Tag Archives: 2015

ObamaCare 2015: The Best Strategies for Saving Your Money and Protecting Your Health Under the Affordable Care Act Reviews

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New Milliman Study: Hepatitis C Drugs Could Increase Medicare Part D Spending by $2.9 to $5.8 Billion in 2015

Washington D.C. (PRWEB) July 29, 2014

New high priced hepatitis C drugs will increase federal spending in Medicare Part D by a projected $ 2.9 to $ 5.8 billion next year, according to a new report by the actuarial firm Milliman released today by the Pharmaceutical Care Management Association (PCMA). Milliman projects that average Part D premiums could increase by as much as 8.6 percent in 2015 as a result of high-priced hepatitis C drugs, including Sovaldi and Olysio.

The study finds that the majority of new Federal spending will come from increased federal reinsurance subsidies. Medicare payments for Part D catastrophic coverage have grown considerably faster than other components of Part D spending. According to the Medicare Payment Advisory Commission, between 2007 and 2012, payments have increased at an average annual rate of 14 percent while nearly doubling from $ 8 billion to $ 15.6 billion.

Milliman bases its cost projections on the assumption that 15 percent to 30 percent of the Medicare Part D population estimated to be infected with hepatitis C will receive an $ 84,000 course of treatment in 2015.

“While most payers cover about 75 percent of an enrollee’s prescription drug costs, Medicare Part D covers 95 percent at high spending levels,” said PCMA President and CEO Mark Merritt. “The study shows taxpayers will bear the lion’s share of the increased drug costs for Medicare Part D beneficiaries taking hepatitis C drugs.”

Click here to read the new report.

Major findings from the report include:


    New hepatitis C drugs, including Sovaldi and Olysio, will increase 2015 federal spending on Medicare Part D by $ 2.9 to $ 5.8 billion for beneficiaries enrolled in Medicare Prescription Drug Plans (PDPs), an increase of $ 100 to $ 200 per beneficiary per year.

    Average monthly premiums for Medicare PDPs are projected to increase 4.3 percent to 8.6 percent next year as a result of new hepatitis C drugs, an increase of $ 17 to $ 33 per beneficiary per year.

Milliman’s analysis measured the impact of these new drugs on the Medicare Part D program; the study did not include the effect of the drug therapy on other medical costs.







Related Medicare Enroll Press Releases

Obamacare premiums to rise a modest 4.2% in 2015

Obamacare premiums to rise a modest 4.2% in 2015
Defying an industry trend of double-digit rate hikes, California officials said the more than 1.2 million consumers in the state-run Obamacare insurance exchange can expect modest price increases of 4.2% on average next year. On Thursday, Covered …
Read more on Los Angeles Times

Senate documents and interviews undercut 'bombshell' lawsuit against
This argument is based on the language in the ACA that says subsidies go to those using the “exchange established by the state,” which, it is said, cannot apply to the exchange established by the federal government. If this is somehow upheld by the …
Read more on Washington Post (blog)

State sits out new Obamacare grants
Although the two actions appear somewhat contradictory, the bottom line is the same: Oklahoma will remain on the sidelines as Washington hands out money to states and health-care groups that apply to participate in Affordable Care Act grant programs.
Read more on Norman Transcript

Q&A: Are you ready for MASSIVE Obamacare premium hikes in 2015?

Obamacare Enrollment
by SS&SS

Question by Bad Wolf: Are you ready for MASSIVE Obamacare premium hikes in 2015?
The latest demographics for Obamacare enrollment show rates will need to increase 67% – 100% next year.

Best answer:

Answer by jimmy
ever hear a little something abut blood and turnips?…

Know better? Leave your own answer in the comments!

April 23 Webinar Will Provide Analysis, Strategies for the Final CMS 2015 Pay Notice and Call Letter

Washington, DC (PRWEB) April 15, 2014

The final 2015 Medicare Advantage (MA) and Part D pay notice and Call Letter, issued by CMS earlier this month, contains good news but also a host of changes that plans were not expecting. There is a lot of uncertainty, since the impact of many of the changes in the final notice will vary dramatically depending on the particular counties served by the MA plans. On April 23, participants of the Atlantic Information Services webinar, “Final CMS 2015 Pay Notice and Call Letter: Implications and Strategies for MA and Part D,” will learn the implications of CMS’s final 2015 documents and the strategies MA and Part D plans should consider as a result.

William MacBain, senior vice president of strategy at Gorman Health Group, LLC, and Tim Courtney, senior consulting actuary at Wakely Consulting Group, will analyze the final notice and Call Letter, and translate it into steps and strategies organizations should consider for the rapidly approaching bids deadline and beyond. In a lively 60-minute presentation, followed by 30 minutes of responses to individual questions, participants will get reliable answers to questions such as:


What will be the range of the final “all in” 2015 pay change for MA plans? On what will the impact on a particular MA plan depend?
How can MA plans determine the effect of the new reduction in the fee-for-service normalization factor in each of your plan’s service areas?
What will be the impact of CMS’s unprecedented decision to retreat from the phase-in of its new MA risk adjustment system? Why did it do that?
Why did CMS decide to delay its controversial rule limiting the use of home health risk assessments for pay-related diagnosis purposes? What might the agency wind up doing, and when?
How can plans offset declining pay for 2015 if CMS is limiting the maximum increase in Total Beneficiary Cost to less than is permissible for 2014?
How will new restrictions, including possible midyear special enrollment periods, on mass terminations of providers by MA plans affect plan strategies?
What will be the impact of CMS’s decision to delay implementation of the new Part D risk adjustment model?
What information are Part D plans still missing regarding preferred pharmacy cost sharing, and how should they prepare bids until they get it?

Visit http://aishealth.com/marketplace/c4a19_042314 for more details and registration information.

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