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What We're Reading: Medicare Lab Testing; CHIP Deadline; AMA Expands Diabetes Efforts
Medicare is alleging laboratories improperly billed the government for improper tests; time is running out for children receiving healthcare from CHIP; the AMA extends its diabetes prevention model to Maryland and other states.
Taxpayer Losses to Medicare for Suspect Lab Tests Run Into Millions
Medicare is alleging laboratories improperly billed the government for unnecessary urine, genetic, or heart disease tests, which is expected to cause hundreds of millions dollars in losses to taxpayers, an investigation by Kaiser Health News found. But repayment is unlikely since at least 6 of the clinical labs are stuck in bankruptcy court. Medicare and also private insurers are taking a harder look at these tests as their costs have risen to about $8.5 billion a year.
Time Running Out for Low-Income Children on CHIP
Lawmakers have yet to agree on renewing federal funding for the Children’s Health Insurance Program (CHIP), which covers millions of children from low-income families, reported The New York Times. Federal funding expired on Sept. 30. States are getting ready to send out notices advising families that their care will be cut off next year unless lawmakers can come to an agreement about CHIP, which historically has had bipartisan support.
AMA Expands Diabetes Prevention Efforts to Maryland, Other States
Maryland becomes the latest state to work with the American Medical Association (AMA) in a multi-state effort to reduce type 2 diabetes. The AMA is partnering with MedChi, the Maryland State Medical Society, reported the Associated Press. Besides Maryland, the AMA added Maine, Mississippi, New York, Ohio, Oregon, Pennsylvania, and Rhode Island, joining California, Michigan, and South Carolina to its diabetes prevention model.
Prices for care at hospital trauma centers vary across hospitals; drug shortages reached a record high during the first quarter of 2024; although 3 of the biggest makers of asthma inhalers pledged to cap out-of-pocket costs for some US patients at $35, these do not apply to daily inhalers used by the youngest kids with asthma.
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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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Beyond Insulin: The Impact of Next-Generation Diabetes Technology
April 17th 2024Experts explain how new diabetes technologies like continuous glucose monitors are transforming care beyond intensive insulin therapy, offering personalized insights and improving outcomes for patients of all treatment levels.
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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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