The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced the selection of 15 additional drugs covered under Medicare Part D for price negotiations. In accordance with the Inflation Reduction Act, the negotiations with participating drug companies for these 15 drugs will occur in 2025 and any negotiated prices will become effective in 2027. Between November 2023 and October 2024, about 5.3 million people with Medicare Part D coverage used these drugs to treat a variety of conditions, such as cancer, type 2 diabetes, and asthma. These selected drugs accounted for about $41 billion in total gross covered prescription drug costs under Medicare Part D, or about 14%, during that period. When combined with the total gross covered prescription drug costs under Medicare Part D of the 10 drugs selected for the first cycle of negotiations over that same time, this represents over a third of total gross covered prescription drug costs under Medicare Part D. You can read more about the announcement and selected drugs in this HHS Press Release and CMS Factsheet.

President Trump ordered all executive departments and agencies to take the following steps:

·    Do not propose or issue any rule in any manner, including by sending a rule to the Office of the Federal Register (the OFR), until a department or agency head appointed or designated by the President after noon on Jan. 20, 2025, reviews and approves the rule.

·    Immediately withdraw any rules that have been sent to the OFR but not published in the Federal Register

·    Consistent with applicable law and subject to the exceptions described in paragraph one, consider postponing for 60 days from the date of the memorandum the effective date for any rules that have been published in the Federal Register.

President Trump signed an Executive Order that terminates DEI preferencing in federal contracting and directs federal agencies to combat private sector discrimination. The enforces long-standing federal statutes and faithfully advances the Constitution’s promise of colorblind equality before the law. Read the fact sheet.

Congress faces an array of policy choices as it confronts large federal deficits and rising federal debt. In June 2024, under the assumption that current laws governing taxes and spending generally would not change, the Congressional Budget Office (CBO) projected that the federal deficit would average $1.9 trillion per year between 2025 and 2034, or 5.4 percent of gross domestic product (GDP) over that period. In comparison, over the past 50 years, the annual deficit averaged 3.7 percent of GDP. In response, the CBO published Options for Reducing the Deficit: 2025 to 2034 in December 2024.

Novartis this week became the fifth manufacturer to sue the Health Resources and Services Administration (HRSA) to implement a 340B rebate model. Novartis filed its complaint Wednesday in the US District Court for the District of Columbia.

Reps. Vern Buchanan (FL) and David Schweikert (AZ) will continue to chair the Ways & Means health and oversight subcommittees, respectively. Buchanan brings with him expertise on CMS coverage issues and a pledge to push the incoming administration’s goals to cut regulations and offer alternative coverage options. Schweikert advocates for telehealth and artificial intelligence.

A private business, Apexus, has helped supercharge the controversial federal drug program, 340B. Patients and insurers have been left with big bills. The intention behind the program was for a small number of safety-net providers to have access to affordable drugs and be able to expand their care for needy patients. But instead, the program has exploded: Now, more than half of nonprofit hospitals in the United States take part. While some providers say it has helped keep their doors open, others — especially large nonprofit health systems — have been accused of maximizing payouts and swallowing the profits. Source: New York Times

Recent attacks on Medicaid have proposed a per capita cap on federal funding and potentially instituting block grants. While these are not new proposals, this would dramatically change federal and state Medicaid structures by shifting the cost and the risk directly to states. With more and more consumers relying on Medicaid, changes and cuts could leave millions without coverage nationally. Some states have begun the groundwork to reinstate work requirements. In 2019, the Centers for Medicare and Medicaid Services approved 13 Medicaid demonstration projects centered around work requirements as a condition of Medicaid eligibility. Previous research indicated that among enrollees who aren’t already working, nearly all have disabilities, serious health conditions, childcare or caretaking responsibilities, or are in school.

The US Supreme Court has agreed to hear arguments to consider whether the Affordable Care Act’s preventive care coverage should be reinstated after a lower court struck it down. If the court rules in favor of the Texas employers who filed the case, tens of millions of people who get their health insurance from their employer or through the ACA marketplace would be impacted by the removal of these services, which require insurers to cover the full cost of everything from birth control to vaccines to mental health screenings. Since the enactment of the ACA in 2010, more than 2,000 legal challenges have been filed in state and federal courts contesting all or part of the law. While the law remains popular and enrollment in the Health Insurance Marketplaces through the ACA has soared to more than 23 million people, challenges jeopardize the law and its effectiveness.

A free dental salary survey report from DentalPost is now available for download. The report includes nationwide data on income, benefits, hours, turnover, retirement plans, and more for dentists, dental hygienists, dental assistants, and front office specialists. Salary and benefits packages for these disciplines have increased significantly over the past year. See how your salaries compare with the other practices and download your copy of the survey here.