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What We’re Reading: House Passes Health Care Package; Insurers Tighten Ozempic Coverage; Arizona Court to Hear Abortion Arguments
End-of-year victory for lawmakers as health care policies pass in the House; insurance limitations prompt concerns over access to semaglutide (Ozempic) for diabetes; a legal battle ensues over the fate of abortion laws in Arizona.
House Passes Health Care Package in Bipartisan Vote
The House passed a significant health care package in a bipartisan 320-71 vote, marking an end-of-year accomplishment after previous setbacks, according to Stat. While the bill is unlikely to pass the Senate in its current form, the policies, including equalizing drug administration payments in Medicare across hospital outpatient departments and physician offices, addressing pharmacy benefit manager practices, and implementing health care price transparency rules, gain visibility for potential inclusion in a government funding deal. The most debated aspect, the Lower Costs, More Transparency Act, featuring site-neutral payments for drug administration, faces opposition from hospitals concerned about potential financial consequences and broader Medicare implications.
Patients Face Reimbursement Hurdles for Ozempic as Insurers Impose Restrictions
Some patients with type 2 diabetes are experiencing challenges in getting reimbursed for drugs like semaglutide (Ozempic) due to US insurers implementing restrictions to discourage prescribing the medication for weight loss, according to Reuters. Novo Nordisk acknowledged tighter health plan management of glucagon-like peptide-1 drugs, contributing to a recent decline in US prescriptions. Patients report delays and obstacles, including prior authorization requirements and the need to try alternative medications, raising concerns about potential impacts on diabetes management and overall health outcomes.
Arizona State Supreme Court to Hear Arguments on Reinstating Near-Total Abortion Ban
The Arizona State Supreme Court is set to hear oral arguments regarding the potential reinstatement of a centuries-old near-total abortion ban, with conflicting laws causing uncertainty after the US Supreme Court overturned Roe v Wade, according to ABC News. The current 15-week abortion ban in Arizona faces challenges, and the court will decide whether the 1864 law, which bans abortion with criminal penalties, will be enforced. Planned Parenthood Arizona aims to affirm the Court of Appeals' decision to preserve abortion access, while abortion advocates simultaneously seek a ballot measure to secure abortion rights in the state's constitution.
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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USPSTF Lowers Age for Biennial Mammograms to 40, Citing Early Detection Benefit
April 30th 2024The USPSTF lowered the recommended starting age for mammograms from 50 to 40 years, citing moderate benefits for early detection in this age group. Disparities persist, especially for Black women, highlighting the need for improved access to health care and social support.
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Makers of medical tests will have about 4 years to show the FDA that their new offerings deliver accurate results; after previously decreasing for 27 years, US tuberculosis (TB) cases increased every year since 2020; a US district judge rejected a challenge by Bristol Myers Squibb and Johnson & Johnson to the Medicare drug price negotiation program.
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