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Lax Policing of Doctor and Pharmacy Conflicts Is Found in Medicare Coverage Decisions
WASHINGTON — Deciding which drugs will be covered by Medicare can influence huge amounts of spending, but government officials do little to police conflict of interest among doctors and pharmacists who make those decisions, federal investigators said Monday.
In a new report, Daniel R. Levinson, the inspector general at the Department of Health and Human Services, said the federal Medicare agency had not clearly defined “conflict of interest” and did not enforce standards meant to prevent such conflicts from influencing coverage decisions by the panels, known as pharmacy and therapeutics committees.
Read the full story: http://nyti.ms/WLfpWM
Source: The New York Times
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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