Medicare News
- CMS released Part D bid information this week. This includes the national average monthly bid amount (NAMBA). NAMBA will be $179.45, up significantly from prior years due to changes caused, primarily, by implementation of Inflation Reduction Act requirement. The preliminary estimated average government subsidy will be $142.67 in 2025. The base beneficiary premium increase for 2025 for people with Part is $2.08 (up to $36.78).
- CMS also announced a voluntary demonstration targeting stand-alone prescription drug plans (PDPs) designed to improve premium stability. The program reduces base beneficiary premium by $15, limits premium increases and changes risk corridors. The program effectively gives a premium subsidy of $15.
- Novo Nordisk’s attempt to block implementation of drug price setting program was denied by a federal judge. To date, the Biden administration has won all of the court hearings. Today (August 1) is the deadline to end negotiations for the first cycle.
ACA/Commercial News
- Sabrina Corlette examined proposed 2025 rate increases for the individual market in this piece. The piece looked into the assumptions/justifications of a sample of individual market proposed rate filings. She found that generally, specialty drug costs as well as hospital costs were the largest contributor to premium growth in 2025.
- Matt Fiedler and Loren Adler released new research on outcomes under the No Surprises Act (NSA). The NSA prevents providers from surprise billing patients and instead, potentially shifts those costs into an arbitration process between insurers and providers. The findings on the arbitration process, suggest that the current process in place has the potential to increase prices and premiums.
Medicaid News
- CMS approved a North Carolina proposal that would provide enhanced reimbursement to hospitals that do away with low- and middle-income patient debt. The proposal could be copied by other states as the issue of medical debt has gained salience recently.
