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NASHP Model Act to Limit Out-of-Network Provider Rates

NASHP

This model legislation limits out-of-network rates for inpatient and outpatient hospital services to the lesser of (a) the state’s median in-network commercial rate for the same service; or (b) [X]% of the Medicare rate for the same service in the same geographic area.

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Public Health Modernization Toolkit: Key Commitments, Priorities, and Strategies to Advance Collaboration between Public Health and Health Systems

NASHP

Funding for state and local health departments decreased 17 percent between 2009 and 2019, while experts estimate that an additional $4.5 billion per year is necessary to ensure access to basic public health services.[1] billion per year is necessary to ensure access to basic public health services.”

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CMS Releases Guidance on Implementation of Rebate Programs for Certain Medicare Part B and Part D Drugs

Sheppard Health Law

The Rebate Programs are administered as part of the prescription drug affordability provisions of the Inflation Reduction Act (the “IRA”), which is aimed at “lower[ing] out-of-pocket drug costs for people with Medicare and improv[ing] the sustainability of the Medicare program for current and future generations.” [1]

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The End of Public Health? It’s Not Dead Yet

Bill Of Health

This separated spheres of authority vision does not account for the ubiquitous use of federal/state partnerships in achieving national and state policy goals, especially health policy goals. Yet, these laws have no federal alternative if states fail or if implementation is otherwise thwarted, say, by court order.

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Healthcare Reforms Under the IRA: Expanding Access to Care

Sheppard Health Law

The expansive legislation includes key health care provisions, including drug pricing reforms, inflationary rebates, Medicare Part D benefit redesign, as well as myriad other updates. Medicare Drug Price Negotiation Program. The Inflation Reduction Act (“IRA”) was signed into law by President Biden on August 16, 2022.