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Rural Health Information Hub

Rural Health
News by Topic: Pharmacy and prescription drugs

Nov 13, 2024 - Outlines current and projected funding challenges for Federally Qualified Health Centers. Discusses common sources of revenue, reimbursement rates, the 340B program, and policy opportunities for federal and state government. Notes that rural residents are a significant user base for Community Health Centers.
Source: The Commonwealth Fund
Nov 6, 2024 - Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on the following information collections: 1) Quality Improvement Organization (QIO) Assumption of Responsibilities and Supporting Regulations; and 2) CMS Plan Benefit Package (PBP) and Formulary CY 2026. Comments are due by January 6, 2025.
Source: Federal Register
Nov 1, 2024 - Pre-publication notice of final rule from the Centers for Medicare & Medicaid Services (CMS) addressing: 1) changes to the Physician Fee Schedule and Medicare Part B payment policies; 2) policies for the Medicare Prescription Drug Inflation Rebate program under the Inflation Reduction Act of 2022; 3) updates to the Medicare Diabetes Prevention Program expanded model; 4) payment for dental services inextricably linked to specific covered medical services; 5) updates to drugs and biological products paid under Part B including immunosuppressive drugs and clotting factors; 6) Medicare Shared Savings Program requirements; 7) updates to the Quality Payment Program; 8) Medicare coverage of opioid use disorder services furnished by opioid treatment programs; 9) updates to policies for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs); 10) electronic prescribing for controlled substances for a covered Part D drug under a prescription drug plan or an MA-PD plan; 11) updates to the Ambulance Fee Schedule regulations; 12) updates to Clinical Laboratory Fee Schedule regulations; 13) updates to the diabetes payment structure and COVID-19 public health emergency (PHE) flexibilities; 14) expansion of colorectal cancer screening and Hepatitis B vaccine coverage and payment; 15) establishing payment for drugs covered as additional preventive services; and 15) Medicare Parts A and B Overpayment Provisions of the Affordable Care Act and Medicare Parts C and D Overpayment Provisions of the Affordable Care Act. These regulations are effective January 1, 2025.
Source: Federal Register
Oct 28, 2024 - Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on a new information collection request titled "Medicare Transaction Facilitator for 2026 and 2027 under Sections 11001 and 11002 of the Inflation Reduction Act (IRA) Information Collection Request." CMS will collect information from manufacturers of Medicare Part D drugs selected for negotiation under the Inflation Reduction Act for the initial price applicability years 2026 and 2027 and the dispensing entities that dispense the selected drugs to maximum fair price (MPF)-eligible individuals. CMS will also use a Medicare Transaction Facilitator (MTF) to facilitate the effectuation of MPFs. Comments are due by December 27, 2024.
Source: Federal Register
Oct 28, 2024 - Notice of proposed rules from the Employee Benefits Security Administration (EBSA), Internal Revenue Service (IRS), and Department of Health and Human Services (HHS), proposing to amend regulations regarding coverage of certain preventive services under the Patient Protection and Affordable Care Act, which requires non-grandfathered group health plans and non-grandfathered group or individual health insurance coverage to cover certain over-the-counter and prescription contraceptive items without cost sharing. These proposed rules would not modify federal conscience protections related to contraceptive coverage for employers, plans, and issuers. Comments are due by December 27, 2024.
Source: Federal Register
Oct 21, 2024 - Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on the following information collections: 1) National Provider Identifier (NPI) Application and Update Form and Supporting Regs in 45 CFR 142.408, 45 CFR 162.408, 45 CFR 162.406; and 2) Medicare Drug Coverage and Your Rights. Comments are due by November 20, 2024.
Source: Federal Register
Oct 10, 2024 - Notice of proposed rule from the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) proposing payment parameters and provisions related to the risk adjustment and risk adjustment data validation programs and user fee rates for federally-facilitated exchanges and state-based exchanges on the federal platform, among other things. Comments are due by November 12, 2024.
Source: Federal Register
Oct 8, 2024 - Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on the reinstatement of an information collection titled "Medicare Program: Conditions for Payment of Power Mobility Devices, including Power Wheelchairs and Power-Operated Vehicles." This information collection is related to requirements for a face-to-face examination of the beneficiary by the physician or treating practitioner, a written prescription, and receipt of pertinent parts of the medical record by the supplier within 45 days after the face-to-face examination that the durable medical equipment (DME) suppliers maintain in their records and make available to CMS and its agents upon request. Comments are due by November 7, 2024.
Source: Federal Register
Oct 2, 2024 - Notice from the Centers for Medicare & Medicaid Services (CMS) making technical and typographical corrections to the August 28, 2024, final rule. This correction is effective October 1, 2024.
Source: Federal Register
Sep 30, 2024 - Notice from the Centers for Medicare & Medicaid Services (CMS) making technical and typographical corrections to the April 23, 2024, final rule. This correcting amendment is effective September 30, 2024.
Source: Federal Register