addiction crisis
Biden's buprenorphine backtrack
Addiction doctors, public health experts, and even some congressional Democrats are up in arms about a new Biden administration proposal that would roll back Covid-era flexibilities surrounding the prescribing of buprenorphine, a key drug used to treat opioid addiction, my colleague Lev Facher writes.
The new regulation would require that patients prescribed buprenorphine via telemedicine show up for an in-person evaluation within 30 days if they want to keep taking the medication. Addiction doctors, however, argue that they've issued both new prescriptions and refills via telemedicine for years now — largely without issue. And while the DEA says the regulation is aimed "at ensuring patient safety," its opponents say any limitation to buprenorphine access will have the opposite effect, leading people cut off from buprenorphine to return to illicit drug use.
The move represents "a step in the wrong direction," Rep. Paul Tonko (D-N.Y.) told Lev. While the Covid-era flexibilities "opened the doors to recovery for millions," he added, "the DEA's proposal mandating an in-person follow up for telehealth patients using buprenorphine threatens to shut the doors once again." Read more here.
insurance
Same drug, same patient, same insurer — coverage denied
Utilization management can be a jargon-y term that makes most people's eyes glaze over, but it has real implications for patients. My colleague Tara Bannow tells the powerful story of a patient who required an infusion medication to manage her rare kidney disease.
The first time she needed the medication, Blue Cross Blue Shield of Massachusetts covered it, no questions asked. The medication helped her, and her disease went into remission for years. But when the disease reared its head again, the insurer refused to pay and sent her three denials.
Tara's reporting seems to have gotten results — the day after she called up the insurer, they suddenly decided to cover the infusions after all. Read the full story here.
budget battles
Medicaid mudslinging continues
Roughly a week out from the start of federal budget battles, Democrats and Republicans are ratcheting up accusations that the other party would take health care away from millions or slash their benefits.
President Joe Biden in a Tuesday speech warned that "MAGA Republicans" want to "do away with the Affordable Care Act." Democratic lawmakers amped that message Wednesday, with leadership from both the Senate and House arguing in a press briefing that their GOP counterparts would gut Medicaid and relaunch attempts to repeal ACA (though many in the GOP caucus abandoned that plan after multiple failed attempts during the Trump administration). Meanwhile House Republican committee leaders in a statement accused Biden of "fearmongering" and actually spearheading efforts to kick people out of ACA coverage.
So what's really happening? Everyone is getting ready to make their pitch, since Biden's budget is due out next week. It's clear that Biden is readying his case for what he knows will be some controversial policies ("I want to make it clear, I'm gonna raise some taxes out there") by making the populist argument that things like tax hikes — which he says will target billionaires — will protect health care access and reduce the deficit along the way. Republicans say they want to balance the budget in a decade, which would take significant spending cuts, it's just a matter of where.
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Rachel Cohrs/STAT
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