About health insurance/insurers
New Medicaid rule expected to lower wait times for home-based care, raise caregiver wages “The new rule brings sweeping changes to a bevy of Medicaid programs throughout the country, including fee-for-service and managed care delivery systems. One of the most notable changes applies to the home and community-based services (HCBS) industry. CMS will now require home-based care providers to use 80% of the Medicaid reimbursements they receive toward caregiver compensation.”
Healthcare billing fraud: 11 recent cases FYI
Biden administration: DACA recipients eligible for ACA coverage “Individuals who are part of the Deferred Action for Childhood Arrivals program will be able to enroll in ACA marketplace plans beginning in November.
In a final rule published May 3, CMS said it will extend marketplace eligibility to DACA recipients. The immigration program allows individuals brought to the U.S. as children without legal status to remain in the country.
CMS expects 100,000 uninsured DACA recipients could receive coverage through the program.”
More Medicare enrollees are choosing supplement plans, data shows “The share of fee-for-service Medicare enrollees choosing a Medicare Supplement plan rose to 41.4% in 2022…
A majority of Medicare Supplement (56%) policyholders are women, while 41% are 75 years old or older. At the same time, a significant percentage of Medicare Supplement enrollees are people with lower incomes. For example, 21% have incomes below $30,000…”
About pharma
Novo Nordisk cuts price of weight loss drug Wegovy as competition heats up “Novo Nordisk is lowering prices of its weight loss drug Wegovy as it boosts sales volumes and responds to higher competition from US rival Eli Lilly, leading to lower than expected quarterly revenue from the blockbuster jab. The company said it was now prescribing the drug to 25,000 new patients in the US per week, compared with 5,000 in December.”
Label Accuracy of Weight Loss Dietary Supplements Marketed Online With Military Discounts “This case series study analyzed 30 dietary supplement products purchased from online companies advertising military discounts for products with claims about weight loss. Twenty-five had inaccurate labels, 24 were misbranded, 7 had hidden components detected, and 10 contained substances prohibited for military use.”
Coming to a CVS Near You: A Store Brand Monoclonal Antibody “Last year, CVS Health launched a venture called Cordavis, a unit that will partner with drug manufacturers to commercialize these biosimilar drugs.”
Walgreens inks deal with Boehringer Ingelheim to advance clinical trials for obesity treatment “The company signed a deal with Boehringer Ingelheim to use its community pharmacies as clinical trial sites for people living with obesity, overweight and type 2 diabetes.
Walgreens launched its clinical trials unit back in June 2022 as the company's healthcare ambitions continue to grow. The company has signed more than 35 clinical trial contracts with drugmakers including Freenome and Prothena.”
About the public’s health
HHS' final rule to combat disability discrimination: What healthcare leaders should know “HHS finalized a rule May 1 that updates protections against disability discrimination in healthcare.”
Among the provisions:
“The final rule…bans the use of ‘any measure, assessment or tool that discounts the value of a life extension on the basis of disability to deny, limit, or otherwise condition access to an aid, benefit or service.’ Additionally, the final rule includes a definition of accessibility for websites and mobile applications; adoption of the U.S. Access Board's standards for accessible medical diagnostic equipment; details of requirements to ensure nondiscrimination in the services provided by HHS-funded child welfare agencies; and clarification around obligations to provide services in the most integrated setting appropriate for those with disabilities, according to HHS.”