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A significant part of the Healthesystems vision is to create a more integrated experience for our customers

Regulatory Tag: Cost Containment

December 13, 2024
Ohio Delays Pharmacy Reimbursement Rulemaking to Allow for Stakeholder Input

The Bureau of Workers’ Compensation will take additional time to address stakeholder concerns and make necessary revisions.

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December 9, 2024
CMS Publishes 2025 Q1 Updates to NCCI Edits

Changes will impact DME supplier services, facility outpatient hospital services, and practitioner services.

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December 3, 2024
California Reports on Inflation’s Impact on State Fee Schedule

The CWCI notes that cumulative percent increases to the Official Medical Fee Schedule have been lower than economy-wide inflation.

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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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