Putting Patients First Blog

JULY 2, 2024

Without appropriate guardrails, CMS’ broad definition of drugs eligible for negotiation may discourage these types of improvements. Prior authorization and association with delayed or discontinued prescription fills. Active Moiety and Single Source Qualifying Drugs (Section 30.1) and Keating, N. link] xii Chino, F., and Thom, B.

Drug Pricing 52

Drug Pricing Insurance Coverage and Processing Labelling HIPAA 52

Putting Patients First Blog

JANUARY 27, 2025

To strengthen the proposal, the NHC recommends that CMS avoid implementing rigid definitions of overweight and obese. Instead, CMS should review Part D plan prior authorization criteria to ensure that plan definitions align with treatment guidelines and ICD-10 diagnosis codes, promoting consistency and alignment among providers and payers.

Insurance Coverage and Processing 40

Insurance Coverage and Processing Biosimilars Communication Department of Veterans Affairs 40

PharmD Live

MAY 13, 2024

Defining Polypharmacy: Variability and Impact Polypharmacy, the concurrent use of multiple medications, lacks a universal definition despite its prevalence. It is commonly defined as the routine use of five or more medications, encompassing prescription drugs, over-the-counter (OTC) medications, herbals, and supplements.

Long-Term Care Facilities 105

Long-Term Care Facilities Diabetes Nursing Homes Prescription Filling 105