In this edition:

• 💊 Over 800 medications to get price increase

• 5️⃣0️⃣ Medicare Advantage Insurers Made Nearly 50 Million Prior Auths in 2023

• 💰 Bill introduced to boost physician pay through December

• And more!

More than 800 medications to get price increase

Drugmakers raised the list prices of more than 800 prescription drugs for blood pressure, cancer and other conditions by a median 4% at the start of this year.

The modest size of the annual increases could help companies avoid criticism of gouging from President Trump while seeking his administration’s support for such priorities as taking aim at the rebates given to middlemen and altering a federal program providing discounts to certain hospitals. Last year’s median price increase was 4.5%.

Although most companies kept increases below 10%, some drugs were already so expensive that even relatively moderate boosts can add hundreds or even thousands of dollars to the monthly tab. 

Medicare Advantage Insurers Made Nearly 50 Million Prior Auths in 2023

Medicare Advantage insurers made nearly 50 million prior authorization determinations in 2023, reflecting steady year-over-year increases since 2021 (37 million) and 2022 (42 million) as the number of people enrolled in Medicare Advantage has grown.

The determinations represent requests for approval that providers are required to submit before providing a service. Substantially fewer prior authorization reviews for traditional Medicare beneficiaries were submitted to CMS – just under 400,000 in fiscal year 2023 – though the number of people enrolled in Medicare Advantage and traditional Medicare were similar in these years.

Bipartisan lawmakers introduce bill boosting physician pay by 6.6% from April through December

A bipartisan group of representatives introduced a bill Friday that would offset and exceed a pay cut for doctors that went into effect at the top of this year.

The proposed adjustment would take effect April 1 and run through the rest of 2025, thereby leaving the year’s 2.83% Medicare pay cut in place for services furnished from January to March. Services furnished after the cutoff, however, would see a 6.62% increase—offsetting the pay cut, adjusting for inflation and prorating the first three months of pay cuts.