medicare
Prioritizing prior auth reforms
The government hopes to rein in the insurance industry's use of prior authorizations soon, Center for Medicare Director Chris Klomp told doctors on Wednesday during an American Medical Association conference.
Chelsea was at the conference bright and early after staying up late for the State of the Union. She reports that Klomp, who also serves as an HHS senior counselor, said he'd like to see results "in double digit months," instead of years. There are double-digit months in a single year. No matter, he clearly meant that prior authorization reforms are a priority.
The insurance industry is on board with voluntarily cutting down on the number of medical codes that require prior authorization, which Klomp said will build trust with the public.
Read more.
surgeon general
The nation's MAHA mom
The surgeon general is often called the "nation's doctor." On Wednesday, the epitome of the MAHA mom interviewed for that position before the Senate committee with jurisdiction over her nomination. Elizabeth Cooney has the dispatch.
Casey Means's confirmation hearing was scheduled for last October, but she went into labor five hours before the session started.
That was a good setup for this week's hearing. Means invoked motherhood, "wholeness" in health, and tenets of the MAHA movement led by health secretary Robert F. Kennedy Jr. She also sparred with senators and faced some uncomfortable questions, including one about the little voice in her head that she heard while tripping on psychedelic mushrooms.
Read more about the bipartisan scrutiny that Means faced. And read this story about an eight-minute exchange on vaccines between Means and health committee Chair Bill Cassidy (R-La.).
drug prices
A peek at how drugmakers plan to beat Trump in court
The drug industry previewed the arguments that drugmakers might make in court against proposed experiments to lower drug prices in Medicare.
The president has struck voluntary deals with drugmakers to lower prices in Medicaid and for cash-paying consumers. Separately, the administration has proposed to test similar "most-favored nation" pricing schemes in two Medicare pilot programs.
In comments on those proposals, trade groups for drug and biotech companies outlined why they think the proposals are unconstitutional, exceed the CMS's authority, and violate appropriations law.
The proposed pilots would need to be finalized before drugmakers could sue over them. Read more about what might be in store if those lawsuits come to pass.
glp-1
Novo cuts list price of obesity drug
Elaine Chen looks into who will benefit from the lower list price of Novo's GLP-1s.
Coinsurance is based on list prices, so the new lower list price will benefit many people with insurance, especially those with high deductible plans.
But the price cut might not encourage more plans to cover Novo's semaglutide drugs, and it could even encourage some insurers to drop coverage. Read more for the explanation.
No comments