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Seema Verma Confirmed as CMS Administrator
Verma is best-known as the designer of Indiana's Medicaid expansion program, which features a lockout provision for those who fail to pay premiums.
The Senate today voted 55-43 to confirm President Donald Trump’s nominee to run CMS.
Seema Verma will take over the giant agency that operates Medicare and Medicaid and is the nation’s largest payer, setting policy for those programs and the blueprint that most other commercial plans follow.
An ally of many conservatives, she is best known as the designer of the alternate Medicaid plan developed in Indiana under former governor Republican Governor Mitch Daniels, and carried to the fruition by now-Vice President Mike Pence. She has also been involved in developing work requirements to overhaul the Medicaid expansion program for Kentucky for its new governor, Matt Bevin.
As Indiana governor, Pence modified Daniels’ program for Medicaid expansion, which featured premium contributions, incentives for healthy behaviors, and a benefit lock-out if they failed to pay premium. However, there have been recent accusations that Healthy Indiana 2.0, as the program is called, may have fudge the numbers when evaluating its performance.
Critics of Verma disagree with her approach to making the poor pay more to get less from Medicaid. And Democrats said they struggled to get complete answers to their questions.
“What I read was a lot of happy talk that didn't amount to much substance," Sen. Ron Wyden. D-Oregon, has said.
Prices for care at hospital trauma centers vary across hospitals; drug shortages reached a record high during the first quarter of 2024; although 3 of the biggest makers of asthma inhalers pledged to cap out-of-pocket costs for some US patients at $35, these do not apply to daily inhalers used by the youngest kids with asthma.
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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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The Biden administration recently launched the Global Health Security Strategy, a new effort to combat the spread of infectious diseases; lawmakers zeroed in on the risks of massive consolidation in health care during the first congressional hearing on the Change Healthcare hack; the FDA recently announced the recall of a pair of heart devices linked to numerous deaths and injuries.
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Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
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