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Whitepapers, briefs, press releases and more
Pricing Considerations for the Program Integrity Rule
HHS has proposed a Marketplace Integrity and Affordability rule that will result in decreased marketplace enrollments in 2026, ranging from 750,000 to 2,000,000 fewer enrollees than otherwise expected. They further estimate this reduction in enrollment will lead to a reduction in average claims of between -0.9% and -5.4%. This outcome is counterintuitive to most pricing ... Read more
Week in Washington 4/10/25
Tariffs: President Trump announced that most of the recently enacted tariffs would be paused for 90 days. However, he also announced that tariffs would be increased on Chinese goods to 125%. The fallout from the tariff news this week was lower stock prices and higher bond prices. Both indicators were interpreted by market watchers as ... Read more
Events & More
Wakely Webinar: PACE - Part D Funding
The webinar will be focused on changes to Medicare Part D, highlighting where responsibility has shifted from CMS to the Medicare plans and PACE organizations.
We intend to cover the following items:
1) How did the Inflation Reduction Act change the Part D benefit design?
2) How did the revamped benefit design impact payments to PACE programs?
3) Is Part D a pass-through program?
4) What can we do to maximize funding?
Newsworthy Findings
CMS Finalizes 2026 Payment Policy Updates for Medicare Advantage and Part D Programs
This release — combined with the CY 2026 MA and Part D final rule that was released on April 4 — makes annual routine and technical updates to the MA and Part D programs.
Trump Says ‘Major’ Tariffs Coming on Pharmaceuticals
President Trump on Tuesday said he’s planning soon to announce “a major tariff on pharmaceuticals,” which were exempted from the new levies he imposed this month. Trump didn’t offer any details on the scope of the tariffs or the timing for the announcement, though he said it would come “very shortly.” He promised the action would spur drugmakers to leave China and other countries and move manufacturing to the U.S.
Trump Rejects Biden Administration Plan to Let Medicare Cover Obesity Drugs
The Trump administration will not permit Medicare to pay for obesity drugs directly, declining on Friday to finalize a Biden-era proposal that would have allowed the federal health insurance program to cover popular GLP-1 medications like Wegovy and Zepbound.
Market Volatility Suppresses Hospital M&A: Report
Hospital M&A plummeted during the first quarter, with systems announcing only five deals amid significant market uncertainty, according to Kaufman Hall.
Trump Healthcare Price Transparency Order may not Bring Intended Relief to Patients
President Donald Trump first told hospitals to put prices online in 2019 during his first administration and transparency rules for insurers soon followed, as the government sought to lower U.S. healthcare spending, the highest in the world. But not all prices were posted and consumers struggled to find and analyze the scattered data.
Bonus Article
Harvard Tuition is Now Free for Families Earning Under $200k–Includes Housing and Books for Those Below $100k
Just for Fun
Math Joke:
Why was the equal sign so humble?
Prior Week
Q: Why did the math teacher refuse to argue with a triangle?
A: Because it was always right, no matter the angle!
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