What We're Reading: Democrats Win With Medicaid Work Rule Promise; Trump Says No to Pelosi Plan; UnitedHealthcare Biosimilar Switching

November 6, 2019
AJMC Staff
AJMC Staff

Medicaid work requirements were front and center in the outcomes of Kentucky governor's race as well as the statehouse in Virginia; the Trump administration called the drug plan from House Speaker Nancy Pelosi, D-California, "unworkable;" UnitedHealthcare is switching patients to biosimilar epoetin alfa in 2020;

Medicaid Requirements Featured Heavily in Outcomes in of Kentucky Governor's Race, Virginia Legislative Battle

The apparent winner of the governor’s race in Kentucky, Democratic Attorney General Andy Beshear, said he would rescind the state's Medicaid work requirements soon after he is sworn in, The Hill reported. The work requirements were put in place by Republican Gov. Matt Bevin, but the requirements have been tied up in a federal lawsuit. Beshear’s father, Steve, was among the first to expand Medicaid when he was governor when the Affordable Care Act took effect. Elsewhere, Democrats took control of the state legislature in Virginia, paving the way for Gov. Ralph Northam to rescind work requirements for recipients that were approved in a deal with Republicans in order to expand Medicaid, The Washington Post reported.

Trump Administration Backing Bipartisan Senate Drug Pricing Bill

President Trump is backing a bipartisan bill in the Senate to crub drug prices rather than the plan put forth by House Speaker Nancy Pelosi, D-California, The Associated Press reported. While rising drug prices are a concern for both parties, a senior White House official said that Pelosi’s plan is “unworkable,” pointing out that Pelosi’s bill lacks Republican support.

UnitedHealthcare Patients Will Switch to Biosimilar Epoetin Alfa in 2020

UnitedHealthcare has revised its community and commercial plans’ coverage of erythropoiesis-stimulating agents for 2020, The Center for Biosimilars® reported. Effective January 1, patients who are receiving the reference epoetin alfa, Epogen or Procrit, will be required to switch to Pfizer’s biosimilar, Retacrit, unless they meet medical necessity criteria. Coverage for Retacrit will not require prior authorization for patients who meet diagnosis-specific criteria for indications including anemia due to chronic kidney disease, anemia due to chemotherapy, and anemia associated with myelodysplastic disease, among others.