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What We're Reading: Taxpayers Spending Millions on Expensive Generic Drugs
What we're reading, December 18, 2015: HHS report finds generic drug prices rising faster than inflation; UnitedHealthcare's real-time drug approval tool; and government overcharged by private Medicare Advantage plans.
A report released by HHS, based on their investigation of rising generic drug prices, has found that taxpayers paid $1.4 billion resulting from increasingly expensive generic drugs. The HHS enquiry was at the behest of Sen. Bernie Sanders (I-VT) and Rep. Elijah Cummings (D-MD). Rising faster than inflation, the drug costs could have saved Medicare over $700 million during 2013 and 2014 if rebates were applied to the generic costs.
UnitedHealthcare is collaborating with providers to offer them a fast-track drug approval process that is almost real-time. AIS Health reports that the approval process will follow the recommendations of the National Comprehensive Cancer Network Clinical Practice Guidelines. The pilot was initiated in May 2014 for providers in Florida, and the current program went live in June for Medicaid as well as commercial members of the company in the states of Florida and Arizona.
Records from CMS reveal that private Medicare Advantage plans continued to overcharge the government millions of dollars, despite officials within CMS drawing attention to this fraud as early as 2008. According to a report by NPR, short staffing resulted in very few financial audits by CMS—just 30 audits per year, which account for only 5% of the total number of Medicare Advantage contracts. The first batch of audits are expected to be completed in 2016, per CMS.
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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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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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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The Biden administration recently launched the Global Health Security Strategy, a new effort to combat the spread of infectious diseases; lawmakers zeroed in on the risks of massive consolidation in health care during the first congressional hearing on the Change Healthcare hack; the FDA recently announced the recall of a pair of heart devices linked to numerous deaths and injuries.
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