What We’re Reading: Insurers Publicly Shamed; HHS Grants for COVID-19 Countermeasures; Medicare Obesity Drug Coverage


Patients and physicians are publicly shaming insurance companies on social media for the troublesome prior authorization process; HHS has awarded $1.4 billion in grants for the creation of new technologies and tools to prevent COVID-19 infection; Novo Nordisk has increased lobbying efforts to allow Medicare coverage of weight loss drugs.

Patients, Doctors Shame Insurers to Reverse Prior Authorization Denials

Patients and physicians have been publicly shaming insurance companies on social media to get drugs, tests, and treatments approved that were previously denied through the prior authorization process, according to KFF Health News. Patients explain that the rules create barriers that delay, or deny, access to treatment, and doctors note that these delays and denials mean death in some cases. Consequently, the federal government proposed prior authorization reform that would require insurance companies to be more transparent about denials and develop quicker response times; if finalized, these changes would be implemented in 2026. These reforms would exclude employer-sponsored health plans, meaning roughly half of the US population would not benefit from them.

HHS Awards $1.4 Billion for COVID-19 Countermeasures

HHS has awarded $1.4 billion in grants through its Administration for Strategic Preparedness and Response (ASPR) to fund the development of tools and technologies to protect against COVID-19, according to The Hill. HHS awarded the grants to pharmaceutical companies, nongovernmental organizations, and nonprofits as part of Project NextGen, an initiative led by ASPR to foster public-private partnerships to develop COVID-19 countermeasures. Most of the money that was awarded, $1 billion, went to 4 clinical trial partners of HHS’s Biomedical Advanced Research and Development Authority to support vaccine phase 2b clinical trials: Pharm-Olam LLC, ICON Government and Public Health Solutions Inc, Technical Resources International Inc, and Rho Federal Systems Inc. These were the first grants issued from NextGen of the $5 billion initial investment.

Novo Nordisk Boosts Lobbying for Obesity Drug Coverage

Novo Nordisk, creator of diabetes medication Ozempic and weight loss drug Wegovy, has increased its lobbying efforts in the past 6 months to push Congress to pass a bill that would lift Medicare restrictions against weight management treatment coverage, according to The Hill. The pharma giant has hired 3 new lobbying firms in the past 3 months to focus solely on obesity and Medicare coverage of anti-obesity drugs. This comes after the implementation of a 2023 law that excluded weight-loss drugs from Medicare coverage. Consequently, Novo Nordisk is increasing its lobbying efforts for the passing of the Treat and Reduce Obesity Act as public demand increases for weight loss drugs and clinical trials suggest Wegovy reduces the risk of serious heart problems. The act would expand weight management medication coverage to qualifying Medicare beneficiaries.

Related Videos
Seun Ross, PhD
Alicia Donner, Pittsburgh Financial Empowerment Center
Nicolas Ferreyros, Community Oncology Alliance
Vikki Walton, MBA, Mercer
Matthew Crowley, MD, MHS, associate professor of medicine, Duke University School of Medicine.
Dr Seun Ross: Achieving Equity is Necessary to Sustain the Health Care System
UPMC Health Plan Neighborhood Center
Nick Ferreyros, Community Oncology Alliance
Ryan Haumschild, PharmD, MS, MBA, director of pharmacy, Emory Winship Cancer Institute
Related Content
© 2023 MJH Life Sciences
All rights reserved.