Medicare
Documentation of surgical decision-making may reduce Medicare audit requests
SAN DIEGO — Standardized documentation of surgical decision-making and preoperative surgical care may reduce Medicare audit requests for total joint arthroplasty cases, according to results.
High inhaler costs increase difficulties for patients, cause skipped doses
SAN DIEGO — More research is needed to determine drivers of inhaler costs and patient knowledge on available financial assistance, according to a poster presentation here.
ACR cheers ‘positive first step’ in reforming prior authorization for Medicare
Prior authorization reforms, increased biosimilar access and the future of the Medicare drug price negotiation program are among the American College of Rheumatology’s top concerns in a letter recently submitted to CMS.
COPD inhaler adherence rises with lower cost sharing, medication management service invite
Patients with COPD had better inhaler adherence when invited to enroll in a program that lowers cost sharing for maintenance inhalers and offers medication management services, according to results published in JAMA Internal Medicine.
Odds for poor outcomes high with endobronchial valve vs. lung volume reduction surgery
Medicare beneficiaries with emphysema who received an endobronchial valve vs. lung volume reduction surgery faced elevated risk-adjusted odds for poor outcomes, according to data presented at the Society of Thoracic Surgeons Annual Meeting.
‘We applaud CMS’: Two more rheumatology drugs bound for Medicare price negotiation
The second round of Medicare Part D price negotiations will feature two drugs familiar to rheumatologists — Ofev and Otezla — a move applauded by experts as they await the impact of the first-round of discounts anticipated next year.
Competitive Bidding Program not linked to supplemental oxygen use, COPD outcome changes
No link was found between Competitive Bidding Program implementation and changes in supplemental oxygen use or clinical outcomes in a population of Medicare beneficiaries with COPD, according to results published in JAMA Internal Medicine.
Phosphate binder rule is disease-specific discrimination
In April, CMS issued guidance for the inclusion of oral-only drugs in the end-stage renal disease bundled payment. The directive included Xphozah as a renal dialysis service.
ACR urges congressional leaders to reform ‘underwater’ biosimilar reimbursement
The American College of Rheumatology has joined a coalition of more than 40 other organizations calling on congressional leaders to address what they see as insufficient Medicare reimbursements for biosimilars.
Biden proposes Medicare, Medicaid cover weight-loss drugs for obesity
On Tuesday, the Biden-Harris administration proposed a rule that would require Medicare and Medicaid to cover anti-obesity medications.