It’s been four years since the first CAR T cell therapies were approved and inadequate reimbursement is still a barrier to access in the U.S. A new payment rule proposed by CMS aims to change...

CMS and the biopharma industry are presenting conflicting explanations for a spike in Medicare Part B premiums and deductibles. CMS says the increases are “largely due to rising spending on physician-administered drugs” (see “Medicare Part...

The Trump administration Monday attributed a jump in Medicare Part B premiums and deductibles to increasing spending on physician-administered drugs. The administration is likely to use the increases to justify its proposal for an international...

CMS has proposed that next-generation sequencing should be covered for Medicare beneficiaries with advanced cancer. In a proposed decision memo , the agency said NGS as a diagnostic laboratory test when performed in a CLIA-certified laboratory...

HHS Acting Inspector General Joanne Chiedi wrote in a letter to Sens. Charles Grassley (R-Iowa) and Marco Rubio (R-Fla.) that the department will begin a review this fall to determine whether CMS has developed a...

After receiving 146 comments across two comment periods, CMS has opened up its coverage criteria for CAR Ts. In a final National Coverage Determination issued Wednesday, the Centers for Medicare & Medicaid Services said it...

CMS updated its payment system last week to make it easier for antibiotic companies to turn a profit, but the changes improve an already-established pathway rather than implementing an innovative subscription-based model as called for...

A set of five different payment models announced by the Centers for Medicare & Medicaid Services for patients with chronic kidney disease or end-stage renal disease could be a boon for companies that have taken...

A bill that would advance research into new treatments for drug-resistant infections, the DISARM Act of 2019, was reintroduced in the Senate this week. The Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms Act ( S.1712...

CMS will not implement a proposed change to Medicare Part D that would have allowed plans to exclude some drugs in six protected therapeutic classes from their formularies, but will allow for broader use of...