On Dec. 12, 2024, the Centers for Medicare and Medicaid Services (CMS) issued a final rule titled, “Modifications of Health Insurance Portability and Accountability Act of 1996 (HIPAA) National Council for Prescription Drug Programs (NCPDP) Retail Pharmacy Standards; and Modification of the Medicaid Pharmacy Subrogation Standard” (Final Rule).
Prescription Digital Therapeutics (PDTs) offer vast opportunities but require careful consideration for coverage and reimbursement. At the direction of the AMCP Board of Directors we have developed definitions and principles to simplify your decision-making and provide digital health innovators with essential insights for evaluating safety and efficacy.
On November 12, more than 50 managed care professionals and various health care stakeholders gathered in Old Town Alexandria, Virginia to examine these barriers to adoption for RWE in managed care. The multi-day meeting, our latest Partnership Forum event hosted by the AMCP Research Institute, consisted of a series of workshops that challenged participants to examine opportunities and challenges posed by RWE use and identify ways to address these barriers to adoption through refining and applying a set of RWE standards geared toward payer decision-makers that we have developed over the past year.
Academy of Managed Care Pharmacy (AMCP) issued the following statement from AMCP CEO Susan A. Cantrell, RPh, CAE about the passing of Brian Thompson, UnitedHealthcare CEO.
On December 4, 2024, the Centers for Medicare and Medicaid Services (CMS) announced that two drug manufacturers of gene therapies for sickle cell disease have entered into agreements to participate in the Cell and Gene Therapy Access Model (CGT Access Model).
Our Associate Vice President of Congressional Affairs Adam Colborn unpacks the key issues the health policy community should be on watch for when preparing for the incoming presidential administration in a recent article for First Report Managed Care.
AMCP Publishes 2024 Election Impacts Deck. Following the Nov. 5 general election, AMCP published a deck highlighting the election results and their expected impact on health policy nationwide.
The United States Pharmacopeia Convention (USP) and the United States Food and Drug Administration (FDA) have updated an educational resource on biosimilars to help healthcare practitioners improve patient confidence in the quality and effectiveness of these treatment options. The following are recommended social media, website, and email content you can use to share this resource with your network.
On November 21, the New York Department of Financial Services (DFS) announced sweeping
market conduct regulations for pharmacy benefit managers (PBMs) serving health plans in the state. The DFS rule implements a landmark 2021 bill, S. 3762/A. 1396, which imposed restrictions on PBM contracts with health plans and pharmacies and established consumer
protections. This action follows previous DFS rulemaking that created a broad definition of
pharmacy benefit management services, required PBMs operating in the state to obtain a license, and established annual reporting requirements.