10 Key Facts About Women with Medicare April 30, 2024 Issue Brief This brief examines 10 key facts about women with Medicare and presents new statistics on the health, economic and functional status of women with Medicare.
An Estimated 1 in 4 Medicare Beneficiaries With Obesity or Overweight Could Be Eligible for Medicare Coverage of Wegovy, an Anti-Obesity Drug, to Reduce Heart Risk April 24, 2024 News Release In a new analysis, KFF finds that 3.6 million people with Medicare could be eligible for coverage of Wegovy (semaglutide) now that the Food and Drug Administration has approved the use of the anti-obesity drug to reduce the risk of heart attacks and stroke in certain patients. This change potentially…
A New Use for Wegovy Opens the Door to Medicare Coverage for Millions of People with Obesity April 24, 2024 Issue Brief The FDA recently approved a new use for Wegovy, the blockbuster anti-obesity drug, to reduce the risk of heart attacks and stroke in people with cardiovascular disease who are overweight or obese – a decision that opens the door to Medicare coverage of Wegovy, which is prohibited by law from covering drugs used for obesity. This brief analyses how many Medicare beneficiaries could be eligible for the new use of Wegovy and the potential impact on Medicare spending.
Section 1115 Waiver Watch: Medicaid Pre-Release Services for People Who Are Incarcerated April 16, 2024 Issue Brief In April 2023, the Centers for Medicare and Medicaid Services (CMS) released guidance encouraging states to apply for a new Section 1115 demonstration opportunity to test transition-related strategies to support community reentry for people who are incarcerated. To date, CMS has approved Section 1115 reentry waiver requests from three states (California, Montana, and Washington). This Waiver Watch reviews CMS guidance and summarizes key features of the three approved 1115 reentry waivers.
Gaps in Medicare Advantage Data Remain Despite CMS Actions to Increase Transparency April 10, 2024 Issue Brief The Centers for Medicare and Medicaid Services has recently taken actions to increase transparency in Medicare Advantage, however substantial data gaps remain that limit the ability of policymakers and researchers to conduct oversight and assess the program’s performance, and for Medicare beneficiaries to compare Medicare Advantage plans offered in their area.
SCOTUS Case Could Weaken the Impact of Regulation on Key Patient and Consumer Protections April 9, 2024 Issue Brief This brief discusses the longstanding legal doctrine, Chevron deference, being challenged in two cases before the U.S. Supreme Court and includes examples of what could be at stake for health care consumers should federal courts no longer use this doctrine to address litigation related to federal health regulations. The focus here is on patient and consumer protection regulation, but overturning the Chevron deference would have implications in all areas of health care.
Access to Adult Dental Care Gets Renewed Focus in ACA Marketplace Proposal March 8, 2024 Blog Adult dental care can lead to high out of pocket costs for consumers, especially for those with private insurance coverage. This post analyzes a proposed provision in the HHS Notice of Benefit and Payment Parameters for 2025, and possible implications for consumers who have Marketplace coverage.
Preventive Services Covered by Private Health Plans under the Affordable Care Act February 28, 2024 Fact Sheet Note: This content was updated on February 28, 2024 to incorporate new FAQs from CMS. Tables 1 and 2 were also updated to include updated recommendations. It has been more than ten years since the Affordable Care Act (ACA) required private insurance plans to cover recommended preventive services without any…
3 Charts: Drug Prices in the United States February 7, 2024 News Release This post was updated to clarify that less than 10% of the nation’s total health spending is spent on retail prescription drugs and does not include spending on drugs administrated by physicians or in hospitals.Prescription drug costs are a top concern for the American public. While retail prescription drugs represent…
3 Charts: Medicare Drug Price Negotiations January 31, 2024 News Release Under the Inflation Reduction Act, the federal government for the first time will negotiate directly with drug companies to determine the prices that Medicare will pay for certain high expenditure drugs covered under Medicare Part D (starting in 2026) and Part B (starting in 2028). Part D covers retail prescription…