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May 21, 2024

Wyden Wants Tough Stance On Exchange Agents and Brokers

Finance Chair Ron Wyden wants the Centers for Medicare and Medicaid Services (CMS) to crack down on rogue brokers and agents in the nation’s Exchange signup process. 

(Article may require a subscription.)

#exchanges #agents #brokers #fwa 

https://www.modernhealthcare.com/insurance/ron-wyden-cms-exchange-marketers-aca

Huge Proliferation Of Firms Devoted Just To GLP-1s

More and more startups are popping up to promote GLP-1 use just for weight loss.  This caters to the better off.  Hims and Hers has been around for awhile and is jumping on the bad wagon but by offering compounded versions, largely due to the shortages. The overall trend has been a disservice to the nation as it tends to create shortages for those who need the drugs for disease state treatment. A new analysis by Kaiser says high prices of such drugs also lock out those with modest incomes.

Additional article: https://www.modernhealthcare.com/digital-health/hims-hers-wegovy-weight-loss-drugs-novo-nordisk-eli-lilly-zepbound

(Some articles may require a subscription.)

#weightlossdrugs #drugpricing

https://kffhealthnews.org/news/article/high-prices-ozempic-mounjaro-wegovy-glp1s/

Biden Emphasizing Healthcare In Election

President Biden is pivoting to healthcare issues in the election to attract swing voters.  Good Kaiser Health News article on the subject.

#biden #healthcare #election2024

https://kffhealthnews.org/news/article/biden-health-care-ad-buy-obamacare-aca/

Providers Want Clarification On Breach Notification

Providers have written federal regulators to get clear guidance on who should notify victims of the Change Healthcare cyberattack.

#changehealthcare #cyberattacks

https://www.healthcaredive.com/news/change-healthcare-cyberattack-data-breach-reporting-hhs-ocr-ama/716696

Senate Looks To Hone In On Brand Drug Makers’ Patent Abuse

Democratic senators are looking to build on a number of new laws that seek to stop patent abuse by brand drug makers.  Ideas include much greater coordination between the Food and Drug Administration (FDA) and the Patent and Trademark Office (PTO).  As well, it wants the FDA to review every patent request. The proposals are good one as brand drug makers continue nefarious practices to stop generic and biosimilar introductions.

#drugpricing #brandrugmakers #patents #antitrust

https://www.medpagetoday.com/washington-watch/washington-watch/110257

Former Surgeon General Shares His Surprise Billing Travails

A good article from former Surgeon General Jerome Adams.  He shares a personal story on a huge bill he received while on business travel.  He traces issues back to a lack of transparency, surprise billing, uncontrolled pricing, and underinsurance in America.

#pricetransparency #transparency #surprisebilling #healthcare #underinsured #uninsured

https://www.medpagetoday.com/opinion/second-opinions/110190

Vermont Has New Prior Authorization Law

Vermont joins a growing number of states with new prior authorization laws.  Among other changes, the law allows consumers to ask for exemptions to step therapy and requires health insurers to decide prior authorizations within 24 hours for urgent situations and two business days for nonurgent care.

#priorauthorization #healthplans

https://www.beckerspayer.com/payer/vermont-governor-signs-prior-authorization-reform-bill.html

Less Than Half Of Nursing Homes Can Meet Staffing Requirements

A new analysis by the Kaiser Family Foundation finds that fewer than half of nursing facilities in 45 states can currently meet all three staffing minimums required in the new federal rule promulgated by the Centers for Medicare and Medicaid Services (CMS). In 28 states, less than a quarter meet the requirements.

Additional article: https://www.kff.org/medicaid/press-release/in-45-states-fewer-than-half-of-nursing-facilities-have-enough-staff-to-meet-new-federal-requirements/

#nursinghomes #staffing

https://www.kff.org/medicaid/issue-brief/a-closer-look-at-the-final-nursing-facility-rule-and-which-facilities-might-meet-new-staffing-requirements/

— Marc S. Ryan

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