Complications: Health Policy Unraveled
Tired of being baffled by healthcare policy? McGuireWoods Consulting presents Complications: Health Policy Unraveled, your solution to the policy puzzle. With our host, Stephanie Kennan, discover the ins and outs of healthcare policy and gain insights crucial for providers and investors. Let's simplify the complex together. Follow us in your favorite podcast app and never miss a healthcare update by subscribing to host and JD Supra’s #1 healthcare author Stephanie Kennan’s Washington Healthcare Update www.mwcllc.com. And if you found this podcast valuable, please share it with your colleagues and leave us a review. We always appreciate your feed...
Understanding Medicare’s Negotiated Drug Prices: What Are The Real Savings?
In mid-August, the Biden administration announced it had completed negotiations for the first 10 drugs in Medicare’s price program and that the new prices will be implemented in 2026. The achievement marks decades of effort and is a stellar achievement for the Democrats and the administration.
But Medicare already receives discounts and rebates on drugs, so it’s unclear what the savings will really be off the list price. And, as Stephanie Kennan points out, it is also unclear how much of any savings will filter through to patients because their costs will be determined by their insurance plan...
How the Inflation Reduction Act Is Affecting Medicare Part D Drug Costs
In an ironic move, it’s likely that Medicare Part D insurance premiums will rise next year even as a 2022 law sought to lower costs for patients, but the administration is planning on implementing a program to stabilize the market.
Under the 2022 law, insurers must now make up the difference between costs formerly covered by patients and are raising drug premiums to compensate, explains host Stephanie Kennan. Join her as she explains the changes facing insurers and the efforts the government is making to stabilize the market during the transition brought about by the 2022 Inflation Reduction Act.
<...Rejecting a Psychedelic Drug for PTSD Treatment: Why and What’s Next
A revolution in the use of psychedelic drugs to treat mental health issues experienced a setback in early August when the FDA declined to approve MMDA as a treatment for post-traumatic stress disorder.
Host Stephanie Kennan provides important context to the FDA’s decision, which came as the agency has faced criticism for approving therapies without convincing evidence. She outlines the fallout, including a peer-reviewed journal’s decision to retract three papers about MMDA-assisted psychotherapy. She also looks ahead, explaining that, while this first attempt for MMDA stalled, other companies are working on their own applications.
Mee...
Reforming the Medicare Physician Fee Schedule: Controversy and Urgency
Congress is teeing up discussions on a controversial issue that strikes at the heart of the Medicare system: how physicians are paid.
Lawmakers are weighing changes to the Medicare Physician Fee Schedule for the first time since 2015, and host Stephanie Kennan lays out the landscape. She provides background on the pay schedule, describes reforms under consideration, and explains why physicians and other stakeholders are warning about a gap between rising costs and physician payments – which could impact care.
Meet Your Host
Name: Stephanie Kennan
Title: Senior Vice President, Federal Public Affairs at...
How Site-Neutral Payment Reform Divides Policymakers and Hospitals
“Site-neutral” is a short name for a proposal that has bipartisan interest in Congress, but is being fiercely fought by hospitals.
Host Stephanie Kennan explores the divisive issue of site-neutral payment reform, an approach to healthcare spending that would align Medicare payments for outpatient services across care settings. Amid growing bipartisan interest and pressure to rein in healthcare costs, Congress has proposed reforms such as the Medicare Patient Access to Cancer Treatment Act. But hospitals are fighting it because of the potential to reduce revenue and, they worry, decrease healthcare access in rural and low-income communities.
Tune...
A Closer Look: NIH Reform Recommendations In Congress
The National Institutes of Health (NIH) has been under scrutiny since COVID-19, so it is not surprising that members of Congress have released NIH reform initiatives.
In this episode of Complications: Health Policy Unraveled, host Stephanie Kennan provides a summary of NIH reform recommendations, starting with the white paper released by Republican Senator Bill Cassidy, which suggests reform priorities around transparency and research grants. Stephanie also breaks down the broader NIH Energy and Commerce Framework released by House Energy and Commerce Chair Kathy McMorris, which recommended comprehensive NIH reform in several areas, including mission and leadership, financial...
340B ACCESS Act Aims to Clarify Contract Pharmacy Role in Drug Discount Program
“The 340B Drug Discount Program is the second largest government pharmaceutical program based on net drug spending and is only behind Medicare Part D. It's been the subject of a lot of legislation and hearings in Congress because of its growth and because of the confusion over contract pharmacies.”
In this episode of Complications: Health Policy Unraveled, host Stephanie Kennan discusses the latest on the 340B Drug Discount Program, which since 1992 has provided low income and uninsured patients increased access to drugs by requiring manufacturers to provide outpatient drugs to eligible healthcare organizations at a discount.
Tune...
Supreme Court to Hear Arguments on Medicare’s Disproportionate Share Hospital Payments
In 2022, the Supreme Court of the United States heard arguments related to Medicare’s Disproportionate Share Hospital Payments. Now that issue is before the court again.
In this episode of Complications: Health Policy Unraveled, host Stephanie Kennan discusses an upcoming SCOTUS case involving hospitals and the Department of Health and Human Services (HHS). The hospitals argue that HHS in not following the 2022 SCOTUS decision related to how patients receiving SSI are counted. The hospitals argue that the manner in which HHS counts patients has resulted in funding cuts and puts some hospitals in jeopardy of not being eli...
New Medicaid Rule Promotes Transparency and Should Improve Quality of Care
Medicaid is complicated.
In this episode of Complications: Health Policy Unraveled, host Stephanie Kennan discusses the newly finalized regulations concerning Medicaid, specifically as they pertain to the Managed Care Rule. These new regulations aim to increase transparency and improve access in states' Medicaid programs. Key points discussed include: changes in state-directed payments to ensure they are reasonable, enhanced requirements for reporting and evaluation, alterations in the medical loss ratio, imposition of enrollee protections, and improvements in the quality of care through careful evaluation and public comments.
Tune in as Stephanie helps simplify the complexities of...
New CMS Guidelines for Drug Price Negotiation
The Center for Medicaid & Medicare Services (CMS) recently released new guidelines that will affect the Medicare drug price negotiation process beginning in 2026.
In this episode of Complications: Health Policy Unraveled, host Stephanie Kennan provides a summary of the new CMS guidelines, including the new requirements for drug manufacturers and Part D dispensing entities, the timeline for negotiating new drug prices, and some of the challenges in navigating these new guidelines. Tune in to learn more about these new CMS guidelines.
Meet Your Host
Name: Stephanie Kennan
Title: Senior Vice President, Federal P...
