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New Reimbursement Opportunities for Digital Mental Health Treatment in 2025: CMS’ Final Rule

Nixon Gwilt Law

CMS issued its 2025 Medicare Physician Fee Schedule (the “2025 MPFS” or “Final Rule”) on November 1, 2024. The Final 2025 MPFS contains some modifications and clarifications to several elements of the original proposal released in July 2024 (the “Proposed Rule”), which we discussed in this earlier post.

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New Reimbursement Opportunities for Digital Mental Health Treatment in 2025: CMS’ Final Rule

Nixon Gwilt Law

CMS issued its 2025 Medicare Physician Fee Schedule (the “2025 MPFS” or “Final Rule”) on November 1, 2024. The Final 2025 MPFS contains some modifications and clarifications to several elements of the original proposal released in July 2024 (the “Proposed Rule”), which we discussed in this earlier post.

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Are new weight loss drugs an answer or problem?

World of DTC Marketing

Novo Nordisk more than doubled its sales targets for obesity drugs to $3.7bn by 2025. Payers also face hurdles, so patients must obtain permission before filling a prescription. One Maryland pharmacist told me she had seen many prescriptions for Wegovy, none of which had ever come back after being sent for authorization. .

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Consequences of the First 10 Drugs Selected for Medicare’s Negotiation Program

PM360

As many in the industry now know, the Inflation Reduction Act (IRA) is the most significant reform of Medicare prescription drug coverage since the creation of Part D and has wide-ranging implications for the healthcare industry. After this period, CMS will begin to include physician-administered drugs covered under Part B in the program.

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10 New Solutions, Strategies, and Devices to Boost Adherence

PM360

billion in 2025. The combined solution enables health plans and self-insured employers to realize immediate pharmacy cost savings and near-term medical cost reductions by integrating Levrx’s plan-specific and real-time prescription insights into the Adhere Platform medication optimization offerings. from 2021 and reach $4.2

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How retailers and “payviders” are disrupting U.S. healthcare in 2024

Clarivate

RxPass offers more than 50 select prescriptions at no additional cost for $5 per month. In classic Amazon style, its pharmacy offers two-day shipping on prescriptions by mail, with same-day delivery available in seven markets, with plans to add a dozen more cities by year end.

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Diagnostics Market Expectations and Opportunities Post Pandemic

PM360

Before the COVID-19 pandemic, diagnostic testing procedures involved patients visiting HCPs—namely their physician or nurse practitioner—for sample collection. While her primary care physician wrote her concern off, Christine chose to undergo a colonoscopy which revealed that she had Stage 3 cancer and a nearly two-inch tumor in her rectum.