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Congress could appropriate federal funds for csr payments to issuers Commercial plan policies are based on national reimbursement determinations, along with state government program reimbursement policies, and requirements. Paying for csrs directly might appeal to some senate republicans because it could reduce the deficit more than funding csrs via larger aptcs

Those enhanced aptcs will expire at the end of this year. Managed care contracts restructure how reimbursement occurs between payors and providers Private plans, which cover far more americans than public plans, have more flexibility to make coverage and reimbursement determinations

All plans implement various cost containment measures which may impact plan beneficiaries’ access to certain drug products.

Generally, cost reimbursement contracts have their own cost rules and contain some kind of economic price adjustment (“epa”) clause specifying when and how the contractor gets compensated. By working closely with the contracting officer, they adjust project milestones while ensuring all expenses are properly documented for reimbursement. On july 1, 2025, the senate passed its version of h.r 1 (senate bill), which made various amendments to the bill, including changes to the tax subtitle that was included in the house bill (read taxnewsflash).

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