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What We're Reading: Pfizer Kickback Case; Concerns for Association Health Plans; Swallowable Sensor
As part of a settlement with the Department of Justice, Pfizer will pay the government nearly $24 million to resolve kickback allegations; both blue and red states worry association health plans could become targets for scam artists; a prototype of a swallowable sensor that can send results to a smartphone app will provide a peek into the digestive system.
Pfizer to Pay $24 Million in Kickback Settlement
States Worry About Association Health Plans
Swallowable Sensor Can Provide Insight Into the Gut
As part of a settlement with the Department of Justice, Pfizer will pay the government nearly $24 million to resolve kickback allegations. According to Kaiser Health News, the lawsuit claimed that Pfizer donated to the Patient Access Network Foundation and steered Medicare patients to the foundation to cover copays for Pfizer’s drugs. Federal law does not allow drug makers to directly offer copay assistance to patients on Medicare or Medicaid.Association health plans that the Trump administration is promoting as a cheaper alternative to Affordable Care Act health plans could become targets for scam artists. Both blue and red states are worried that their authority over plans will be weakened and plans will be sold that have skimpy or nonexistent benefits, reported Stateline. Insurance regulators in California, Iowa, Minnesota, New Mexico, and Washington have raised concerns and want states to be able to establish protections and financial stability standards, as well as being able to bar plans from doing business in their states.A prototype of a swallowable sensor that can send results to a smartphone app will provide a peek into the digestive system. STAT reported that the sensor could help understand why the digestive system isn’t working properly or a new way to diagnose diseases. The new tool uses engineered bacteria and a tiny electrical circuit to detect other molecules in the digestive tract.
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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