Author: Scott Welch
The Paragon Health Institute has published a series of new reports once again alleging large-scale “fraud” in health care. This time their target is enrollment in the Insurance Marketplace. They then use these allegations as rationale for a set of policy recommendations, including allowing the enhanced premium tax credits to expire at the end of ...
Under the new budget signed by Gov. Gavin Newsom, Medi-Cal — the state’s Medicaid program — would no longer cover weight loss drugs, such as Wegovy and Zepbound, unless they’re prescribed to treat diabetes. The measure is intended to promote fiscal responsibility.
For employers, covering COVID-19 shots and other vaccinations is now a lot more complicated. Officials at the U.S. Food and Drug Administration took vaccinations off the auto-pilot list Wednesday, by withdrawing emergency use rules for COVID vaccinations like Novavax’s Nuvaxovid vaccine and tightening access rules for other COVID vaccinations. A team at the Pandemic Mitigation Collaborative says wastewater ...
While data released earlier this week raised questions about the administrative costs associated with No Surprises Act (NSA) arbitrations, a second study suggests the legislation is working to reduce out-of-pocket costs for members. Researchers at Harvard University and Mass General Brigham examined a sample of 17,351 privately insured adults, 8,204 of which lived in states that gained ...
President appears divided between RFK Jr. and detractors, despite clear evidence favoring vaccines
The White House quickly named a new leader of the Centers for Disease Control and Prevention (CDC) after Health and Human Services Secretary Robert F. Kennedy Jr. pushed out Director Susan Monarez this week. Jim O’Neill, a senior Department of Health and Human Services (HHS) official with deep ties to President Trump donor Peter Thiel, will take over the agency amid ...
Prior authorization is similar to how private insurers operate, often resulting in a delay or denial of treatments
GLP-1 agonists — including semaglutides like Ozempic and Wegovy and tirzepatides like Mounjaro and Zepbound — were originally intended to treat type 2 diabetes and obesity. But in recent months, studies have shown that these popular medications can have numerous other health benefits. Some have even claimed that GLP-1s could eventually become the new “everything drug.” Dr. ...
Accountable care organizations saved Medicare $2.4 billion last year, according to new federal data. The Centers for Medicare & Medicaid Services released (PDF) the latest results from the Medicare Shared Savings Program, which shows that 75% of the 476 participating ACOs earned $4.1 billion in performance payments. These organizations represent 80% of the 10.3 million beneficiaries assigned ...
This year’s updated Covid-19 vaccines have been approved by the US Food and Drug Administration for adults 65 and older and younger people with certain medical conditions that put them at a higher risk of a severe Covid-19 infection. Although federal officials have emphasized that people who want a Covid-19 vaccine can get one after ...