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Regulatory Tag: Cost Containment

November 21, 2024
New York Adopts PBM Regulations, with Exemption for Workers' Comp

Healthesystems' Advocacy & Compliance team successfully engaged the DFS to create an exemption for workers' comp PBMs

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November 11, 2024
CMS to Reduce Medicare Physician Fee

The physician fee schedule will be reduced by 2.93%, while other changes are in store for primary care, telehealth, and more.

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November 11, 2024
Vermont Seeks Stakeholder Input on Medical Fee Schedule

Written comments from stakeholders who use the fee schedule will be accepted until December 15th.

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November 11, 2024
Department of Justice Reaches $21.5 Million Settlement Over Inflated AWP for Compound Ingredients

According to the DOJ, Medisca Inc. purchased resveratrol at $0.37 a gram, sold it for under $2.00 a gram, but reported an AWP of $777 per gram.

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November 4, 2024
Mississippi Requests Stakeholder Input for 2025 Fee Schedule

No deadline for feedback has been given, but the Commission will consider feedback for fee schedule changes for 2025.

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October 21, 2024
California P&T Meeting Reviews Pharmacy Fee Schedule and Formulary Updates

Public comments for the proposed changes to the fee schedule will be accepted until October 23rd.

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October 14, 2024
CWCI: Are Migraine Drugs Becoming a New WC Cost Driver?

Drug payments increased eight-fold since 2018.

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October 14, 2024
California P&T Committee to Discuss Pharmacy Fee Schedule

The meeting takes place October 16th to discuss the fee schedule and other matters.

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September 30, 2024
Texas Releases 2025 Audit Plan

Audits will focus on timely and accurate reimbursement, bill reporting, and delivery of benefits.

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September 16, 2024
Oregon to Hold Rulemaking Advisory Committee Meeting

A November 5th meeting will review fee schedule revisions and certain reimbursement rules.

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