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Cancer Drug Manufacturers Sue HHS OIG Over Denial Of Part D Patient Assistance Program

 
• By Cathy Kelly

Complaint against the US government watchdog agency disputes its conclusion that a proposed cost sharing assistance program in Medicare to be funded by a coalition of cancer drug manufacturers would likely violate the federal anti-kickback statute.

Lawsuit Follows Three Year-Plus Effort To Obtain Favorable OIG Opinion • Source: Shutterstock

The cost sharing limits in Medicare Part D that will be established in the coming years under the Inflation Reduction Act will still leave many patients in need of assistance, a coalition of manufacturers described as the Pharmaceutical Coalition for Patient Access argue in a lawsuit against the Health and Human Services Department’s Office of Inspector General.

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Proposed HHS Budget Would Eliminate Medicare Negotiation Program Start-Up Funding

 
• By Cathy Kelly

The preliminary budget document supports legislation clawing back funds appropriated for the program.

Medicare Price Negotiation: Trump Order Adds Momentum To ‘Pill Penalty’ Fix

 
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Wide-ranging executive order to lower drug prices also hints at changes in upcoming guidance on the Medicare price negotiation program but few other potentially impactful near-term actions.

GLP-1 Drug Coverage Growing For Obesity In Medicaid, But Only For Diabetes In Medicare

 
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Coverage data from the two programs suggest Medicare beneficiaries may be more disappointed than Medicaid enrollees by the Trump Administration’s decision not to mandate the programs cover obesity drugs.

New Medicare Negotiation Program ‘Iterations’ Inevitable, Former CMS Official Blum Says

 
• By Cathy Kelly

Jonathan Blum, who was principal deputy administrator during the Biden Administration, explained the agency’s approach to setting up the price negotiation program and said changes likely will be implemented by the Trump Administration.

More from Government Payers

UK Health Secretary Admits VPAG ‘More Expensive’ Than Expected & Needs To Be ‘Resolved’

 
• By Eliza Slawther

The UK government has listened to industry concerns about high clawback rates under the voluntary scheme and will review it in June in a bid to resolve the issue and “move on to bigger and more important things,” health secretary Wes Streeting says.

Dr. Oz Takes Over CMS Amid Major Transformation Of Medicare Part D

 
• By Cathy Kelly

As CMS administrator, Mehmet Oz will oversee the second cycle of Medicare drug price negotiations and Part D redesign issues, but will have experienced deputies to help.

Dramatic HHS Layoffs A Response To ‘Existential Crisis,’ Kennedy Advisor Argues

 
• By Cathy Kelly

Calley Means defended reductions in force at the Health and Human Services Department that shocked and outraged federal workers and stakeholders.