Federal Policy
As the largest, single US healthcare payer, the government plays a dominant role in shaping the healthcare marketplace. Our experts track, interpret, and model federal policies that affect insurance coverage, access, and consumer choice so you can see around the bend.
Featured Content
CMS Proposes to Cover TMVR under CED
On May 14, CMS released a proposed national coverage determination (NCD) for Transcatheter Mitral Valve Repair (TMVR), and proposed to cover TMVR under its Coverage with Evidence Development (CED) program.
Downward Pressure on Medicare Advantage Payment Continues in Final Rate Notice
On April 7, CMS finalized their Calendar Year (CY) 2015 capitation rates, methodological changes to rates and risk models, and other payment and program policies for Medicare Advantage (MA) and Part D plans.
Congress Proposes Bill to Expand New Technology Add-On Payments for Antibiotics under Medicare
In the July/August 2013 RPM Report, I co-wrote an article with Avalere's Scott Gottlieb and Lauren Barnes discussing the potential to use the new technology add-on payments (NTAPs), a novel pathway created by Congress in 2001, as a foundation for new policies that support innovation and address public health goals.
Congress Passes Drug Quality and Security Act; Includes Both Compounding and Track & Trace Provisions
On Nov. 18, the Senate passed the Drug Quality and Security Act, roughly two months after it passed the House in September, seeking to clarify laws related to human drug compounding and to strengthen the prescription drug supply chain by creating a national system.
Infographic: A View of Broad-Based Efforts to Engage Patients
As regulators struggle to find answers to differing needs across the healthcare sector, patients are becoming a more integral part in shaping policy.
Podcast: Understanding New Approaches to Medicaid Expansion
In this podcast, Matt Eyles, Executive Vice President of Health Plans and Providers, gives a short preview of his upcoming MHPA presentation, Medicaid Premium Assistance Programs: Opportunities and Challenges for States and Plans.