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Medicare Coverage of Wegovy Raises Questions Regarding the Affordability and Accessibility of Novel Medications | McDermott+Consulting

Last week, the Centers for Medicare & Medicaid Services (CMS) announced that it would allow health plans under Medicare Part D (the Medicare prescription drug benefit) to cover Wegovy...
Parashar Patel Amy Kelbick Paul Radensky Us Department Of Health Human Services Centers For Medicare Medicaid Services

CMS Finalizes its Proposal to Advance Interoperability and Improve Prior Authorization Processes | Sheppard Mullin Richter & Hampton LLP

On December 13, 2022, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule, titled Advancing Interoperability and Improving Prior Authorization Processes...
Children Health Insurance Program Centers For Medicare Medicare Promoting Interoperability Program Department Of Health Medicaid Services Health Insurance Portability

Health Care Week in Review: Congress Passes Continuing Resolution to Avert Government Shutdown; CMS Issues Final Rule on Interoperability and Prior Authorization | Alston & Bird

Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and...
District Of Columbia United States Los Angeles Angela Meriquez Rachel Beale Nicole Heim

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Centers for Medicare and Medicaid Services Interoperability Rules

Advancing Interoperability and Improving Prior Authorization Processes Proposed Rule. If certain components finalized impacted payors required compliance by 1 January 2026. Prior Authorization Proposed Rule builds upon CMS Interoperability and Patient Access Final Rule.
United States Public Health Emergency On Medicare Promoting Interoperability Program Children Health Insurance Program American Hospital Association Centers For Medicare Medicaid Services

HHS Finalizes Rule to Strengthen Medicare, Improve Access to Affordable Prescription Drug Coverage, and Hold Private Insurance Companies Accountable to Delivering Quality Health Care for America's Seniors and People with Disabilities

New law to lower prescription drug costs, the final rule will also improve access to affordable prescription drug coverage for an estimated 300,000 individuals
United States Meena Seshamani Xavier Becerra Centers For Medicare Medicaid Services Behavioral Health Strategy Biden Harris Administration
Source: hhs.gov

UnitedHealth Group reduces use of prior authorization process by 20%

Ahead of a final rule that would limit the amount of time insurers have to approve prior authorization requests and would require an electronic, FHIR API standard, UnitedHealth Group on Wednesday said it would reduce the use of its prior authorization process by 20% for some nonurgent surgeries and procedures. Starting this summer, hospitals and physicians will get coverage
Anne Docimo Health Level Unitedhealth Group On Gold Card Program Unitedhealth Group Medicaid Services

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