Community Pharmacy

NOVEMBER 15, 2022

If this applies to you, then you can begin your application process here to get the process started. Medicare Part D has four phases of coverage that users need to be aware of before and during enrollment in the program. In 2022, the initial coverage limit was $4,430. In 2022, the coverage gap limit was $7,050.

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Putting Patients First Blog

JANUARY 4, 2024

Considerations for Hernia Patients when Selecting a Surgeon January 4, 2024 By: Abdominal Core Health Quality Collaborative Patient Engagement & Advocacy Committee & Abdominal Core Health Quality Collaborative Board of Directors Choosing a surgeon is a decision that can significantly impact patients’ health and well-being.

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Putting Patients First Blog

JANUARY 10, 2024

Making available more specific information about total costs and coverage will ensure that all consumers have comprehensive information to help them make smart health care decisions. These resources should aim to clarify insurance terms and concepts, aiding consumers in navigating the complexities of selecting a health plan.

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Putting Patients First Blog

MARCH 15, 2024

NHC Response to the House Education and the Workforce RFI on ERISA Plans (PDF) March 15, 2024 The Honorable Virginia Foxx Chairwoman Committee on Education and the Workforce U.S. ERISA is long overdue for Congressional attention, and we appreciate that the RFI starts this process.

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Putting Patients First Blog

FEBRUARY 1, 2024

Health Care Riders February 1, 2024 By: Allen Pinn, Coordinator, Policy In January, the Senate and House reached an agreement to fund the government through the first week of March. We reiterated these priorities to start the year in January 2024. The House passed H.R. 5378 More Transparency, Lower Costs Act in December 2023.

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Putting Patients First Blog

OCTOBER 15, 2023

As the primary insurer for millions of Americans and as the programs that drive decisions throughout the health ecosystem, these federal programs can be a critical driver of innovations. Finally, the timing of the scoring process can be frustrating when working to advance good policy. Best Price).

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Putting Patients First Blog

AUGUST 2, 2024

legislation (PDF) August 2, 2024 The Honorable Diana DeGette The Honorable Larry Bucshon, M.D. The NHC supports the survey on sources of coverage and learning collaborative on long-COVID proposed is Section 101. legislation. Health literacy is another vital issue.

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Putting Patients First Blog

JULY 2, 2024

We believe that patient-centric engagement is essential to ensure that the negotiation process leads to outcomes that genuinely benefit patients. Patient Engagement The NHC recognizes and commends CMS’ willingness to improve the listening sessions and the data submission processes. Improving the Data Collection (ICR) Process.

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Putting Patients First Blog

SEPTEMBER 9, 2024

16 We encourage CMS to continue refining these data collection processes to ensure they capture meaningful and actionable information. We believe this process is crucial for adapting the payment system to evolving clinical practices and emerging medical technologies.

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Putting Patients First Blog

MARCH 4, 2024

Under the new Manufacturer Discount Program, manufacturers will be required to provide discounts on applicable drugs during the initial coverage phase and catastrophic phase of the defined standard Part D drug benefit.

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Putting Patients First Blog

MARCH 4, 2024

Ensure Comprehensive Transparency in Formulary Management: Provide clear, comprehensive guidelines to Part D plans to ensure transparency in plan coverage, tiering, and utilization management (UM) policies, offering safeguards against practices that could restrict access to necessary treatments.

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Express Pharma

JANUARY 12, 2024

The time for commencing manufacturing or production was extended to 31 March 2024 by the Finance Act, 2022. Due to the multiplicity of regulatory processes and multiple regulators, undertaking operations become complex and time consuming. For pharma and medical devices policies, the Department of Pharmaceutical is the nodal agency. –

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Putting Patients First Blog

MAY 29, 2024

1 This trend underscores the importance of informed decision-making for those with chronic diseases and disabilities, who face crucial choices regarding their health care coverage – whether selecting between traditional Medicare and MA, choosing among MA plans, or navigating their selected plan to access necessary care. As of 2023, 30.8

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Putting Patients First Blog

APRIL 29, 2024

Communication and Transparency Clear Communication : We emphasize the need for documents to clearly and effectively communicate the nuances of the MPPP to beneficiaries, aiding in their decision-making process.

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Putting Patients First Blog

DECEMBER 13, 2023

NHC 2024 Policy Priorities December 13, 2023 By: Allen Pinn, Coordinator, Policy The National Health Council (NHC) prides itself in providing a voice for the over 160 million people living with a chronic disease or disability and their caregivers.

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European Pharmaceutical Review

MARCH 28, 2024

FDA is expected to provide initial feedback on the data submitted by July 2024, with further data to be collected and analysed over the next two years. When Aidan’s insurance company denied coverage for EXONDYS, the data she captured overturned the denial in 24 hours without engaging in the appeal process.

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Big Molecule Watch

AUGUST 25, 2023

Congress left Medicare drug pricing to the drug manufacturers, pharmacies, and insurance plan sponsors to determine, and expressly prohibited the government from “interfering” in those private price negotiations under the so-called “Non-Interference Clause” of the Medicare Modernization Act of 2003.

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Putting Patients First Blog

MARCH 18, 2024

The NHC supports the development and use of processes and tools that enhance beneficiary experience, making interactions with the MPPP smoother and more intuitive for all beneficiaries. Similarly, updating the Explanation of Benefits to include visual aids and examples will clarify MPPP’s impact on cost-sharing and coverage.

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Putting Patients First Blog

MARCH 18, 2024

The NHC supports the development and use of processes and tools that enhance beneficiary experience, making interactions with the MPPP smoother and more intuitive for all beneficiaries. Similarly, updating the Explanation of Benefits to include visual aids and examples will clarify MPPP’s impact on cost-sharing and coverage.

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Putting Patients First Blog

JULY 15, 2024

Too often the formal notice and comment process does not reach these marginalized communities and federal agencies must actively work to seek their input in non-traditional ways. This process respects their autonomy by involving them in decision-making to the extent that they are able.

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Express Pharma

JULY 29, 2024

Shield is also the first blood test for CRC screening that meets the requirements for Medicare coverage. 2 The American Cancer Society estimates that more than 150,000 people will be diagnosed with CRC in 2024 and the disease will be responsible for more than 53,000 deaths. Cancer Facts & Figures 2024. Doubeni, C, et al.

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Putting Patients First Blog

SEPTEMBER 9, 2024

As these technologies become increasingly integral to patient care, it is essential for CMS to develop clear and consistent guidelines for the payment and coverage of AI-enabled services. Providing clear guidance, technical assistance, and streamlined processes can help facilitate the adoption of this innovative care model.

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Putting Patients First Blog

NOVEMBER 12, 2024

General Support for CMS Proposals The NHC commends CMS for its ongoing commitment to advancing health equity, improving access to care, ensuring program integrity, and maintaining affordability through Marketplace coverage. Copay Assistance and Drug Coverage in Large Group Plans Accumulator Adjustment Programs and Cost Sharing.

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