Florida Bills Would Increase Funds, Managed Care in Mental Health Delivery
March 18th 2015Mental health advocates say Florida ranks near the bottom of states for spending on mental health. Bills introduced last week would draw down more federal Medicaid dollars to increase payments to providers, expand services, and prevent those at risk from ending up in prison. The system also has limited experience with managed care.
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With New Cholesterol Drugs, Should Managed Care Brace Itself for the Next Sovaldi?
March 17th 2015Powerful cholesterol-fighting drugs, PCSK9 inhibitors, could break new ground for payers: a higher-priced therapy could replace generic statins for patients suffering a chronic condition, perhaps for an unspecified period of time.
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AMA, CDC Launch Diabetes STAT to Prevent More Cases of Type 2
March 13th 2015An estimated 86 million Americans have prediabetes and 90% don't know it. The initiative announced yesterday seeks to reach this population and intervene before the disease progresses to type 2 diabetes mellitus, which costs $245 billion a year.
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Cancellation of Managed Care Contract Creates Upheaval in Alabama's Mental Health System
March 12th 2015Blue Cross Blue Shield of Alabama and a large provider could not come to renewal terms, forcing 28,000 mental health patients to go elsewhere. Critics have said the episode is the latest in state's dismal record in mental health.
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Prime Healthcare Drops Bid for Charity Hospitals; Cites Conditions From California Attorney General
March 11th 2015At a time of rapid change and consolidation in healthcare, California's attorney general put conditions on the Daughters of Charity sale that would restrict Prime Healthcare's growth and limit its ability to negotiate managed care contracts.
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CMS Gives New Hampshire Nod for Custom Medicaid Expansion
March 9th 2015New Hampshire's waiver features premium assistance to shop on the HealthCare.gov exchange and includes a work-referral requirement. CMS resisted linking a waiver to work-related requirements more than a year ago when granting Pennsylvania's waiver.
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Study of Heart Failure Patients Defines How Avoiding Risk Factors Can Add Years to Life
March 5th 2015The study, which will presented next week at the meeting of the American College of Cardiology, defined how much avoiding diabetes, obesity, and hypertension before age 45 matters if one is later diagnosed with heart failure.
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Questions of Context, Practical Effect Highlight Oral Arguments in King v. Burwell
March 4th 2015The Supreme Court's liberal wing grilled the petitioner's attorney on whether today's argument squared with what he said in the 2012 challenge to the Affordable Care Act. Justice Kennedy asked how states could be forced to set up exchanges or see their residents lose tax credits.
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Nurse Who Contracted Ebola to Sue Texas Hospital Parent Company
March 2nd 2015Nina Pham was the first nurse at Texas Presbyterian Hospital in Dallas to contract the Ebola virus after caring for patient Thomas Eric Duncan, who died October 8, 2014. In an interview with The Dallas Morning News, Pham said she will sue the hospital's parent company today for unspecified damages, citing inadequate training and safety measures and for violations to her privacy.
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Kaiser Report Predicts Severe Market Disruption if ACA Subsidies Are Lost
February 26th 2015A lengthy report published by the Kaiser Family Foundation predicts widespread market disruption if ACA premium subsidies are lost under King vs. Burwell. Adverse selection, insurers exiting markets, and higher rates are just some of the possibilities.
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Tax Preparer Says More Than Half Who Got ACA Subsidies Must Repay a Portion
February 25th 2015H&R Block, the largest consumer tax preparer, said those who underestimated their 2014 income must repay an average of $530. Those who failed to get coverage at all must pay an average penalty of $172.
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Study Suggests Lung Cancer Screening Criteria May Not Capture All Smokers Who Need It
February 24th 2015A study published today in JAMA suggests that former long-term smokers who have quit for more than 15 years would benefit from access to the lung cancer screening recently approved for coverage by Medicare; however, these smokers no longer meet the criteria.
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Dietary Panel Releases Report; Cholesterol Removed From List of Nutrients to Avoid
February 20th 2015The 2015 Dietary Guidelines Advisory Committee met for more than a year to review scientific evidence and discuss "patterns" of food consumption, and those discussions are reflected in the report. After a 45-day comment period and public hearing, the US Secretaries of Agriculture and Health and Human Services will issue the final Dietary Guidelines for Americans, the nation's official nutrition policy.
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CMS Adds Special Enrollment Period to Help Consumers Avoid Tax Penalty
February 20th 2015Consumers would have to show they only learned about the tax penalty when they went to file their tax returns, according to CMS' Andrew Slavitt. Under the Affordable Care Act, penalties for not having coverage for 2015 are $325 or 2% of household income.
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Obesity Among Children and Teens Demands Stronger Response, Lancet Authors Find
February 19th 2015The article was part of a Lancet series which took aim at the "unacceptably slow" response to rising rates of childhood obesity, and the effects not only on health but also on its social and economic effects on children. Authors called on nations to rein in marketing aimed at children.
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Early Figures Put Final 2015 ACA Enrollment at 11.4 Million
February 18th 2015Last night's announcement came in a video release featuring President Obama and HHS Secretary Sylvia Mathews Burwell. The president cited the Affordable Care Act's reach into previously underserved markets and the increased level of consumer choice in 2015; increased competition as the law goes forward will drive down premiums over time, he said.
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