April 26, 2024

FTC Approves Rule Extending Data Privacy To Digital Apps

On a 3-2 vote, the Federal Trade Commission (FTC) finalized a rule that extends the scope of its breach notification rule to include personal health information collected by health apps and other technology that are outside the Health Insurance Portability and Accountability Act.  It is a very controversial move and may be beyond the FTC’s authority.

Additional article: https://insidehealthpolicy.com/daily-news/ftc-issues-controversial-breach-notification-rule-despite-two-commissioners-dissent

#cybersecurity #breaches


Study Shows Hospital Mergers Raise Price, Little Government Scrutiny

Two academic studies say hospital mergers and acquisitions raise price and receive little scrutiny from regulators. That could change with the Biden administration’s new focus.

#manda #mergers #acquisitions #hospitals


Centene Reports Positive Financial News

Centene reported reasonably good financial news, beating expectations.  It says its Medicaid dominant business is doing well against forecasts for redetermination enrollment losses and is about 90% through the process. Q1 medical costs were up. 

In other Medicaid news, Centene says few Medicaid states are adding GLP-1 weight-loss drugs.

Additional articles: https://www.beckerspayer.com/payer/centene-states-slow-to-pick-up-medicaid-weight-loss-drug-coverage.html and https://www.modernhealthcare.com/finance/centene-prior-authorization-sarah-london and https://www.healthcaredive.com/news/centene-medicaid-redeterminations-q1-2024/714397/

(Some articles may require a subscription.)

#centene #medicareadvantage #medicaid


Some Medicare Advantage Plans Covering Wegovy For Cardiovascular Disease

With the approval of GLP-1 Wegovy for those who are overweight or obese and have cardiovascular disease, some Medicare Advantage (MA) plans have said they will cover the drugs in those circumstances.  Others have yet to decide.  Many plans cover GLP-1s for diabetes and costs are blossoming in Part D. GLP-1 use for general weight loss is not allowed in Part D. The Congressional Budget Office (CBO) says GLP-1s are not cost-effective at this time.

(Article may require a subscription.)

#weightlossdrugs #branddrugmakers #partd #medicare #drugpricing


House Budget Committee GOP Calls For Investigation Into Innovation Center

Citing a Congressional Budget Office (CBO) finding that CMS’ innovation center increased net spending, Republicans on the House Budget Committee want a look at the innovation center.  Senate Democrats cite another CBO analysis that accountable care organizations (ACOs) save and need to be expanded.  The truth is savings are limited and administrative costs high for the Medicare fee-for-service (FFS) system pilots.

(Article may require a subscription.)

#acos #medicare #cms


Kaiser Health News Sensationalizes Medicaid Rate Hikes Amid Roster Cuts

I am a big defender of Kaiser Health News’ (KHN) reporting.  It investigates many topics not often seen in the mainstream healthcare press.  But it is disturbing that KHN has stooped to sensationalizing things of late.  Case in point, the headline of an original piece today: “Millions Were Booted from Medicaid. The Insurers That Run It Gained Medicaid Revenue Anyway.” 

The article itself was not terribly unbalanced. It laid out the enrollment losses due to redeterminations as well as the fact that revenue has increased in many cases due to rate hikes at the state level.  It does touch upon the likely change in member selection or health that led states to grant interim and annual hikes. Largely a poor headline choice for a stellar organization and the need to add some additional economic context: medical loss ratios are among the highest and margins among the lowest of any health plan line of business.

#khn #medicaid #redeterminations #managedcare


— Marc S. Ryan

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