come far since hitting the scene in 2000 and today — with nearly 1,500 clinics nationwide — they are proving their importance within the changing healthcare landscape.

January 8, 2014

Aetna has announced that Walmart and Sam’s Club pharmacies have been added to the preferred pharmacy network of the Aetna CVS/pharmacy Prescription Drug Plan as of Jan. 1.

HARTFORD, Conn. — Aetna has announced that Walmart and Sam’s Club pharmacies have been added to the preferred pharmacy network of the Aetna CVS/pharmacy Prescription Drug Plan as of Jan. 1.

January 7, 2014

Growth in health spending has slowed in recent years, including spending by private and public payers, according to data released by the Centers for Medicare and Medicaid Services that also found a small contribution to the lower growth from the healthcare reform law.

WASHINGTON — Growth in health spending has slowed in recent years, including spending by private and public payers, according to data released Monday by the Centers for Medicare and Medicaid Services that also found a small contribution to the lower growth from the healthcare reform law.

January 7, 2014

Navarro Discount Pharmacy has been recognized as a winner of the 2013 UnitedHealthcare Medication Adherence Targeted Intervention Program Challenge benefiting the National Association of Chain Drug Stores Foundation.

MIAMI — Navarro Discount Pharmacy has been recognized as a winner of the 2013 UnitedHealthcare Medication Adherence Targeted Intervention Program Challenge benefiting the National Association of Chain Drug Stores Foundation.

Navarro was recognized in the small retail pharmacy chain and independent community pharmacy category for its ability to address gaps in medication adherence among a subgroup of UnitedHealthcare Medicare Advantage-Part D plan members.

January 7, 2014

The National Community Pharmacists Association on Tuesday expressed support of several policy changes proposed by the Centers for Medicare and Medicaid Services.

ALEXANDRIA, Va. — The National Community Pharmacists Association on Tuesday expressed support of several policy changes proposed by the Centers for Medicare and Medicaid Services, according to a document filed in the Federal Register. 

January 6, 2014

InComm, a leading prepaid product and transaction services company, announced that six health plans across Arizona and Texas will be providing over-the-counter benefits through Medagate, InComm's healthcare platform.

ATLANTA — InComm, a leading prepaid product and transaction services company, on Monday announced that six health plans across Arizona and Texas will be providing over-the-counter benefits through Medagate, InComm's healthcare platform. 

December 26, 2013

Now, a year later, as the company completes its 50th year in business and the country awaits a period of change in health care unlike anything seen in at least that time, CVS Caremark executives are quite confident that its unique hybrid structure and its ability to leverage the three core parts of its business — either individually or together, in varying combinations to serve a multitude of needs — aligns more effectively with the long-term trends in health care and puts the company in a unique position at a singular moment in history.

In 2012, DSN presented an in-depth report on CVS Caremark’s integrated pharmacy business model — part big retail pharmacy chain, part big PBM, part big retail clinic operator — and the innovative products and solutions that were coming out of the organization, particularly where the three parts of the business came together, its “integration sweet spots,” as company executives referred to them.

December 23, 2013

The Centers for Medicare and Medicaid Services is encouraging health plans to cover patients' existing non-formulary drugs as though they were formulary drugs for the first 30 days after the Jan. 1 rollout of the insurance coverage provided under the Patient Protection and Affordable Care Act.

ARLINGTON, Va. — The Centers for Medicare and Medicaid Services is encouraging health plans to cover patients' existing non-formulary drugs as though they were formulary drugs for the first 30 days after the Jan. 1 rollout of the insurance coverage provided under the Patient Protection and Affordable Care Act.

December 20, 2013

CVS Caremark announced on Friday that the Centers for Medicare and Medicaid Services has lifted the sanctions imposed against the company's SilverScript Medicare Part D Prescription Drug Plan, effective Jan. 1.

WOONSOCKET, R.I. — CVS Caremark announced on Friday that the Centers for Medicare and Medicaid Services has lifted the sanctions imposed against the company's SilverScript Medicare Part D Prescription Drug Plan, effective Jan. 1.

 "We are pleased by this news," stated Jon Roberts, president of the PBM business of CVS Caremark. "We have worked hard to implement improvements to address the enrollment processing issues that occurred in early 2013 and are committed to providing our members with quality service and support."

December 18, 2013

Winning with ability and agility in the age of healthcare retail-ization. That’s what it is all about for CVS Caremark, and that was a central theme of Wednesday’s timely Analyst Day meeting in New York City.

NEW YORK — Winning with ability and agility in the age of healthcare retail-ization. That’s what it is all about for CVS Caremark, and that was a central theme of Wednesday’s timely Analyst Day meeting in New York City, held just weeks before the New Year when health reform will begin to significantly alter the healthcare landscape.

December 18, 2013

The U.S. healthcare system saved $217 billion in 2012 thanks to the use of generic drugs, according to a new report by a generic drug industry trade group.

WASHINGTON — The U.S. healthcare system saved $217 billion in 2012 thanks to the use of generic drugs, according to a new report by a generic drug industry trade group.

December 18, 2013

UnitedHealthcare on Wednesday announced the winners of the 2013 UnitedHealthcare Medication Adherence Targeted Intervention Program Challenge benefiting the National Association of Chain Drug Stores Foundation.

MINNETONKA, Minn. — UnitedHealthcare on Wednesday announced the winners of the 2013 UnitedHealthcare Medication Adherence Targeted Intervention Program Challenge benefiting the National Association of Chain Drug Stores Foundation. The company presented a $100,000 donation to the foundation on behalf of the winning pharmacies at the 15th annual NACDS Foundation Dinner in New York earlier this month. 

December 17, 2013

Nearly 1,200 seniors have complained to Medicare this year about a litany of problems with mail-order pharmacies, including shipping unneeded medication and going without medication due to delayed shipments, the National Community Pharmacists Association noted Tuesday citing documentation recently released by the U.S. Centers for Medicare & Medicaid Services.

ALEXANDRIA, Va. — Nearly 1,200 seniors have complained to Medicare this year about a litany of problems with mail-order pharmacies, including shipping unneeded medication and going without medication due to delayed shipments, the National Community Pharmacists Association noted Tuesday citing documentation recently released by the U.S. Centers for Medicare & Medicaid Services.

December 12, 2013

The National Community Pharmacists Association urged U.S. Senators on the Senate Finance Committee to support a proposal intended to expand coverage in the Medicare Part D prescription drug program of medication therapy management programs.

ALEXANDRIA, Va. — The National Community Pharmacists Association on Wednesday urged U.S. Senators on the Senate Finance Committee to support a proposal — scheduled for a vote as soon as Thursday — intended to expand coverage in the Medicare Part D prescription drug program of medication therapy management programs.

December 11, 2013

Reimbursement cuts to California's state Medicaid program are the subject of a lawsuit filed last week in San Francisco.

SACRAMENTO, Calif. — Reimbursement cuts to California's state Medicaid program are the subject of a lawsuit filed last week in San Francisco.

The Professional Pharmacy Alliance and the California Korean American Pharmacists Association filed suit against the California Department of Health Care Services in San Francisco Superior Court over an across-the-board 10% cut in 2011 to the reimbursement rates for most providers under the program, known as Medi-Cal.