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This Week in Managed Care: July 4, 2015


This week GOP presidential candidate hopefuls turned their attention to the 2016 election as the next best chance to repeal Obamacare, and CMS released data revealing $6.5 billion payments to healthcare providers from drug and medical device makers in 2014.

Although the Supreme Court ruled in favor of the government in King v. Burwell, opponents of the health law are not ready to back down. GOP presidential hopefuls have turned their attention to the 2016 election as the next best opportunity to repeal and replace Obamacare. Although most candidates had not clearly outlined what they plan to do, they all promised to dismantle the law in the next term if elected.

CMS released Open Payments data for 2014, which revealed payments totaling $6.5 billion from drug and medical device makers to healthcare providers. Despite applauding CMS' efforts for more transparency, the American Medical Association expressed concern over the validity of the data as many physicians find the process to correct inaccuracies too complicated and time consuming.

Finally, a study in Annals of Internal Medicine found that state Medicaid policies for reimbursement of sofosbuvir differ widely across the country and that criteria does not conform to the standards set by professional infectious disease organizations. For example, 75% of the 42 states examined limit access to patients with advanced fibrosis.

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