Medicare

CMS Nominee Oz Nears Confirmation Despite Concerns About Medicaid Cuts

 
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Democrats opposed the nomination because they believe Mehmet Oz will not defend Medicaid from spending cuts. His pledge to continue lowering drug costs in Medicare and Medicaid did not offset the concerns.

Study Shows ‘Insurer-PBMs’ Dominate Medicare Part D, Steer Patients to Their Pharmacies

 
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An analysis of Medicare Part D and other data found that more than one-third of all pharmacy spending went through pharmacies owned by Cigna, CVS Health, Humana or UnitedHealth Group.

Stelara Biosimilars Storm US Market With 85% Discounts Ahead Of Price Drop In Medicare

 
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The development could highlight the power of competitive market forces over government price controls or suggest Medicare price negotiation is enhancing competitive market forces.

Oz’s Magic: US CMS Administrator Pick Praises Staff, Unlike Other Trump Health Care Nominees

 

US CMS Administrator nominee Mehmet Oz promises to inspire the agency he is set to lead and seems likely to succeed compared to other Trump Administration nominees.


Medicare Part D Spending Cap Will Save Seniors $7bn in 2025, HHS Data Suggests

 
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An ASPE report on Part D savings released before the Trump Administration took office indicated the new $2,000 spending cap could save some beneficiaries thousands of dollars per year.

Medicare Price Negotiation ‘One of Many’ Solutions CMS Will Pursue, Oz Says

 
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Physician and TV personality Mehmet Oz, who is President Trump's nominee for CMS administrator, said he was instructed by President Trump to explore “every single way” the agency could lower drug costs.

CMS May Engage In Medicare, 340B Discount Deduplication ‘Eventually,’ Ex-CMS Official Says

 
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Former CMS official John Coster offered insights into why the agency has declined to directly engage in efforts to avoid duplication of Medicare negotiated prices and 340B discounts during an interview with the Pink Sheet.

Health Insurers May Sue if CMS Finalizes Obesity Drug Coverage Expansion

 
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Insurance companies and others warned that CMS could be sued over its reinterpretation of existing law expanding coverage of GLP-1s for obesity treatment.


IRA Negotiation Changes: Pharma’s Focus Remains On Near-Term Legislative, Regulatory Options

 
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Manufacturers still hope to advance legislation removing the “pill penalty” from the law, as well as changes they want included in the CMS guidance for the 2028 price implementation year.

PhRMA Kicks Off Year Attacking China, Wrapping Agenda In American Flag

 

US pharma leadership is painting its mission, particularly its goal to end Medicare price controls, as patriotic and essential to America’s global dominance over China, a move that seems designed to align with President Trump’s priorities.

PhRMA Still All In For Trump Despite Chaos Hitting US Health Sector

 

The pharmaceutical industry has been quiet on Trump's early federal government overhauls that could harm the drug business, still betting he will help produce better results than Biden.

CMS Layoffs Broader Than Reports Indicate, Former Administrator Brooks-LaSure Says

 
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The "interwoven" nature of the offices within the agency likely means Medicare and Medicaid benefits may be disrupted by staff cuts despite assurances from the administration, Brooks-LaSure warned.


Congress Can, But Likely Will Not, End Part D Stabilization Demo

 
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Congress may be empowered to change the Part D stabilization demo, but a health policy expert said CMS is more likely to repeal, adjust or replace the program.

US Medicare Agency Brings Back Familiar Faces For Trump 2.0

 

Several first-term Trump veterans are returning to leadership roles at the US Centers for Medicare and Medicaid Services ahead of the expected confirmation of Mehmet Oz to lead the agency.

Medicare Part D Redesign: More Firms See New Discounts Offsetting Spending Cap Benefit

 
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AbbVie, J&J, Merck and Pfizer discussed recent projections for the redesign's impact.

Medicare 2027 Negotiating Class: Austedo, Linzess, Xifaxan May Face Generic, OTC Price Comparators

 
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Manufacturers will address what constitutes appropriate therapeutic alternatives for the selected drugs as part of the negotiation process.


Medicare Price Negotiation Will Continue Under Trump With Possible ‘Improvements’

 
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HHS Secretary nominee Robert F. Kennedy Jr. discussed the Trump Administration's support for Medicare price negotiation during his confirmation hearing.

Pink Sheet Podcast: Concerns and Questions As Trump Administration Takes Control Of US FDA

Pink Sheet reporter and editors discuss the uncertainty created by the Trump Administration freezing most communications at the Health and Human Services Department, new travel and telework bans, as well as the delay in announcing an acting FDA leader and the impact of new executive orders on the FDA and CMS.

Deciphering Trump’s Executive Order On Medicare, Medicaid Payment Models

 
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Since CMMI does not need an executive order to conduct demonstrations, President Trump's executive order does not appear to mean the models developed under the Biden Administration will be suspended, yet.

Medicare Price Negotiation Round Two: New Administration, More Drugs, Less Time

 
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Speculation that the Trump Administration may "pause" the second negotiation cycle to make changes to the program adds uncertainty to an already challenging scenario.