Seema Verma, administrator of CMS, is looking to make broad changes to Medicaid expansion without Congress’ help. According to STAT, Verma is looking to cut enrollment and costs for the program, which was expanded under the Affordable Care Act (ACA). She also plans to loosen rules for states to get waivers to make changes to their Medicaid programs. Some opponents are concerned that more leeway with Medicaid waivers could undermine access to care.
A federal judge has blocked a petition from several states to order a restraining order against the Trump administration for ending the ACA’s federal subsidies to insurers. The judge ruled that an emergency order compelling the White House to pay the subsidies was “counterproductive” since states had already prepared for the administration to cancel the payments, California Healthline reported. The lawsuit had been brought by 18 states and the District of Columbia, and the judge’s ruling only applies to the restraining order request. He did not weigh in on whether the funds for the subsidies had been properly appropriated.
After severely cutting back on its ACA business, Anthem is now reporting its ACA business has broken even. Reuters reported that Anthem’s outlook, which forecasts a slight profit for 2018, takes into account lost subsidies that were canceleld by the Trump administration. Anthem’s exit from some ACA markets means it will have reduced enrollment by 70% next year. Another reason why Anthem has been able to break even is that its consumers have been healthier, which has lower medical costs.
CMS' 340B Repayment Proposal May Harm Vulnerable Hospitals, Reward Those With Higher Revenues
April 26th 2024The 340B hospitals not receiving an offsetting lump-sum payment from CMS following 2018-2022 cuts later ruled unlawful are disproportionately rural, publicly owned, and nonacademic, according to a new study.
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Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
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Empowering Community Health Through Wellness and Faith
April 23rd 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In the third episode, Camille Clarke-Smith, EdD, MS, CHES, CPT, discusses approaching community health holistically through spiritual and community engagement.
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Kaiser Permanente was hit by a data breach in mid-April, impacting 13.4 million health plan members; GlaxoSmithKline (GSK) sued Pfizer and BioNTech for allegedly infringing on its messenger RNA technology patents in the companies’ COVID-19 vaccines; the CDC announced the first-known HIV cases transmitted via cosmetic injections.
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