Proposed Coverage of Anti-Obesity Drugs in Medicare and Medicaid Would Expand Access to Millions of People with Obesity November 26, 2024 Blog This policy watch examines the implications of new proposed regulations that would allow Medicare and require Medicaid to cover drugs used to treat obesity, including a relatively new class of highly effective but costly drugs known as GLP-1s.
Medicare Part D in 2025: A First Look at Prescription Drug Plan Availability, Premiums, and Cost Sharing November 22, 2024 Issue Brief Medicare Part D is a voluntary outpatient prescription drug benefit for people with Medicare provided through private plans, including stand-alone prescription drug plans and Medicare Advantage plans that offer drug coverage. This analysis provides an overview of Medicare Part D plan availability, premiums, and cost sharing in 2025 and key trends over time.
FAQs about the Inflation Reduction Act’s Medicare Drug Price Negotiation Program November 19, 2024 Issue Brief The Centers for Medicare & Medicaid Services (CMS) recently concluded the first round of negotiation for the new Medicare Drug Price Negotiation Program, which was established by the Inflation Reduction Act. These FAQs address several questions related to Medicare’s drug price negotiation program and CMS’s implementation of the program, with a focus on the details that apply for 2027, the second year that negotiated prices will be available under the program.
Weighted Average Monthly Premium for Medicare Part D Stand-alone Prescription Drug Plans November 7, 2024 State Indicator
Medicaid Coverage of and Spending on GLP-1s November 4, 2024 Issue Brief This brief examines the implications of rising prescriptions for costly GLP-1 drugs for state Medicaid programs as more states consider covering the drugs for weight loss. It examines recent trends in Medicaid prescriptions and gross spending on GLP-1s, and explores the potential implications of expanding coverage obesity drugs for Medicaid programs.
Copay Adjustment Programs: What Are They and What Do They Mean for Consumers? October 24, 2024 Issue Brief Drug makers sometimes offer copay coupons to lower consumers’ out-of-pocket costs for their brand-name prescriptions, though how private health plans treat those coupons can substantially limit their value to consumers. This issue brief provides an overview of such copay adjustment programs, stakeholder arguments for and against their use, their prevalence, and federal and state efforts to address them.
As Pandemic-Era Policies End, Medicaid Programs Focus on Enrollee Access and Reducing Health Disparities Amid Future Uncertainties: Results from an Annual Medicaid Budget Survey for State Fiscal Years 2024 and 2025 October 23, 2024 Report This report highlights certain policies in place in state Medicaid programs in FY 2024 and policy changes implemented or planned for FY 2025, which began on July 1, 2024 for most states.
After Pandemic-Era Policies and Enhanced Funding End, State Medicaid Officials Report Enrollment Declines and Upward Cost Pressures October 23, 2024 News Release States expect national Medicaid enrollment to decline by about 4% and state Medicaid spending to rise by 7% in fiscal year (FY) 2025. These rates follow a larger but anticipated enrollment decline and state spending increase in FY 2024, as pandemic-era policies and federal funding expired, according to KFF’s 24th…
Recent Trends in Medicaid Outpatient Prescription Drugs and Spending October 11, 2024 Issue Brief This issue brief describes recent trends in the number of Medicaid outpatient prescriptions and the spending on those drugs and examines how the pandemic and pandemic-era policies may have impacted those trends.