Tennessee is set to become the first state to transition its Medicaid program to a block grant; a federal judge has blocked cuts to Medicare rates for 340B hospitals but did not grant permanent injunction; Senator Elizabeth Warren has unviled a plan to combat the opioid epidemic that would spend $100 billion over 10 years.
Governor Bill Lee, R-Tennessee, is expected to sign legislation requesting approval from the Trump administration to turn the state’s Medicaid program into a block grant, according to The Wall Street Journal. If approved, Tennessee would become the first state to make the transition. While supporters of the move say that the grants would give states more flexibility to try novel ideas that may increase coverage or lower costs and is a better way to control Medicaid spending, opponents argue that the switch would challenge Medicaid’s guarantee of coverage for eligible low-income and disabled adults because of the fixed funding amounts.A federal judge has blocked the Trump administration’s 340B Medicare rate cuts for hospitals, ruling that the decreased rates aren’t lawful for 2018 and 2019. But, according to Modern Healthcare, the judge did not grant hospitals a permanent injunction against the cuts and instead ordered HHS to try out a remedial measure and to provide a status update on August 5. The judge said that eliminating the rule would wreak havoc on Medicare and that HHS can’t add to the department’s expenses.Democratic presidential candidate Elizabeth Warren on Wednesday released a $100 billion plan to combat the opioid epidemic over 10 years. The plan, which is an expansion of the CARE Act that she introduced last year in the Senate, would include changes to Medicaid and expanded access to medication-assisted treatment. The New York Times reported that, as she unveiled her plan, Warren also announced that she would donate the $4500 in campaign contributions she had received from the Sackler family, which owns Purdue Pharma, and called for Harvard University to remove the family name from all campus buildings.
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.
Read More
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.
Listen
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.
Read More
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.
Listen