The December Omnibus Bill ’s Little Secret: It Was Also a Giant Health Bill
Congress passed legislation on mental health, drugs, pandemic preparedness, new Medicare benefits and Medicaid expansion — all before the arrival of the new House. (Source: NYT)
Source: NYT - January 22, 2023 Category: American Health Authors: Margot Sanger-Katz Tags: Law and Legislation Health Insurance and Managed Care United States Politics and Government Medicare Federal Budget (US) Medicaid Pelosi, Nancy Source Type: news
California Sues Companies Over Insulin Prices, Joining Other States
The state is taking action against three major drug companies and the big pharmacy benefit managers in an effort to temper costs for people with diabetes. (Source: NYT Health)
Source: NYT Health - January 18, 2023 Category: Consumer Health News Authors: Benjamin Ryan Tags: Diabetes Drugs (Pharmaceuticals) Insulin Health Insurance and Managed Care Research Law and Legislation Medicare Inflation Reduction Act of 2022 Prices (Fares, Fees and Rates) Suits and Litigation (Civil) your-feed-healthcare Source Type: news
CMS: Agency Information Collection Activities: Proposed Collection; Comment Request
The Centers for Medicare and Medicaid Services is seeking comment on the following information collections: 1) Medicaid Managed Care and Supporting Regulations; 2) Testing Experience and Functional Tools (TEFT): Functional Assessment Standardized Items (FASI) Based on the CARE Tool; 3) the Home Health Care CAHPS ® Survey (HHCAHPS); and 4) Collection of Diagnostic Data in the Abbreviated RAPS Format. Comments are due by March 20, 2023. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - January 17, 2023 Category: Rural Health Source Type: news
Medicare Begins to Rein In Drug Costs for Older Americans
Reforms embedded in the Inflation Reduction Act will bring savings to seniors this year. Already some lawmakers are aiming to repeal the changes. (Source: NYT Health)
Source: NYT Health - January 14, 2023 Category: Consumer Health News Authors: Paula Span Tags: Medicare Diabetes Health Insurance and Managed Care Inflation Reduction Act of 2022 Law and Legislation Insulin Drugs (Pharmaceuticals) Elderly Vaccination and Immunization Politics and Government United States Source Type: news
Study finds hepatitis C cure saved Medicaid $15 billion
New research published in theAmerican Journal of Managed Care (AJMC) underscores the critical role that medicines play in improving health and reducing disease complications and other, often costly, medical care and services. The study finds that since curative direct-acting antiviral medications for hepatitis C were approved in 2013, even after factoring in the cost of treatment, Medicaid has saved an estimated $15 billion in avoided health care costs and nearly 285,000 Medicaid enrollees are estimated to have been cured. (Source: The Catalyst)
Source: The Catalyst - January 5, 2023 Category: Pharmaceuticals Authors: Lindsey Seidlitz Tags: Drug Cost Hepatitis C Medicaid Source Type: news
Medical Debt Is Being Erased in Ohio and Illinois. Is Your Town Next?
Cook County, Ill., and Toledo, Ohio, are turning to the American Rescue Plan to wipe out residents ’ medical debt. Experts caution it is a short-term solution. (Source: NYT)
Source: NYT - December 29, 2022 Category: American Health Authors: Amanda Holpuch Tags: RIP Medical Debt Debt Collection Health Insurance and Managed Care City Councils Local Government Budgets and Budgeting Law and Legislation American Rescue Plan (2021) Hospitals Cook County (Ill) Illinois New Orleans (La) Toledo (O Source Type: news
Most Older Adults Concerned About Emergency Department Costs
WEDNESDAY, Dec. 28, 2022 -- Eight in 10 older U.S. adults are concerned about the costs of an emergency department visit, according to a study published online Dec. 16 in the American Journal of Managed Care.
Rachel E. Solnick, M.D., from the... (Source: Drugs.com - Pharma News)
Source: Drugs.com - Pharma News - December 28, 2022 Category: Pharmaceuticals Source Type: news
U.S. Health Officials Seek New Curbs on Private Medicare Advantage Plans
Proposed regulations would crack down on misleading ads for the private plans and would enhance scrutiny of denials for coverage of medical care. (Source: NYT Health)
Source: NYT Health - December 17, 2022 Category: Consumer Health News Authors: Reed Abelson and Margot Sanger-Katz Tags: Medicare Health Insurance and Managed Care Medicare Advantage Centers for Medicare and Medicaid Services Source Type: news
Centene to pay $44.4 million to settle latest PBM allegations
So far, Centene has reached settlements that have been announced by at least 12 states, requiring the nation's largest Medicaid managed care provider to make about $552.4 million in payments. Centene last year set aside $1.1 billion to resolve allegations from states. (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - December 15, 2022 Category: Biotechnology Authors: James Drew Source Type: news
Centene stock slides as Bank of America Securities issues downgrade
In a note, Research Analyst Kevin Fischbeck expressed concern about Medicaid redeterminations, recent setbacks and possible future ones on contracts to run Medicaid managed care programs in states, and a poor rating from the federal government on Centene's Medicare Advantage plan. (Source: bizjournals.com Health Care:Pharmaceuticals headlines)
Source: bizjournals.com Health Care:Pharmaceuticals headlines - December 13, 2022 Category: Pharmaceuticals Authors: James Drew Source Type: news
CMS, HHS: Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Advancing Interoperability and Improving Prior Authorization Processes for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, Children's Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, Issuers of Qualified Health Plans on the Federally-Facilitated Exchanges, Merit-Based Incentive Payment System (MIPS) Eligible Clinicians, and Eligible Hospitals and Critical Access Hospitals in the Medicare Promoting Interoperability Program
Notice of proposed rule from the Centers for Medicare& Medicaid Services (CMS) that would place new requirements on Medicare Advantage (MA) organizations, state Medicaid fee-for-service (FFS) programs, state Children's Health Insurance Program (CHIP) FFS programs, Medicaid managed care plans, CHIP managed care entities, and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs) to improve the electronic exchange of healthcare data and streamline processes related to prior authorization. This proposed rule would also add a new measure for eligible hospitals and Critical Access Hospitals (CAHs) und...
Source: Federal Register updates via the Rural Assistance Center - December 13, 2022 Category: Rural Health Source Type: news
Roche ’s subcutaneous crovalimab given every four weeks achieves disease control in people with PNH, a life-threatening blood condition
The phase III COMMODORE 3 study ofcrovalimab met primary endpoints of transfusion avoidance andhaemolysis control in people with paroxysmal nocturnal hemoglobinuria (PNH)1COMMODORE 3 is the first China-specific study in PNH. Current treatment options are extremely limited in China, resulting in significant levels of disease-related morbidity and mortality for people living with PNH2Based on these datacrovalimab has received Breakthrough Therapy Designation and is under Priority Review for approval in ChinaBasel, 11 December 2022 - Roche (SIX: RO, ROG; OTCQX: RHHBY) today announced positive new data from the phase III COMMO...
Source: Roche Investor Update - December 11, 2022 Category: Pharmaceuticals Source Type: news
Roche ’s subcutaneous crovalimab given every four weeks achieves disease control in people with PNH, a life-threatening blood condition
The phase III COMMODORE 3 study ofcrovalimab met primary endpoints of transfusion avoidance andhaemolysis control in people with paroxysmal nocturnal hemoglobinuria (PNH)1COMMODORE 3 is the first China-specific study in PNH. Current treatment options are extremely limited in China, resulting in significant levels of disease-related morbidity and mortality for people living with PNH2Based on these datacrovalimab has received Breakthrough Therapy Designation and is under Priority Review for approval in ChinaBasel, 11 December 2022 - Roche (SIX: RO, ROG; OTCQX: RHHBY) today announced positive new data from the phase III COMMO...
Source: Roche Media News - December 11, 2022 Category: Pharmaceuticals Source Type: news
Families before profits: How nonprofit managed care benefits the whole health of Georgians
Improving health care in Georgia begins by addressing the social determinants of health, non-medical factors that influence health outcomes. These factors can include education, neighborhood environment, access to food and health care, as well as economic and financial conditions. For example, lack of affordable housing, while not a medical issue, affects health in many ways — from potential exposure to lead or asbestos to lack of a safe place for children to play and increased stress due to fear… (Source: bizjournals.com Health Care:Pharmaceuticals headlines)
Source: bizjournals.com Health Care:Pharmaceuticals headlines - December 8, 2022 Category: Pharmaceuticals Authors: Jason Bearden Source Type: news
Public Inspection: CMS, HHS: Medicare and Medicaid Programs: Advancing Interoperability and Improving Prior Authorization Processes for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, etc.
Pre-publication notice of proposed rule from the Centers for Medicare& Medicaid Services that would place new requirements on Medicare Advantage (MA) organizations, state Medicaid fee-for-service (FFS) programs, state Children's Health Insurance Program (CHIP) FFS programs, Medicaid managed care plans, CHIP managed care entities, and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs) to improve the electronic exchange of healthcare data and streamline processes related to prior authorization. This proposed rule would also add a new measure for eligible hospitals and Critical Access Hospitals ...
Source: Federal Register updates via the Rural Assistance Center - December 7, 2022 Category: Rural Health Source Type: news
