What We're Reading: SCOTUS Could Rule Big Against Pharmaceutical Industry

What we're reading, April 26, 2016: the Supreme Court could rule for new process of reviewing drug patents; new Medicaid rules announced; 7 New York insurers will expand coverage of hepatitis C drugs.

The Supreme Court could rule against the pharmaceutical industry in a case with serious implications for drug prices. According to STAT, drug makers are urging the court to change rules for a new process of reviewing patents, which could make it easier to invalidate a patent. However, the 4 liberal justices and Justice Anthony Kennedy seemed skeptical about the plaintiffs’ arguments. Even if there was a 4-4 split, the lower court’s decision, which was in favor of the Obama administration, would be upheld.

New rules for Medicaid private insurance plans were announced on Monday. The rules require that insurers guarantee access to certain types of service providers and that at least 85% of what insurers are paid must be spent on medical care, reported AP. In addition, the rules include a quality rating system to assist beneficiaries as they pick a Medicaid plan. The changes will take effect on January 1, 2017 and will take years to fully implement.

In New York, 7 health insurance companies will cover hepatitis C medications for nearly all patients. The change in criteria for covering the expensive drugs is part of an agreement with the office of the state attorney general after an investigation showed a wide discrepancy in how companies cover these drugs, according to The Wall Street Journal. The investigation had found that 5 of 7 insurers denied anywhere from 30% to 70% of claims. The 7 plans were Affinity Health Plan; Empire BlueCross BlueShield; Excellus BlueCross BlueShield; HealthNow New York Inc; Independent Health Association Inc; Oxford Health Plans; and MVP Health Care.

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