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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

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March 7, 2024

Almost 18 Million Initially Lost Medicaid Coverage During Redeterminations The Kaiser Family Foundation reports that almost 18 million initially lost coverage during Medicaid redeterminations.  Some regained eligibility later.  Most lost coverage on procedural grounds.  Enrollment has dropped by about 10M so far in Medicaid nationwide. #medicaid #redetermintations Link to Article Evernorth Continues Growth Cigna’s Evernorth service subsidiary continues its growth. It announced an expansion to its GLP-1 management solution as well as the launch of a new behavioral-health-focused medical group. #cigna #evernorth Link to Article Biden To Propose Major Expansion Of Healthcare Initiatives President Biden will propose major healthcare expansions in his State of the Union Address tonight.  Among other things, a Fact Sheet says he will propose an expansion of Medicare drug price negotiation (500 drugs negotiated over the next 10 years), permanent expansion of enhanced premium subsidies in the Exchanges, a special program for those in the coverage

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March 6, 2024

Walgreens Will Have Long Road To Recovery Walgreens says that its road to financial recovery will be long – not a 12-month plan.  It is undertaking a strategic review of its business. It plans to cut $1 billion in expenses this year.  Additional article: https://www.modernhealthcare.com/providers/walgreens-tim-wentworth-villagemd-shields-health-ownership (Some articles may require a subscription.) #walgreens Link to Article Major Claims Reductions Reported In Light of Change Healthcare Cyber Attack While UnitedHealth Group remains mum, Humana and Elevance Health say they are seeing a 15% to 20% reduction in data from providers since the Change Healthcare cyber attack. The rate of reduction is now down to 10% as providers and plans adapt to the outage from Change. Plans are adopting a reserve strategy to ensure a set aside for such claims in the future. Change Healthcare/Optum will likely lose a great deal of business as providers and plans lose faith in Change and migrate to other

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