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December 31, 2024

Kennedy And Oz At Odds On GLP-1s Department of Health and Human Services (HHS) Secretary-nominee Robert F. Kennedy Jr. and Centers for Medicare and Medicaid Services (CMS) Administrator-nominee Dr. Mehmet Oz are at odds over support for GLP-1 weight-loss drugs. Oz has opined that the drugs could have a positive effect on weight loss and reducing disease prevalence. Kennedy sees them as a scam and insists that the American public simply needs to eat better. The Biden administration has proposed in a draft rule to provide Medicare Part D coverage for obesity alone. Trump will need to finalize the rule or remove the provision. This will be the first test of who will win the GLP-1 coverage war. The drugs are expensive at $1,000 or greater per month at list price. #glp1s #weightlossdrugs #drugpricing #branddrugmakers https://thehill.com/policy/healthcare/5055607-rfk-jr-vs-oz-sets-up-clash-on-weight-loss-drug-coverage Employers And PBMs Under Attack A good article on the rise of lawsuits against

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December 30, 2024

Some Hope For Medicaid Hikes Medicaid managed care plans have argued that risk in the program has gone up with the Medicaid unwinding (redeterminations) and rates have become inadequate to serve remaining enrollees. A number of state Medicaid directors are now saying mid-year rate hikes could address the financial woes of plans. The Alliance of Community Health Plans is urging the current administration to urge states to re-evaluate current rates. Notwithstanding the positive signs, states will have a hard time affording major hikes given the drying up of extraordinary federal revenue given to states during the COVID pandemic. (Article may require a subscription.) #medicaid #redeterminations #rates #healthplans #managedcare https://insidehealthpolicy.com/daily-news/states-promote-mid-year-rate-adjustments-mcos-struggling-post-covid Article Recaps Tough Year for UnitedHealth Group Becker’s recounts the very tough year seen by UnitedHealth Group, including the Change Healthcare cyberattack, government investigations, and the tragic killing of executive Brian Thompson. #unitedhealthcare #tragedy #changehealthcare #cyberattacks https://www.beckerspayer.com/payer/an-unimaginable-year-for-unitedhealth.html MA Does Not Offer

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