CBO Analysis of GOP Health Bill Coming
Almost a week after Republicans unveiled their healthcare reform bill, the Congressional Budget Office (CBO) is expected to reveal its analysis. According to AP, the expectation is that the CBO will show a reduction in coverage in contradiction to President Donald Trump’s promise that everyone will have insurance. House Speaker Paul Ryan (R-Wisconsin) tried to head off Democrat attacks on this point by saying he expects the report to show fewer Americans will have coverage since the plan eliminates the individual mandate.
Informing Medicare Patients of Observation Care
Even when Medicare patients stay overnight in a hospital, they may be admitted under observation care, which results in patients paying more. A new federal law would require that hospitals inform Medicare patients when they are getting observation care, reported Kaiser Health News. Some states had already required that hospitals notify observation patients. Now, hospitals must notify patients if they want to get paid for treating Medicare beneficiaries.
Providing Employers Insight Into Personal Medical, Genetic Information
Republicans have proposed legislation that would let employers get easier access to workers’ personal medical and genetic information. The New York Times reported that the bill in the House would also increase financial penalties for people who opt out of workplace wellness programs. Advocates, such as AARP and the American Diabetes Association, oppose the legislation, as do House Democrats. The bill has yet to be considered by the Senate.
CMS released a final rule to help patients obtain Children’s Health Insurance Program (CHIP) coverage and issued a proposed rule to update Medicare payment policies and rates for inpatient rehabilitation facilities; debate over if gift card incentives are acceptable in health care marketing.
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Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
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A global AIDS program that was in limbo for months got temporary relief after congressional negotiators agreed to a 1-year renewal in the next government funding package; the outcome of the November presidential election could determine the state of fetal tissue research in the US; federal officials and industry executives failed to make improvements that stop hacking attacks.
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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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Fragmented Payer System, Vulnerable Supply Chain Among Threats to Accessing Essential Medicines
March 13th 2024During a session of the 2024 V-BID Summit, panelists Stacie Dusetzina, PhD, and Inma Hernandez, PharmD, PhD, discussed how access to essential medications is curtailed not just by the longstanding complexities of insurance design but also by emerging threats such as supply chain weaknesses and cyberattacks.
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Most private health insurers have yet to publish criteria for when they will cover postpartum depression drug, zuranolone; state lawmakers are increasingly opposing health care mergers that they believe do not serve the public interest; Medicaid extensions made in 2021 led to a 40% decline in postpartum lack of insurance.
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