ms

A Peak At United HealthGroup CEO’s Planned Testimony The United HealthGroup CEO plans on giving detailed testimony this week on Capitol Hill.  His testimony outlines how the cyberattackers got in, which may point to a security flaw in Change Healthcare’s system. United has funneled $6.5 billion to providers impacted so far. Additional article here: https://www.modernhealthcare.com/politics-policy/unitedhealth-andrew-witty-congress-change-healthcare-outage (Some articles may require a subscription.) #changehealthcare #cyberattacks https://www.fiercehealthcare.com/payers/unitedhealth-ceo-witty-set-go-congress-week-heres-look-his-testimony Walmart To Exit Primary Care Market Shocking announcement by Walmart that it will exit the primary care health market, including virtual care, as it has not been profitable.  It will close its Walmart Health locations that have opened.  At one time “retail meets healthcare” was thought to be the future for many retail companies.  While there have been some successes, there are also big failures.  This exit could change many plans to tie healthcare settings to retail ones. In related news, the Walmart co-branded Medicare Advantage

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

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 https://www.fiercehealthcare.com/health-tech/ftc-finalizes-changes-data-privacy-rule-step-scrutiny-digital-health-apps 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 https://www.fiercehealthcare.com/finance/hospital-ma-studies-highlight-higher-prices-tepid-antitrust-intervention 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. 

Cigna Arm To Offer Humira Biosimilar At $0 Cost-Share Finally, we are making some advances on biosimilar adoption.  For awhile, pharmacy benefits managers (PBMs) were teaming up with brand drug makers to stop the uptake of biosimilars through rebate arrangements.  That still happens, but PBMs are seeing the light. Evernorth’s Accredo Specialty Pharmacy will make a Humira biosimilar available to patients with no cost-share. Evernorth is partnering to produce the biosimilar. The biosimilar price is about 85% lower than that of the brand. #biosimilars #drugpricing #brandrugmakers #cigna #evernorth https://www.fiercehealthcare.com/payers/evernorths-accredo-offer-humira-biosimilar-0-out-pocket Kaiser Permanente Reports Major Breach A data breach at Kaiser Foundation Health Plan affected more than 13 million individuals.  It is not a hack or ransomware attack.  It appears the plan’s technology may have inadvertently transmitted personal information to Google, Microsoft Bing and X. (Article may require a subscription.) #cyberattacks #kaiserpermanente #breaches https://www.modernhealthcare.com/cybersecurity/kaiser-permanente-data-breach Mixed News For Molina Healthcare The Molina stock went