Resource Library

Prevalence and Cost of Unsafe Opioid Use in a Medicare Advantage Population

The policy and industry response to prescription opioid overutilization has focused on alerting payers and providers, and limiting patient access to these medications, when utilization patterns suggest overuse, fraud, or evidence of addiction. Authors: Joyce, Amie T; Ross, S. Michael; Kautz, Sharon R; Hamilton , Laurie S; Erxleben, Tori E; McKethan, Aaron N; Benner, Joshua…

RxAnte Perspective: Proposed CMS Medicaid and CHIP Rule Making

Recently, the Centers for Medicare and Medicaid Services (CMS) released proposed changes for Medicaid and Children’s Health Insurance Program (CHIP) managed care programs. This is CMS’s first update to the Medicaid managed care organization (MCO) regulations in over a decade. There have been many changes in the healthcare marketplace since the last MCO rule update…