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Cigna is working with an investment bank to evaluate options for its Medicare Advantage business, which could fetch several billions of dollars in a potential divestment, the sources said. Cigna's Medicare Advantage business generated 4.4% of the company's $179.4 billion in revenue from external customers in 2022. Cigna also said profit margins in Medicare Advantage in 2023 continue to be below its long-term target of 4% to 5%, which it expected to remain the case in 2024. Cigna has said it expects changes to the government's star rating system, which informs some of the reimbursement decisions, will lead to a decrease in the rating of its Medicare Advantage business in payment-year 2024. Cigna said in September it would pay about $172 million to settle charges from U.S. prosecutors that it overcharged the Medicare Advantage program by making patients appear more ill than they actually were.
Persons: Andrew Kelly, Cigna, Goldman Sachs, David Carnevali, Bill Berkrot Organizations: REUTERS, Cigna, Reuters, Medicare, U.S . Centers, Services, U.S . Department of Health, Human Services, Thomson Locations: Queens , New York City, U.S, HealthSpring, Bloomfield , Connecticut, New York
Research suggests each geriatrician should care for no more than 700 patients; the current ratio of providers to older patients is 1 to 10,000. In some respects, geriatrics has been remarkably successful in disseminating principles and practices meant to improve the care of older adults. Under this model, older adults with acute but non-life-threatening illnesses get care at home, managed closely by nurses and doctors. In July 2019, the American College of Surgeons created a program with 32 standards designed to improve the care of older adults. The bright lights, noise, and harried atmosphere in hospital emergency rooms can disorient older adults.
Persons: Jerry Gurwitz, , ” Gurwitz, What’s, “ There’s, , geriatrician Gregg Warshaw, geriatrics, Michael Harper, Thomas Robinson, geriatricians, Dr, Sanjay Gupta, Lisa Walke, Harper Organizations: CNN, University of Massachusetts Chan Medical, National Academies of Sciences, Engineering, Medicine, American Geriatrics Society, University of North Carolina School of Medicine, University of California, Seniors, American College of Surgeons, Initiative, Geriatric, American College of Emergency Physicians, Centers, Medicare, Medicaid Services, UCLA, Indiana University, Johns Hopkins University, UCSF, Get CNN, CNN Health, Penn Medicine, University of Pennsylvania, KFF Health, Kaiser Health, KFF Locations: United States, San Francisco
Political Cartoons View All 1230 ImagesThe Montana State Hospital violates those laws and its patients' constitutional rights to dignity and due process, the lawsuit states. DiMauro, who suffered a traumatic brain injury in 2012, was admitted to the Montana State Hospital in September 2020. Staff also failed to treat a wound on his forehead that he suffered in a fall, the lawsuit states. Patzoldt, then 75, was admitted to the Montana State Hospital on Oct. 19, 2021, after having behavioral disruptions at a memory care center. A review of his records found his heart medication was not given to him for nearly three weeks in November 2021, the lawsuit states.
Persons: HELENA, Lucio DiMauro, David Patzoldt, Lesley Jungers, Greg Gianforte, Patzoldt, cellulitis Organizations: , Montana State Hospital, Department of Public Health, Human Services, The Montana State Hospital, Staff, Medicare, Services Locations: Mont, Butte, Spokespeople, COVID, Montana
Andreswd | E+ | Getty ImagesMedicare beneficiaries have until Dec. 7 to change their Medicare health and prescription drug coverage for the coming year through open annual enrollment. Starting in 2024, people who face high prescription drug costs will not have to pay anything out of pocket once they hit the catastrophic phase of their benefits, she noted, thanks to new prescription drug legislation. Notably, Medicare beneficiaries who take insulin currently do not have to pay more than $35 per month for covered prescriptions. There are other reasons why Medicare beneficiaries should pay attention to the annual enrollment period this year. Medicare open enrollment is when beneficiaries can shop around for health plans or prescription drug coverage that better meet their needs.
Persons: Meena Seshamani, Seshamani, Darren Hotton, Hotton, that's, Catherine, There's Organizations: Getty, Center, Medicare, Centers, Services, National Council, Aging, Insurance, State Health Insurance Locations: Catherine Falls, Medicare.gov, ShipHelp.org, Utah
The standard monthly premium for Medicare Part B will increase by $9.80 per month in 2024, according to the Centers for Medicare and Medicaid Services. That means the standard monthly premium will go up to $174.70 in 2024, an increase from $164.90 in 2023. The new rate is in line with previous projections by Medicare trustees, which had estimated a $174.80 standard monthly premium for next year. The annual deductible for Medicare Part B will be $240 in 2024, a $14 increase from the $226 annual deductible in 2023. Medicare Part B covers physician services, outpatient hospital services, some home health care services, durable medical equipment and certain other services not covered by Medicare Part A.
Organizations: Medicare, Centers, Services
During the enrollment period, which ends Dec. 7, people will have the opportunity to choose between traditional Medicare and privately run Medicare Advantage plans in their area, as well as prescription drug plans. Medicare Advantage plans provided by insurers frequently offer prescription drug coverage , as well as extra benefits like dental or vision coverage not provided by traditional Medicare. The federal government also said Thursday that millions of Social Security recipients will get a 3.2% increase in their benefits next year. The average Medicare beneficiary could choose from 43 Medicare Advantage plans for this year, or more than double the choices available in 2018, according to KFF. After this year’s open enrollment window ends in December, people will be able to switch to another Medicare Advantage plan or opt for traditional Medicare during another enrollment period from Jan. 1 to March 31.
Persons: Tricia Neuman, KFF, Neuman Organizations: Medicare, Medicare’s, Social Security, Services, Social
During the coronavirus pandemic, states were prohibited from removing people from Medicaid in exchange for receiving enhanced federal funding. States have 14 months to finish their backlog of eligibility reviews, according to guidelines from the federal Centers for Medicare and Medicaid Services. Like in most states, many of those who lost Medicaid coverage in Arkansas were removed for procedural reasons, such as not returning renewal forms needed to verify their eligibility. People removed from Medicaid can regain coverage retroactively if they provide information proving their eligibility within 90 days. Arkansas' percentage decline in children covered by Medicaid ranks among the largest in the nation, Alker said.
Persons: , Joan Alker, Kristi Putnam, ” Putnam, Sarah Huckabee Sanders ’, Grant Tennille, “ It’s, ” Tennille, Tippi McCullough, ” McCullough, Joe Biden's, Alker, ___ Lieb Organizations: Republican, Georgetown University Center for Children, Medicare, Services, Arkansas Department of Human, Republican Gov, Arkansas Democratic, Medicaid, District of Columbia, Arkansas Locations: Arkansas, Jefferson City , Missouri
AdvertisementAdvertisementThe Biden administration announced Tuesday it is beginning talks with drug makers behind 10 expensive medications to lower prices for recipients of Medicare, the national health insurance program for older Americans and people with disability status. The negotiations are expected to last until 2024, with the lower prices expected to go into effect in 2026. The Congressional Budget Office "estimated that price negotiation will lower average drug prices paid by Medicare and will reduce the budget deficit by $25 billion in 2031." "Negotiating provides us a critical tool to ensure they get those prescription drugs at lower prices – just as the U.S. Department of Veterans Affairs has done for years." AdvertisementAdvertisementThe Biden administration has recently taken aim at high drug prices and high profits at pharmaceutical companies.
Persons: , Biden, Juliette Cubanski, Harris, Xavier Becerra, Jardiance, Eli Lilly Organizations: Service, Congressional, Medicare, Biden, Harris Administration, Human Services, U.S . Department of Veterans Affairs, HHS, Centers, Services
Also included is diabetes treatment Jardiance, which was used by nearly 1.6 million Medicare enrollees and had a 2022 out-of-pocket cost per enrollee of $490. In all last year, 9 million seniors and other Medicare beneficiaries paid more than $3.4 billion on these 10 drugs alone, the White House said. “For decades, drug companies in America made record profits while big pharma worked to block Medicare from being able to negotiate lower drug prices for seniors. Even with with Tuesday's prescription drugs announcement, however, the process could still be complicated by lawsuits from drugmakers and sharp criticism from Republicans. Biden noted that the drug manufacturers' agreeing to participate followed a court decision allowing Medicare price negotiation plans to move forward.
Persons: Joe Biden, White, , ” Biden, Biden, Organizations: WASHINGTON, Medicare, Services, Democratic, Biden Locations: America, Atlanta
A pharmacist holds a bottle of the drug Eliquis, made by Pfizer Pharmaceuticals, at a pharmacy in Provo, Utah, January 9, 2020. All drugmakers of the first 10 medicines selected for Medicare drug price negotiations have agreed to participate in the talks, even after many of them sued to halt the process last month. The Centers for Medicare & Medicaid Services did not immediately respond to a request to confirm that all drugmakers agreed to the talks. President Joe Biden's Inflation Reduction Act, which passed last year, empowered Medicare to negotiate drug prices for the first time in the program's six-decade history. The pharmaceutical industry also argues that the process will threaten revenue growth, profits and drug innovation.
Persons: Joe Biden's, Boehringer Ingelheim, Johnson Januvia, Merck Farxiga, Novartis Enbrel, Amgen Imbruvica, AbbVie Stelara, Janssen, Bristol Myers, Biden Organizations: Pfizer Pharmaceuticals, CNBC, Medicare, Services, Sunday, Bristol Myers Squibb Jardiance, Johnson, Merck, AstraZeneca Entresto, Novartis, Novo Nordisk, U.S, CMS, Bristol, Bristol Myers Squibb Locations: Provo , Utah
U.S. President Joe Biden delivers remarks on Social Security and Medicare at the University of Tampa in Tampa, Florida, U.S. February 9, 2023. The ruling is the first to come from multiple lawsuits by drug companies and industry groups challenging the program. The drug price negotiation program is part of the Inflation Reduction Act, which Biden, a Democrat, signed last year. The Biden administration has repeatedly said there is nothing in the Constitution that prohibits drug price negotiations. Many other countries already negotiate drug prices.
Persons: Joe Biden, Jonathan Ernst, vindicating, Joe Biden's, Michael Newman, Biden, drugmakers, Newman, Karine Jean, Pierre, Donald Trump, Johnson, Januvia, Bristol Myers, Boehringer, Brendan Pierson, Nate Raymond, Costas Pitas, Alexia Garamfalvi, Bill Berkrot, Chris Reese, Leslie Adler Organizations: Social Security, University of Tampa, REUTERS, U.S, District, U.S . Chamber of Commerce, Medicare, Commerce, U.S . Justice, Republicans, Big Pharma, Republican, U.S . Centers, Medicaid Service, CMS, Bristol Myers Squibb, Pfizer, Johnson, Merck, Co's, Pharmaceutical Research, Manufacturers of America, Companies, Thomson Locations: Tampa , Florida, U.S, Dayton , Ohio, New York, Boston
AstraZeneca and Boehringer Ingelheim on Wednesday told CNBC they will agree to participate in the first round of Medicare drug price negotiations, even after both pharmaceutical companies sued to halt the process last month. AstraZeneca's Type 2 diabetes drug Farxiga and Boehringer Ingelheim's own diabetes drug Jardiance are among the first 10 drugs selected for price talks with Medicare. Manufacturers of the other eight drugs selected have until Oct. 1 to sign an agreement to participate in the process. The Inflation Reduction Act, which passed Congress last year in narrow party-line votes, empowered Medicare to negotiate drug prices for the first time in the program's six-decade history. The law is the central pillar in the Biden administration's efforts to control rising drug prices and was a major victory for the Democratic Party.
Persons: Farxiga, Boehringer Ingelheim, Boehringer, AstraZeneca, Biden Organizations: New, Halsted Pharmacy, AstraZeneca, Boehringer, Wednesday, CNBC, Medicare, Manufacturers, CMS, Centers, Services, Bristol Myers Squibb, Johnson, Merck, Chamber of Commerce, Democratic Party Locations: Chicago , Illinois
Patients with private health insurance aren't likely to see a drop in costs from the negotiations. Longo said the price-setting provisions will drive research and investment away from treatment options for Medicare patients. If drug companies won't come to the negotiating table to lower drug prices paid by private insurers, those insurers could take the companies' drugs off their lists of covered medications. Or, if private insurance companies don't negotiate drug prices down for their patients, patients in some cases could seek out different insurance. "These are not full solutions, but they are the beginning of cracks in the facade" of drug companies' constant price hikes, Feldman said.
Persons: Biden, Juliette Cubanski, Jeffrey Davis, Davis, Richard Frank, , Nicole Longo, Longo, it's, — aren't, Robin Feldman, Feldman, Cuban's Organizations: Medicare, Healthcare, Morning, Centers, Services, Congressional, McDermott, Consulting, Brookings Schaeffer Initiative, Health, Pharmaceutical Research, Manufacturers of America, PhRMA, University of California Law School, Costco, Pharmaceutical Locations: Lower
Circuit Court of Appeals heard oral arguments in cases Thursday involving the coverage of gender-affirming care by North Carolina’s state employee health plan and the coverage of gender-affirming surgery by West Virginia Medicaid. During the proceedings, at least two judges said it’s likely the case will eventually reach the U.S. Supreme Court. Both states appealed separate lower court rulings that found the denial of gender-affirming care to be discriminatory and unconstitutional. “West Virginia is entitled to deference where they're going to take their limited resources," he said. Chambers certified the lawsuit as a class action, covering all transgender West Virginians who participate in Medicaid.
Persons: it’s, Tara Borelli, , Borelli, John Knepper, Knepper, , Caleb David, Virginia's, , Chuck Chambers, Huntington, Chambers, Patrick Morrisey Organizations: , Circuit, Virginia Medicaid, U.S, Supreme, Lambda, Constitution, World Professional Association for Transgender Health, West, U.S . Centers, Medicare, Services, District, Affordable, West Virginians, West Virginia Inc, Public Employees Insurance Agency, West Virginia Republican, Locations: CHARLESTON, W.Va, North Carolina, West Virginia, Richmond, North Carolina’s, Virginia, U.S, “ West Virginia
The rollout of a new round of Covid vaccines in the U.S. is off to a bumpy start as some patients report delays in health insurance coverage for the shots. Private insurance plans and government payers such as Medicare are required to cover the new jabs from Pfizer and Moderna , which became available late last week. It also comes after a huge shift in how Covid vaccines are covered in the U.S. Previously, the federal government purchased Covid vaccines directly from manufacturers at a discount to distribute to all Americans for free. Sarah Lindsey, an owner of a Florida-based jewelry store, called on her own insurer to add the new Covid shots to its formulary.
Persons: Sarah Lindsey, it's Organizations: Pfizer, Moderna, Medicare, Medicaid Services, CVS, U.S, CNBC Locations: U.S, Florida
Investors should pounce on CVS' current attractive valuation, according to Evercore ISI. The firm upgraded the health and pharmacy stock to outperform from in-line in a Tuesday note, accompanied by an $83 per share price target up from $81. CVS stock has slipped more than 24% from the start of the year. CVS YTD mountain CVS stock. "CVS, like many [managed care organizations], is a complex organization, and we see a number of factors swinging in a positive direction, pointing to both a higher degree of confidence in [management's] outlook as well as supportive of higher valuation," Anderson said.
Persons: Elizabeth Anderson, Anderson, CNBC's Michael Bloom Organizations: CVS, ISI, Centers, Medicare, Services
Three-quarters of Americans, or 76%, favor allowing the federal health care program for the elderly to negotiate prices for certain prescription drugs. Americans are split on how Biden is handling the issue of prescription drug prices — 48% approve, making it a relative strong point for Biden, but 50% disapprove. Even among the Americans who support allowing Medicare to negotiate drug prices, approval of Biden’s handling of the issue remains relatively tepid. "They kept prescription drug prices high to increase their profits. “Well, we did it.”Ellen Daily, a 73-year-old retiree in Carrollton, Texas, said she strongly favors allowing Medicare to negotiate on drug prices.
Persons: Joe Biden, trumpeting, drugmakers, Biden, it's, Esperanza Baeza, I'm, , , ” Biden, Ellen Daily, Annie Lok, Lok, doesn’t Organizations: WASHINGTON, Associated Press, NORC, for Public Affairs Research, , Big Pharma, , Medicare, Pharmaceutical Research, Manufacturers of America, Services, Republican Locations: Chicago, Baeza, Carrollton , Texas, Queens , New York
The insurer said the rule, which would apply retroactively, was "arbitrary and capricious," and threatened "unpredictable consequences for Medicare Advantage organizations and the millions of seniors who rely on the Medicare Advantage program for their healthcare." Close to half of the approximately 65 million Medicare enrollees sign up for Medicare Advantage. Medicare Advantage plans differ from traditional Medicare because private companies offer them, and are reimbursed by the government for care. Though Humana is based in Louisville, Kentucky, it filed its lawsuit with the U.S. District Court in the Northern District of Texas. The case is Humana Inc et al v Becerra et al, U.S. District Court, Northern District of Texas, No.
Persons: Andrew Kelly, Humana, Biden, Xavier Becerra, District Judge Reed O'Connor, Becerra, Jonathan Stempel, Leroy Leo, Richard Chang Organizations: Humana Inc, REUTERS, U.S, overcharges, Medicare, Services, Jan, U.S . Department of Health, Human Services, CMS, Northern District of Texas, District, Fort, Affordable, Court, Northern District of, Thomson Locations: Queens , New York City, U.S, Louisville , Kentucky, Northern District, Northern District of Texas, New York, Bengaluru
The nation’s most thinly staffed nursing homes would be required to hire more workers under new rules proposed on Friday by the Biden administration, the greatest change to federal nursing home regulations in three decades. The proposed standard was prompted by the industry’s troubled performance earlier in the coronavirus pandemic, when 200,000 nursing home residents died. But the proposal falls far short of what both the industry and patient advocates believe is needed to improve care for most of the 1.2 million Americans in nursing homes. estimated that three-quarters of the nation’s 15,000 homes would need to add staff members. But the increases at many of those facilities would be minor, as the average nursing home already employs nurses and aides at, or very close to, the proposed levels.
Persons: Biden Organizations: Centers, Medicare, Services, C.M.S
Ohio Governor Mike DeWine, right, shakes hands with Judge Thomas Rose of the U.S. District Court Southern District of Ohio after taking his oath of office, Monday, Jan. 14, 2019, in Cedarville, Ohio. A federal judge on Friday withdrew from a case that could block Medicare from negotiating over drug prices, just hours after a watchdog group revealed his ownership of stock in two pharmaceutical companies that would be directly impacted by the new program. He also owns Moderna stock worth between $15,000 and $50,000, the filing shows. The suit asked the court to rule that for Medicare to negotiate drug prices would be unconstitutional. Merck, Bristol Myers Squibb, Johnson & Johnson, Boehringer Ingelheim, AstraZeneca and the drugmaker lobby PhRMA have all filed complaints in different districts courts.
Persons: Mike DeWine, Judge Thomas Rose, Judge Thomas M, Rose, Biden, George W, Bush, Johnson, Boehringer Ingelheim, Robert Davis, Davis Organizations: U.S, District Court Southern District of Ohio, Southern, Southern District of Ohio, Johnson, AstraZeneca, Republican, Moderna, U.S . Chamber of Commerce, Department of Health, Human Services, Centers, Medicare, Merck, Bristol Myers Squibb, Court, Circuit Court Locations: Cedarville , Ohio, Southern District
Ozempic, the blockbuster diabetes treatment from Novo Nordisk , could be next in line in the price negotiations between manufacturers and Medicare. Ozempic will likely be eligible for negotiations by the time the next round of drugs is selected in 2025, for price changes that will go into effect in 2027. Novo Nordisk's Rybelsus, a diabetes drug taken orally, could also be on the list because it contains the same active ingredient as Ozempic. A spokesperson for Novo Nordisk didn't directly comment on the potential for Ozempic to be included in the next round of talks. Medicare and private insurers typically secure discounts and rebates on the drugs they cover, but it's unclear how large they are.
Persons: Biden, Ozempic, Cantor Fitzgerald, Louise Chen, Elon Musk Organizations: Novo Nordisk, Pharmacy, Ozempic, CNBC, Novo Nordisk's Rybelsus, Medicare, Services, Elon Locations: Provo , Utah, U.S, Novo
Eli Lilly's revenue from Jardiance — which it markets alongside privately held German biotech firm Boehringer Ingelheim — is likely to suffer due to Medicare negotiations. Compared to those growth drivers, Jardiance is a minor character in the Eli Lilly investment story. However, the deceleration is not entirely due to likely lower realized prices from Medicare negotiations. Eli Lilly looks "relatively protected" from early Medicare negotiations, BMO's Seigmerman said. Eli Lilly headquarters in Indianapolis, Indiana, US, on Wednesday, May 3, 2023.
Persons: Eli Lilly, Biden, Myers Squibb, Johnson, Eli Lilly's, , Evan Seigerman, Seigerman, BMO's Seigmerman, Lilly, Jim Cramer's, Jim Cramer, Jim, AJ Mast Organizations: pharma, Myers, Club, Johnson, Medicare, donanemab, Bank of America, FactSet, Mounjaro, Merck, Constitution, Wall Street, Bristol Myers Squibb, BMO Capital, CNBC, Services, drugmakers, and Drug Administration, FDA, Trulicity, Bloomberg, Getty Locations: Bristol, U.S, Indianapolis , Indiana
Share Share Article via Facebook Share Article via Twitter Share Article via LinkedIn Share Article via EmailCMS Administrator on Medicare price negotiations: People will see benefits starting next yearCenters for Medicare and Medicaid Services Administrator Chiquita Brooks-Lasure joins 'Squawk Box' to discuss the Biden administration's unveiling of the first 10 drugs subject to Medicare price negotiations, how the list of drugs were chosen, and more.
Persons: Chiquita Brooks, Lasure Organizations: Medicare, Biden
The medications on the list are taken by millions of older Americans and cost Medicare billions of dollars annually. The drugs were selected by the Centers for Medicare & Medicaid Services through a process that prioritized medications that account for the highest Medicare spending, have been on the market for years and do not yet face competition from rivals. Drugs Selected for Price Negotiations1. Eliquis, for preventing strokes and blood clots, from Bristol Myers Squibb and Pfizer2. Xarelto, for preventing strokes and blood clots, from Johnson & Johnson4.
Persons: Biden, Price, Boehringer Ingelheim, Eli Lilly, Johnson Organizations: Tuesday, Medicare, Centers, Services, Bristol Myers Squibb, Pfizer, Johnson, Merck, AstraZeneca, Novartis, Novo Nordisk Locations: AbbVie, Novo
Bottles of the drug Jardiance, made by Eli Lilly and Company, sit on a counter at a pharmacy in Provo, Utah, January 9, 2020. Two blood thinners and a diabetes medication are the drugs most widely used by Medicare beneficiaries among a list of 10 drugs that will be subject to price negotiations between manufacturers and Medicare. The list names drugs with the highest spending for Medicare Part D, which covers prescription medications, for the period from June 1, 2022, to May 31, 2023. Nearly 1.6 million Medicare enrollees used Jardiance during the same time period, according to the fact sheet. Medicare Part D also spent more on those three drugs during the time period than it did on the seven other medicines on the list.
Persons: Eli Lilly, Biden, Myers Squibb, enrollees, Johnson Organizations: Company, U.S, Medicare, Myers, Centers, Services, Pfizer Locations: Provo , Utah, Bristol
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