Prescription Drug Coverage

On November 14, KFF released a report highlighting certain policies in place in state Medicaid programs in FY 2023 and policy changes implemented or planned for FY 2024, which began on July 1, 2023, for most states. The findings are drawn from the 23rd annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by KFF and Health Management Associates (HMA), in collaboration with the National Association of Medicaid Directors (NAMD). Overall, 48 states responded to this year’s survey, although response rates for specific questions varied...

On July 12, the Kaiser Family Foundation (KFF) released an issue brief describing high-cost drugs which accounted for a disproportionate share of Medicare spending. As required under the Inflation Reduction Act, the federal government will announce 10 Medicare Part D prescription drugs by September 1, 2023, selected for price negotiations in 2026. To provide an understanding of the potential impact of negotiating prices, KFF’s analysis found that Medicare Part D spending was concentrated among a small number of prescription drugs, and ten top-selling Medicare-covered prescription drugs in 2021 accounted for 22 percent or nearly one-fourth of gross Part D spending....

On June 22nd, The Centers for Medicare and Medicaid Services (CMS) released details describing how Medicare beneficiaries can obtain Medicare-covered drugs that may slow the progression of Alzheimer’s disease. Medicare will cover drugs with traditional FDA approval when a physician and clinical team participates in the collection of evidence about how these drugs work, also known as a registry. To get Medicare coverage people will need to 1) be enrolled in Medicare, 2) be diagnosed with mild cognitive impairment or mild Alzheimer’s disease dementia, and 3) have a physician participating in a registry with an appropriate clinical team and follow-up care...