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What We’re Reading: Prior Authorization Gold Carding; Climate Change Dangers; Youth Mental Health Challenges
Overcoming insurance hurdles for critical medications; rising heat and wildfires reverse decades of clean air progress; conflicts between parents and schools arise as teens seek mental health support
Battling Insurance Hurdles: Prior Authorization
Patients seeking critical medications who have faced insurance coverage denials due to the prior authorization process may benefit from several pending bills backed by the AMA, according to Kaiser Health News. The pending bills include several policies for quicker response times, public reporting of insurer’s prior authorization determinations, and programs to reduce volume of requests. These policies are sometimes called “gold carding,” and have been passed in some form in 5 states, with the AMA currently tracking active gold carding bills in 13 states.
Climate Change Reverses Decades of Clean Air Progress in the US
A new study by the climate analytics firm First Street Foundation warned that blistering heat waves and more frequent wildfires are causing a reversal in clean air gains achieved over past decades in the US, according to The Hill. By midcentury, air quality levels are projected to return to levels not seen since 2004, as microscopic soot particles and ozone molecules surge, posing significant health risks to Americans. The study highlights the urgent need for robust climate action and emphasizes the challenges in regulating climate compared with industrial emissions.
Navigating Consent: Challenges in Youth Mental Health Treatment
As schools grapple with a youth mental health crisis, conflicts between parents and schools over treatment consent are emerging, according to The Associated Press. Differing perspectives on mental health, coupled with legal and financial barriers, pose challenges for teens seeking therapy. The issue has become politicized, with some states streamlining access while others propose restrictions, leaving young people to navigate complex paths to mental health support.
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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Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
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Mental Health Diagnoses, Care Challenges Rise Among US Youth, Report Finds
April 26th 2024While behavioral health care utilization has been rising, the treatment landscape has been worsening. New findings show that 20% of youths did not receive any form of treatment within 3 months of their initial behavioral health diagnosis.
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