Beginning January 1, a “wave” of health care regulations took effect. Here’s a few you’ll probably encounter.
- If you don’t already know about the expiration of the ACA
enhanced premium tax credits, you don’t subscribe to a newspaper or cable news. (Congratulations. Your mental health is better than mine!)
- As part of The Inflation Reduction Act, Medicare is implementing the first round of negotiated drug prices for 10 Part D drugs; i.e., Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara and NovoLog/Fiasp, treating conditions such as diabetes, heart failure, cancer, blood clots and autoimmune diseases.
- The Part D annual out of pocket cap increased to $2,100,
following the $2,000 initial limit set in 2025.
- Prior authorization protections for Medicare Advantage and Part D, to improve transparency and clarify appeals and coverage determinations.
There’s more; e.g., new price transparency rules;
physician payment updates; CMS strengthened its authority to pursue enforcement actions against brokers and agents engaged in unauthorized enrollment activity. (Huh!?)
It’ll take more than 30 Seconds, but Becker’s Hospital Review does a nice job of summarizing all this HERE.
And we cheeseheads will soon have lots of free time for reading on Sunday afternoons!
