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April 29, 2024

New Study Recommends Health-Related Tiering For Access To GLP-1s

A new study recommends a tiering of GLP-1 medication access based on health status. The problem is the price of the drugs are exorbitant compared with other developed countries. And wide access to the drugs is often only available in richer health plans. As such, the reasonable proposal is destined for the ash heap for now.

#weightlossdrugs #branddrugmakers #drugpricing

https://www.fiercehealthcare.com/regulatory/heres-what-fair-allocation-glp-1s-and-other-weight-loss-drugs-could-look

Association Health Plans Will Be Barred Under New Rule

The Department of Labor (DOL) is expected to release a final rule that will bar Association Health Plans that were put into effect under the Trump administration. The move was a gimmick to make it look like the GOP had a reasonable alternative to the Affordable Care Act (ACA). It didn’t.

Additional article: https://insidehealthpolicy.com/daily-news/admin-rescinds-ahp-rule-coalition-backs-senate-bill

(Some articles may require a subscription.)

#obamacare #aca

https://www.fiercehealthcare.com/payers/dol-set-reverse-trumps-association-health-plan-policy

New Class-Action Lawsuit Against MultiPlan And Major Insurers

A new class-action lawsuit has been filed by a provider arguing the vendor MultiPlan and major insurers have colluded to reduce out-of-network payments.

Additional article: https://www.modernhealthcare.com/legal/multiplan-cigna-aetna-allegiance-health-lawsuit

See my blog on the subject here: https://www.healthcarelabyrinth.com/out-of-network-provider-billing-is-yet-another-provider-attack-issue-against-plans/

(Some articles may require a subscription.)

#healthplans #providers #payments

https://www.fiercehealthcare.com/payers/multiplan-major-payers-again-accused-colluding-new-provider-class-action

Cyberattack Means Extension To File Quality Data

The Centers for Medicare and Medicaid Services (CMS) and the National Committee for Quality Assurance (NCQA) have extended health plan quality filing deadlines by two weeks to late June due to the Change Healthcare cyberattack.

(Article may require a subscription.)

#changehealthcare #cyberattacks #healthplans

https://www.modernhealthcare.com/safety-quality/change-healthcare-update-cms-ncqa-reporting

United To Appear At Congressional Hearing On Cyberattack

United CEO Andrew Witty likely will get pummeled from both parties when he appears before congressional committees this week.  Both sides of the aisle are upset about United’s response to the Change Healthcare cyberattack. I sympathize with any organization that goes through an attack, especially one that is as far-reaching as this. But United looks flat-footed in its overall response — not very agile and somewhat unaccountable. Providers continue to see daily impacts over two months on. Was its security deficient and did it lack a solid business continuity plan?

Witty recently intimated that United’s size meant the fallout from the cyberattack was better than if it had happened to a less sophistcated organization. I am just not sure that is a good argument to make, especially on Capitol Hill. More and more, people are concluding that bigger is not always better.

See my blog on the topic here: https://www.healthcarelabyrinth.com/the-change-healthcare-cyberattack-what-it-is-and-its-implications/.

See my podcast in the topic here: https://www.healthcarelabyrinth.com/17-what-happened-when-change-healthcare-suffered-a-major-cyberattack-and-what-will-it-mean-to-the-broader-healthcare-system-moving-forward/

(Article may require a subscription.)

#changehealthcare #cyberattacks

https://www.modernhealthcare.com/insurance/unitedhealth-group-empire-andrew-witty

Glimpse At What Trump Drug Policy Might Be

The former Domestic Policy Council head for the Trump administration said that it would be hard to revise the Inflation Reduction Act’s Medicare drug price negotiation, but that Trump could demand more transparency for the ongoing negotiations and that most-favored-nation drug pricing could be resurrected.

(Article may require a subscription.)

#drugpricing #trump

https://insidehealthpolicy.com/daily-news/former-trump-official-talks-ira-tweaks-drug-shortages-reference-pricing-march

FTC Chief Says New Technologies Make It Easier To Fix Prices

The Federal Trade Commission (FTC) chief says that new technologies make it easier for companies to fix prices and discriminate against individual consumer. Based on an executive order, the FTC is getting far more aggressive on anti-competition.

#manda #antitrust

https://www.medpagetoday.com/special-reports/features/109870

— Marc S. Ryan

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