title: Medicare Coverage Strategies: Impact of the MMA and PBMs.
abstract: American Health & Drug Benefits ™ has been created to act as an ideological melting pot focusing on health and drug benefit decision makers, as well as those who may affect or may be affected by those decisions. By engaging in conversations with payors, regulators, employers, and other stakeholders, our journal hopes to enable decision makers to view the impact of benefit designs from as many perspectives as possible. Through this open dialogue, we hope that better decisions may be made, and that the greater healthcare marketplace will be positively impacted. In following our editorial mission, American Health & Drug Benefits ™ has sought thought leaders who have influenced and will continue to influence the healthcare marketplace. During a fall visit to Washington, DC, Dr. Joseph Antos was kind enough to host a visit to the American Enterprise Institute and provide his thoughts to Robert Henry, editor-in-chief, on how the Centers for Medicare & Medicaid Services (CMS) exerts its influence on drug coverage in the wake of the Medicare Modernization Act (MMA) and in the face of evidence-based medicine standards. Following a chronology of CMS's role from its inception to current events, Dr. Antos offers a lively insight into CMS's strategy and its tactical effects on the American healthcare system.
authors.affiliation: Dr. Antos is the Wilson H. Taylor Scholar in Health Care and Retirement Policy at American Enterprise Institute (AEI) for Public Policy Research. He is also a Commissioner of the Maryland Health Services Cost Review Commission, and an Adjunct Professor at the School of Public Health of the University of North Carolina at Chapel Hill. Before joining AEI, Dr. Antos was Assistant Director for Health and Human Resources at the Congressional Budget Office, Director of the Office of Research and Demonstrations, and Deputy Director of the Office of the Actuary at the Health Care Financing Administration (currently CMS). He served as Health Financing Consultant to the World Bank and the Organisation for Economic Co-operation and Development, as well as Senior Economic Advisor to the U.S. Agency for International Development. He currently is a member of the Panel of Health Advisors to the Congressional Budget Office, and is Commissioner of the Maryland Health Services Cost Review Commission.
authors.forename: Joseph
authors.initials: J
authors.lastname: Antos