CER Daily Newsfeed

Senator Cassidy Calls for 340B Program Reform

(4/23, John O’Brien, LinkedIn Post) comments “...[Mark Cuban:] They need to require that PBMs provide all claims to manufacturers and sponsors. It’s the only way to stop double dipping and it will save manufacturers about 10 pct of WAC, which CMS and sponsors can demand is shared with patients. And while they are at it, require formularies can’t be defined by PBMs. Ever. That ends the rebate scam and moves us to net pricing through distribution. Formularies should be designed to optimized wellness of a population, not pay for play like a grocery store checkout line.” Full

ACOs’ Focus on Rooting Out Fraud Aligns With CMS Vision Under Oz

(4/23, Christina Mattina, The American Journal of Managed Care) reports “...First catheters, now skin substitutes—and more areas of anomalous medical billing will continue to pop up, requiring data vigilance and collaboration on the part of accountable care organizations (ACOs), according to speakers at the National Association of ACOs (NAACOS) Spring 2025 Conference. The identification of these areas potentially signaling fraud aligns with the Trump administration’s focus on promoting efficiency and cutting out waste, as described by new CMS Administrator Mehmet Oz, MD.” Full