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Brian Skeats

Brian Skeats

The Medicare Part D Notice is just one of the many compliance responsibilities to which most employer health plans are subject. Since this notice is due in just a couple of weeks, continue reading for what you need to do.

Monday, 13 August 2018 09:25

The Battle to Cut Pharmacy Costs

This past May, the Trump administration released its plans to reduce pharmaceutical prices on four fronts. The policy was laid out in a blueprint which describes the various fronts the Center for Medicare and Medicaid Services (CMS) and the department of Health and Human Services (HHS) propose to take to alleviate the problem. The four areas the administration proposes to target for action are increasing competition, better negotiation, creating lower list prices, and reducing patient Out-of-Pocket spending. Since all employer plans are impacted by the rising costs of prescriptions, we are encouraged to see active steps proposed to address the problem.

The Patient Centered Outcomes Research Institute (PCORI) fee is due July 31, 2018 for employers with any type of self-funded plan and/or a Health Reimbursement Arrangement. The fee helps fund unbiased research that evaluates the clinical effectiveness of medical treatments regardless of the profit potential. This fee is also known as the Comparative Effectiveness Research Fee, or CERF.

Monday, 14 May 2018 09:48

The Latest ACA Regulatory Changes

The final Affordable Care Act provisions for 2019 have been released and they are in line with the regulations proposed on October 27, 2017. The provisions primarily concern the out-of-pocket maximums, Essential Health Benefits (EHBs), and the Marketplace.