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NHC Submits Welcome Letter to 119th Congress (PDF) January 9, 2025 The Honorable John Thune The Honorable Mike Johnson Majority Leader Speaker United States Senate U.S Medicaid is a critical lifeline for patients and provides insurance for nearly 80 million people across every state in the country.
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.
However, we urge CMS to consider the following recommendations to ensure the 2025 policies further align with patient-centered care. Created by and for patient organizations more than 100 years ago, the NHC brings diverse organizations together to forge consensus and drive patient-centered health policy.
Coverage of Anti-Obesity Medications (AOMs) The NHC applauds CMS for aligning with the medical community and proposing to recognize obesity as a chronic disease and allow Medicare Part D coverage for AOMs. Below, we provide detailed comments and recommendations on key provisions of the proposed rule.
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
UHGs journey started in 1974 as Charter Med Incorporated, just another claims-processing operation. February 2024 saw UHGs Change Healthcare crippled by a ransomware attackan attack so severe that hospitals shut down operations, surgeries were delayed, and patients were left in limbo. This isnt just an IT problem. Thats double.
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.
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.
16 We encourage CMS to continue refining these data collection processes to ensure they capture meaningful and actionable information. PHPs and IOPs provide structured and intensive care options that are less restrictive than inpatient hospitalization, making them essential components of the continuum of care.
CY 2025 PFS proposed rule). 19 Telehealth reduces the need for costly emergency room visits and hospitalizations by providing patients with convenient access to preventive care and early intervention services. The NHC also emphasizes the importance of continuous evaluation and improvement.
3 Establishing a feedback loop with stakeholders during this monitoring process will provide additional safeguards against adverse effects. Engaging stakeholders in transparent decision-making processes is critical to the success of risk adjustment model updates.
Saransh Chaudhary, President, Global Critical Care, Venus Remedies and CEO, Venus Medicine Research Centre The Union Budget 2025 has brought several positive developments for the pharma industry, including full exemption from basic customs duty on 36 lifesaving drugs and concessional duty of 5 per cent on 6 more.
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