Author: Scott Welch
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.
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.
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 ...
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.
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 ...
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 ...
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 ...
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 ...
The Federal Trade Commission issued a warning Thursday about companies’ use of consumers’ biometric information such as facial recognition technology, saying it raises “significant consumer privacy and data security concerns.” Why it matters: The warning comes as a growing number of companies amass data based on individuals’ physiological features which could be used to infer consumers’ health or ...
Patient demand for GLP-1 weight loss drugs is continuing to grow, and, if Medicare were to expand coverage to meet that demand, it could cost the program billions each year, according to a new analysis. Traditional Medicare does not currently cover these drugs, which include brand names like Novo Nordisk’s Ozempic and Wegovy, for weight loss. ...