Insurance

Taking effect in October 2026, the final rule will end federal Medicaid and CHIP funding for gender-affirming care for transgender minors.

Brittany G. Craiglow, MD, FAAD, discusses JAK inhibitor hesitancy in pediatric alopecia areata, boxed warnings, and why step therapy falls short.

July AJMC author Anuraag R. Kansal, PhD, explains how metastatic cancer diagnoses drive Medicaid spending and why earlier screening could lower costs.

This study links county-level social vulnerability to variation in Medicare Advantage prior authorization policies.

CANN says the revised pilot reflects stakeholder input and aims to address accountability challenges in the more than $100 billion 340B program.

John Kitchens, MD, explores how GLP-1s, novel drug pipelines, and Medicaid access gaps are shaping the future of DME management.

Brittany G. Craiglow, MD, FAAD, discusses the psychiatric and psychosocial toll of alopecia in children and adolescents, and its impact on treatment initiation.

A federal judge heard arguments over whether CMS unlawfully narrowed the Medicaid work requirement exemption for medically frail beneficiaries.

A July AJMC study found metastatic cancer diagnoses significantly increase Medicaid spending, highlighting the potential budget benefits of earlier detection.

New cancer drugs reached patients fastest, but overall access timelines remained lengthy across the US, France, Germany, and Switzerland.

Anti-VEGF has maxed out in diabetic macular edema (DME), but Ang-2 and Wnt pathway approaches could target disease differently, said John Kitchens, MD.

CMS value-based payment models underrepresent Black, Hispanic, dual-eligible, and disadvantaged Medicare beneficiaries compared with the broader population.

Dermatologists spend 13 hours weekly on prior authorization as health plans tout an 11% reduction in requests.

Existing rebates and manufacturers' gaming risk may limit these gains.

Kerry Rogers, MD, at The James, unpacks what these questions mean for patient counseling and clinical trial equity in chronic lymphocytic leukemia (CLL).

Medicare Advantage (MA) beneficiaries had similar optimal cancer treatment use and treatment timing as traditional Medicare (TM), with lower anticipated costs.

Robert Kratzke, MD, discusses how biomarker testing mandates and faster sequencing can improve access to precision lung cancer care.

Pharmacy eases lung cancer costs; pediatric cancer erases 40% income; BTKis widen CLL access; hospitals lag on translated aid; MN mandate ends NGS denials.

COVID-19-related Medicare spending and health care use declined after acute infection, with minimal excess costs by weeks 13 to 40 after diagnosis.

A secret shopper study found 9 in 10 online GLP-1 sellers issued prescriptions, often with minimal screening for eating disorders or clinical risk.

Senate Democrats introduced a bill to cap out-of-pocket costs at $5000 for traditional Medicare beneficiaries and expand low-income assistance.

Insurance and socioeconomic factors delay optimal anti-VEGF care for diabetic macular edema, worsening vision disparities.

National HIV Testing Day highlights how state policies, pharmacists, and long-acting therapies are reshaping access to HIV testing, PrEP, and PEP.

New research reveals complex treatment costs from MM strain patients and caregivers during active therapy, while pain goes undertreated at end of life.

Texas abortion ban worsens maternal mental health; SCD trials exclude 90% of adults; nutrition, hepatitis B, and cost-control gaps persist.