Biden administration finalizes a deal on covering preventive care despite legal battle; CMS prepares safety net hospital reimbursement plans; over 1 million Americans have been dropped from Medicaid coverage
Biden Keeps ACA Preventive Care Coverage Intact Amid Legal Challenges
Apart from current legal obstacles, the Biden administration finalized a deal to maintain the federal mandate that requires United States health insurers to cover preventive care without additional costs to patients, according to Reuters. The agreement allows the mandate to remain in effect nationwide while the administration appeals a court order that struck it down. However, the deal grants Texas-based company, Braidwood Management, the temporary ability to cease coverage of certain preventive services for its employees, such as pre-exposure prophylaxis for HIV, until the mandate's status is resolved on appeal.
CMS to Reveal Repayment Plan for Safety Net Hospitals
The CMS is preparing to unveil a repayment plan for safety net hospitals to address nearly $10 billion in underpayments from the federal drug discount program, according to Axios. The plan follows a Supreme Court ruling that deemed CMS's program cuts from 2018 to September 2022 as illegal. However, there are concerns that CMS may seek to recover the funds by reducing Medicare payments to non-340B facilities, potentially impacting rural facilities and children's hospitals that were exempt from the cuts.
Concern Over Alarming Rate of Medicaid Enrollment Cuts
The Biden administration raised concerns over Medicaid cuts after more than 1 million Americans lost coverage due to administrative setbacks and the resumption of eligibility checks, according to Kaiser Health News. With the end of pandemic protections on April 1, many states have resumed checking the eligibility of Medicaid recipients, resulting in individuals losing coverage. The administration urges states to take optional steps to ensure eligible individuals remain covered, such as pausing cancellations and aiding in completing required paperwork.
CMS' 340B Repayment Proposal May Harm Vulnerable Hospitals, Reward Those With Higher Revenues
April 26th 2024The 340B hospitals not receiving an offsetting lump-sum payment from CMS following 2018-2022 cuts later ruled unlawful are disproportionately rural, publicly owned, and nonacademic, according to a new study.
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Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
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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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Mental Health Diagnoses, Care Challenges Rise Among US Youth, Report Finds
April 26th 2024While behavioral health care utilization has been rising, the treatment landscape has been worsening. New findings show that 20% of youths did not receive any form of treatment within 3 months of their initial behavioral health diagnosis.
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