CMS finalizes policies to enhance consumer protections, promote competition, and expand access to care for Medicare Advantage (MA) and Medicare Part D; digital therapeutic Rejoyn receives FDA clearance for adults with major depressive disorder (MDD); study reveals minimal symptom reduction from nirmatrelvir–ritonavir (Paxlovid) in high-risk, fully vaccinated patients.
CMS Strengthens Protections, Access for MA, Part D Enrollees
CMS announced the finalization of policies that aim to increase enrollee protections and enhance access to care in Medicare Advantage (MA) and Medicare Part D prescription drug plans, according to a press release. Key measures include restrictions on insurance agent compensation, prohibition of personal beneficiary data sharing, and requirements for health equity analysis and behavioral health provider inclusion. Additionally, the rule mandates evidence-based supplemental benefits, promotes biosimilar substitution, and prioritizes access to accurate information for Medicare enrollees.
FDA Approves First Prescription Digital Treatment for Adults With MDD
The FDA has authorized the use of Rejoyn, the first prescription digital treatment for adults with major depressive disorder (MDD), according to CNN. Developed by Otsuka Pharmaceutical and Click Therapeutics, Rejoyn utilizes a 6-week program incorporating cognitive-emotional training and cognitive behavioral therapy lessons, designed to complement existing antidepressant medications. While the app's effectiveness was not significantly different from a sham app in clinical trials, it aims to serve as an adjunct therapy for partial responders to antidepressants.
Limited Efficacy of Paxlovid in Fully Vaccinated Individuals
A recent study showed nirmatrelvir–ritonavir (Paxlovid) showed little efficacy in reducing symptoms among fully vaccinated individuals with COVID-19 risk factors, according to CIDRAP. In the trial, which included 1296 participants, there was no significant difference in symptom duration between those who received Paxlovid and those who received a placebo. Experts cautioned that the study's findings may not apply to older patients, and further research is needed to evaluate the drug's long-term effectiveness and its potential to prevent long COVID.
CMS Medicare Final Rule: Advancing Benefits, Competition, and Consumer Protection
May 7th 2024On this episode of Managed Care Cast, we're talking with Karen Iapoce, senior director of government products and programs at ZeOmega, about the recent CMS final rule on Medicare Part D and Medicare Advantage.
Listen
Traditional Medicare Supplemental Insurance and the Rise of Medicare Advantage
May 7th 2024Rising Medicare Advantage enrollment occurred alongside declines in enrollment in traditional Medicare with employer-sponsored supplemental coverage and traditional Medicare without supplemental coverage.
Read More
Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
Listen
The Senate Finance Committee has introduced bipartisan legislation that proposes using Medicaid and Medicare programs to help prevent and reduce generic drug shortages; US indicators for COVID-19, flu, and respiratory syncytial virus (RSV) declined further last week; findings from a recent study reveal growing disparities in child death rates across racial and ethnic groups.
Read More
Access Denied: CMS’ Action Hurts Patients With Cancer in Rural America
May 6th 2024CMS rules hindered the access of rural patients with cancer to medically integrated pharmacies in 2023. The authors discuss the impact on equity in health care, emphasizing the need for regulatory change.
Read More