The government is allowing Medicare Advantage (MA) plans to delay returning hundreds of millions of dollars or more in government overpayments; a proposed new extension of the Affordable Care Act (ACA) might make birth control coverage more accessible for certain private insurance plans; a study found that students lost around 33% of their school year because of the pandemic’s educational barriers and are struggling to regain that lost time.
Government Allows MA Plans to Pocket Excess Medicare Cash
On Monday, CMS gave private health insurers a break from returning hundreds of millions of dollars or more in government overpayments on Medicare Advantage plans, said Kaiser Health News. Some of these overpayments are 10 or more years old. CMS said it will require almost nothing from insurers for any extra payments received from 2011 through 2017. Penalties are only expected after payment year audits from 2018 on are conducted, and those haven’t happened yet. In the interim, health plans will likely be able to keep hundreds of millions of dollars or more in overcharges for audits prior to 2018.
Proposed ACA Rule Might Widen Birth Control Coverage
A new rule proposed by the Biden administration has the potential to give women free birth control access if their employers do not cover contraceptives in their health insurance plans because of religious reasons, reported Reuters. Currently, the Affordable Care Act (ACA) demands that private insurance plans cover recommended preventative services like contraception minus patient cost sharing, except under religious or moral objections. Under the change, providers would be able to offer contraception at no cost to the employee and then receive reimbursement from an insurer, who would receive a government credit.
Education Loss Due to Pandemic Is One-Third of a School Year, Study Finds
A worldwide analysis of data from 15 countries found that almost one-third of a school years’ worth of knowledge was lost to children during the COVID-19 pandemic, according to The New York Times. The analysis, published in the journal Nature Human Behavior, is heralded as the most up-to-date comprehensive account of educational hardships brought on by the pandemic. In addition to education lost, other main findings include an unsuccessful bounce back from students after school doors reopened, particularly for students of lower socioeconomic status, social skill deficits, and anxiety disorders.
Brodalumab Is Effective, Safe in Patients With Moderate to Severe Psoriasis
March 18th 2024Posters presented at the American Academy of Dermatology Annual Meeting demonstrated both short- and long-term efficacy and safety profiles of brodalumab in patients with moderate to severe psoriasis.
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Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
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AstraZeneca joins efforts to address high drug prices by capping out-of-pocket costs for its inhalers; Opill, the first OTC birth control pill, is now accessible through online sales; expansion prompts questions on the effectiveness and regulation of remote monitoring technology.
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Drs Raymond Thertulien, Joseph Mikhael on Racial Disparities in Multiple Myeloma Care Access
December 28th 2023In the wake of the 2023 American Society of Hematology Annual Meeting and Exposition, Raymond Thertulien, MD, PhD, of Novant Health, and Joseph Mikhael, MD, MEd, FRCPC, FACP, chief medical officer of the International Myeloma Foundation, discussed health equity research highlights from the meeting and drivers of racial disparities in multiple myeloma outcomes.
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Health Equity and Access Weekly Roundup: March 16, 2024
March 16th 2024This week, the Center on Health Equity and Access highlighted expert opinions on a mental health paradigm shift in the workplace, the impact health care algorithms can have on patient outcomes, and social factors linked with hidradenitis suppurativa severity, in addition to addressing the health needs of justice-involved populations.
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