Articles related to MEDICARE

HRSA’s revised 340B rebate pilot could require covered entities to purchase selected high-cost drugs at full price and recover discounts through manufacturer rebates beginning in 2027, prompting hospitals to evaluate data infrastructure, vendor readiness, and reimbursement workflows while legal and congressional challenges continue.

CMS has proposed 2027 ambulatory surgery center payment changes that would reduce reimbursement for several high-volume ophthalmic procedures, including cataract surgery. The proposal remains under review as ophthalmology organizations evaluate potential impacts on practice operations and patient access.

CMS proposed 2027 Physician Fee Schedule changes that would reduce reimbursement for certain same-day evaluation and management services performed with procedures. Ophthalmology organizations warned the changes could affect glaucoma treatment workflows, although the proposal remains under review.

Retina practices are adjusting after Good Days funding limitations reduced copay support for some patients requiring chronic anti-VEGF therapy. Medicare Advantage patients appear especially exposed to affordability pressure.

Medicare’s new GLP-1 Bridge Program expands lower-cost access to certain weight-loss medications for eligible beneficiaries. Concurrent ISMP guidance outlines common medication errors and counseling challenges as more patients initiate GLP-1 therapy.

Video-based ADHD prescribing increased substantially following Australia’s permanent telehealth reforms, with ADHD consultations showing greater virtual adoption than other psychotropic prescribing categories. Observational findings describe utilization patterns but do not establish causality.