Author: Scott Welch
Employers and health plans continue to grapple with rising specialty drug costs as utilization growth and an expanding pipeline reshape benefit strategy, according to Pharmaceutical Strategies Group’s 13th annual Specialty Drug Benefits Report, which surveyed benefits leaders across employers, health plans and union-sponsored plans nationwide. Specialty drugs now account for more than half of total ...
GLP-1 drugs (glucagon-like peptide-1s) have exploded in popularity in recent years – initially as a way to control diabetes and then as tools for weight loss. Growing research suggests that these drugs – which include semaglutide and tirzepatide – potentially have benefits beyond weight loss, with stronger evidence for cardiovascular and kidney health. Even so, experts ...
Officials have failed to halt pervasive fraud in the hospice industry despite promises of reforms five years ago after learning of widespread corruption that targeted vulnerable patients. California authorities promised to crack down after a Times investigation in late 2020 revealed that a cohort of mostly older Americans was being targeted by unscrupulous providers who ...
A new executive order could eventually put psychedelic drugs on employer health plans’ prescription drug formularies. President Donald Trump signed an executive order Saturday that calls for “accelerating medical treatments for serious mental illness.” The order does not address matters such as health plan provider networks or health plan coverage for inpatient treatment for mental ...
Hospital and pharma groups have sharpened their spears for the rematch on 340B rebates. In comment letters submitted just ahead of a Monday deadline, the stakeholders weighed in on a contentious Trump administration pilot program that would overhaul drug discounts hospitals have received for the past 30 years to subsidize safety-net care. Rather than receive ...
House members got their first opportunity Thursday to grill Health and Human Services Secretary Robert F. Kennedy Jr., as he kicked off a marathon series of seven congressional hearings in seven days with back-to-back hearings in the Ways and Means and Appropriations Committees. In the two appearances, his first before Congress in 2026, Kennedy defended his record in leading the nation’s health agency as Democrats sought to push back ...
Employers, lawmakers, providers and more said the Department of Labor should quickly finalize disclosure mandates for the controversial drug middlemen.
UnitedHealthcare said it’s going to eliminate most requirements for prior authorization for medical care for about 1,500 rural hospitals and their affiliated health care providers by this fall. The change will affect all of the small, isolated rural hospitals classified as “critical access hospitals.” In January, the United States had 1,381 critical access hospitals, according ...
Excess salt intake has long been linked to higher blood pressure, but now a new study has also tied it to quicker cognitive decline in certain groups. In a six-year study of more than 1,200 older adults 60 and older, Australian researchers found that higher baseline dietary sodium intake was associated with faster decline in “episodic recall” in ...
The system of paying Medicare agents and brokers more money if they enroll someone in a Medicare Advantage plan rather than traditional Medicare with a supplement plan needs to be changed, according to several members of the Medicare Payment Advisory Commission (MedPAC). “The broker compensation piece really frustrates me,” MedPAC member Stacie Dusetzina, PhD, of ...