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Brooks-LaSure: CMS Isn’t Done With Prior Auth, MA Reforms

CMS is open to looking into insurers’ prior authorization practices for prescription drugs, Administrator Chiquita Brooks-LaSure told hospitals during a conference Monday (April 15), adding the administration is also diving into the issue of prior authorization as it relates to Medicare Advantage plans.

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Ed & Workforce Dems Urge DOL To Consider ERISA Advisory Recs On Disability Benes

Democratic leaders of the House Education & the Workforce Committee are urging the Department of Labor to take a close look at the ERISA Advisory Council’s recommendations on ending disability benefits’ discriminatory treatment of conditions related to mental health/substance abuse and let lawmakers know whether additional authorities or resources are needed to implement the proposals.

CMS To Pharmacies: Prepare For Upcoming Part B PrEP NCD

CMS is telling pharmacies and other stakeholders to start preparing now for an upcoming national coverage determination (NCD) under Part B for preexposure prophylaxis (PrEP) using antiretroviral drugs to prevent HIV, laying out coding and other implementation details the agency says pharmacies need to have in place so they won’t disrupt patient access when the NCD comes out.

Sanders Presses For Lower Semaglutide Drug Prices, Novo Nordisk Responds

Senate health committee Chair Bernie Sanders (I-VT) is pressing pharmaceutical company Novo Nordisk to lower prices of its blockbuster semaglutide drugs Ozempic and Wegovy, claiming Medicare will go bankrupt if the prices of the diabetes and obesity drugs are not lowered.

FDA To Hold Financial Transparency Meeting For User Fee Programs

FDA is planning to hold a public meeting on financial transparency and efficiency of the prescription drug, generic drug and biosimilar user fee programs in June, and is soliciting public comments ahead of the event on topics addressed in the programs’ commitment letters.

FTC Uses OARFPA To Enforce Health Information Privacy Protections

The Federal Trade Commission on Thursday (April 12) for the first time took enforcement action through the Opioid Addiction Recovery Fraud Prevention Act to stop a telehealth company from disclosing health data to advertising platforms by bringing a case against Monument, which virtually that treats patients with alcohol addiction.