Over 50 Years, Medicare and Medicaid Evolve, With a Greater Role for Managed Care
July 30th 2015Fifty years ago today, President Lyndon B. Johnson signed the law that created Medicare and Medicaid, setting in motion not only the greatest change in healthcare in the nation's history at that point, but also a lasting change for society.
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So Praluent Is Approved. The Question Now Is, Who Gets It?
July 27th 2015Health plans and pharmacy benefits managers are expected to scrutinize the FDA approval to ensure that only those patients who truly need the drug get it.Drugmakers say discounts will cause the price to fall below the $14,600 annual wholesale price listed.
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FDA Approves Alirocumab, First of Cholesterol-Fighting PCSK9 Inhibitors to Hit US Market
July 24th 2015The Sanofi and Regeneron therapy, to be marketed as Praluent, was among the most-anticipated FDA approvals of the year. Late-day reports put pricing at $40 a day wholesale, well above estimates, although insurers will seek discounts.
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Will Drug Costs Be the Big Political Issue of 2016?
July 24th 2015Recent surveys have found that public sentiment on drug costs runs high and crosses the political divide. A move this week by the nation's leading oncologists to rein in therapy pricing may be a sign that this is the breakthrough issue of the presidential campaign.
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GAO Finds CMS Still Falls Short in Screening Potentially Fraudulent Medicare Providers
July 22nd 2015Since the adoption of the Affordable Care Act, CMS has removed 28,000 questionable providers from Medicare. But the Government Accountability Office found more needs to be done to verify addresses and weed out those who have lost their licenses.
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Most Americans Would Keep Medicare, Medicaid Intact, Poll Finds
July 17th 2015Nearly 50 years after President Johnson signed the law that created them, Medicare and Medicaid have become part of the fabric of the US healthcare system. A Kaiser Family Foundation poll finds little support for proposals to alter the basic structure of the programs.
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GAO Finds Bogus Applicants Not Only Enroll in ACA Marketplace, but Get Coverage Renewed
July 16th 2015The Government Accountability Office received notices of inconsistent information, but it wasn't enough for CMS to cancel coverage for the phony beneficiaries. A key flaw revealed is the ability of phony applicants to use the telephone to bypass online controls.
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Medicaid Actuary's Data Latest Evidence That Newly Insured Cost More Than Expected
July 13th 2015The newly insured came to Medicaid with medical issues that had gone unaddressed for years. The same problem has been cited by insurers who have asked for large rate increases for 2016 for plans on the exchanges.
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FDA Gives Restaurants an Extra Year to Display Calorie Counts
July 10th 2015The rule for restaurants and other food retailers is delayed until December 2016 to allow more discussions on how it will apply in many specific situations. Food labeling with calorie counts is mandated by the Affordable Care Act.
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JAMA Oncology Finds Gaps in End-of-Life Care as CMS Proposes Rule Change for Advance Care Planning
July 9th 2015A study of Kaiser Permanente cancer patients found that two-thirds of teen and young adult patients received aggressive care at the end of life. The special issue on the topic comes as CMS proposes paying doctors or nurses to discuss advanced care planning.
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Heroin Deaths Nearly Quadruple in a Decade, CDC Finds
July 8th 2015The study found that 45% of those who used heroin were addicted to opioid prescription drugs. CDC cites several studies showing clear connections between the rise of opioid abuse and heroin use and deaths, especially since 2010.
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GAO Report: Congress Must End Incentives to Prescribe Expensive Cancer Drugs in 340B Program
July 7th 2015The report found that Medicare Part B spending per beneficiary in 340B hospitals was more than twice that of hospitals outside the program. Groups such as the Community Oncology Alliance have long warned that the 340B program, while essential, has grown beyond its original intent.
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