Reimbursement News
Reimbursement news and insurance coverage updates.
CBO Outlines Budgetary Considerations for Policies Focused on Sickle Cell Disease Gene Therapy
The Congressional Budget Office said policies to increase treatment uptake could affect Medicaid, Social Security, and other government programs.
Vertex Pharmaceuticals, Bluebird Bio to Participate in CMS Cell and Gene Therapy Access Model
CMS has negotiated outcomes-based agreements for sickle cell gene therapies with the two companies on behalf of participating state Medicaid programs.
NICE Not Backing AstraZeneca, Daiichi Sankyo's Enhertu in HER2-Low Breast Cancer
Breast cancer patients in England and Wales will not have access to the drug after pricing negotiations failed between NICE and drugmakers.
After years of persistence, genetic counselors at UT Southwestern got BCBS of Texas to fix a system error that was leading to payment denials for services.
CMS Rolling Out New Payment Policy for High-Cost Diagnostic Radiopharmaceuticals
The government payor said it will separately pay for specialized diagnostic radiopharmaceuticals without transitional pass-through payment status.