California Governor Signs Bill To Allocate $150M To Struggling, Closed Hospitals

California Gov. Gavin Newsom signed legislation creating a $150 million loan program for financially distressed hospitals into law May 15.

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California Has Tried To Cut The Cost Of Insulin For Years. Why It Might Finally Succeed

Prices for the 100-year-old drug have increased more than 600% in the past 20 years, and stories of patients rationing doses abound. Even the most conservative economists point to it as an example of a market gone sour.

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Superior Court Upholds CMA Legislation Mandating Reimbursement For COVID-19 Testing And Vaccination

In a ruling issued this week, the Los Angeles Superior Court upheld the constitutionality of a state law requiring health plans to fairly reimburse health care providers for the costs of COVID-19 testing during the COVID-19 state of emergency.

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Private Insurers Estimated To Pay $1.1B in Rebates in 2023

Individual market insurers are estimated to owe about $500 million in rebates to enrollees this year, a Kaiser Family Foundation analysis found. Small group market insurers are anticipated to owe about $330 million, and large group market insurers are expected to owe about $250 million.

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A More Aggressive FTC Is Starting to Target Drug Mergers and Industry Middlemen

Under the leadership of an aggressive opponent of anti-competitive business practices, the Federal Trade Commission is moving against drug companies and industry middlemen as part of the Biden administration’s push for lower drug prices at the pharmacy counter. On May 16, the FTC sued to block the merger of drugmakers Amgen and Horizon Therapeutics, saying ...

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Progressives Reintroduce ‘Medicare For All’ Bill

Key progressives in the House and Senate have revived the fight in Congress over "Medicare for All," a single-payer health system based on the Medicare program.

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House Panel Advances Transparency And PBM Bills

A House Energy and Commerce Committee health markup on Wednesday offered more evidence that price transparency and pharmacy benefit manager regulation are two issues that have enough bipartisan support to move ahead in this Congress. Among the measures the panel advanced on a unanimous 27-0 vote: Codifying and strengthening Trump-era rules for hospitals and insurers to make ...

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Kaiser Permanente Discloses Timeline, Financial Commitments For Its VBC Megadeal With Geisinger Health

Disclosures included in Kaiser Permanente’s quarterly financial statements offer new details on the timeline for its major value-based care deal with Geisinger Health, as well as the upper and lower limits of its investment commitments toward the new entity and expanding Geisinger’s Pennsylvania market presence. The statements, released late Monday, recap the definitive agreement announced ...

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Senate Scrutinizes MA Payment Denials, Including Use Of Algorithms

Medicare Advantage plans’ use of third-party algorithms for coverage determinations is facing some scrutiny in the Senate. Lawmakers in a Wednesday hearing argued something must be done to pare back burdensome prior authorization requirements allowing payers to delay or deny medical care that would be covered under traditional Medicare — including the use of artificial intelligence ...

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Subcommittee Hearing Reveals Plenty Of Targets, But Little Consensus, For Lawmakers’ Healthcare Consolidation Reforms

House members participating in a Wednesday afternoon subcommittee hearing were in broad, bipartisan agreement that consolidation and other anticompetitive practices are prevalent across the healthcare industry and drive untenable costs for patients and the government. Based on their grab bag of witness questions and finger-pointing, however, it’s still up for debate which offending camp—pharmacy benefit ...

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