Read today’s Kaiser Health News
In other news:
Trump’s budget proposes steep cuts to NIH, health funding: The 2026 proposal is seeking to cut $33.3 billion in discretionary funding for HHS, representing a 26.2 percent reduction compared to the fiscal 2025 budget.
This includes a $3.6 billion reduction in discretionary funding for the Centers for Disease Control and Prevention (CDC), an $18 billion reduction for the National Institutes of Health (NIH), a $674 million reduction for the Centers for Medicare and Medicaid Services (CMS) Program Management and a $240 million reduction for Administration for Strategic Preparedness and Response (ASPR) Hospital Preparedness Program.
The only health program that gains discretionary funding in the proposal is HHS Secretary Robert F. Kennedy Jr.’s Make America Healthy Again(MAHA) Commission, for which the budget provides $500 million.
About health insurance/insurers
CMS sets up real-time medical fraud center with DOGE; Federal contractor rolls out commercial tool: The Centers for Medicare & Medicaid Services (CMS) has launched the Fraud Detection Operation Center (FDOC) to fight waste, fraud and abuse, the agency announced this week.
Comment: This task had been done by the Inspector General; it is not new or innnovative.
DOJ sues major insurers, brokers over alleged Medicare Advantage kickbacks:The Department of Justice has filed a sweeping lawsuit against Humana, Aetna, and Anthem, along with Medicare Advantage brokers eHealth, GoHealth, and SelectQuote, alleging a multi-year scheme involving unlawful kickbacks and discriminatory practices against disabled MA enrollees.
According to the May 1 complaint filed in the U.S. District Court for the District of Massachusetts, the insurers paid hundreds of millions of dollars from 2016 through at least 2021 to the brokers in exchange for preferential treatment, including steering enrollees toward their MA plans and away from competitors, regardless of the quality of the plans. The DOJ filed the lawsuit based on a whistleblower complaint initially filed by a former eHealth employee under the False Claims Act.
About hospitals and healthcare systems
Understanding the Hospital Readmission Reduction Program FYI
About pharma
Lilly star weight-loss drug Zepbound faces coverage challenge from CVS Health: CVS Health said the drugs Wegovy and Saxenda from rival drugmaker Novo Nordisk will become the preferred options on its standard formulary, or list of covered drugs, as of July 1. Zepbound will be excluded.
GLP-1s can help employers lower medical costs in 2 years, new study finds:
KEY POINTS
Aon researchers found that within two years, improved health outcomes for patients who were taking GLP-1 drugs lowers the growth rate of medical care costs.
Aon looked at medical claims data for 139,000 U.S.-based workers with employer health coverage who took GLP-1 medications between 2022 and 2024.
Since 2023, GLP-1s have driven up employer spending on drugs at a faster pace than high-priced specialty drugs used to treat cancer and autoimmune conditions, according to an Evernorth study.
About the public’s health
Diabetes deaths fall to lowest levels in years, in early CDC figures:There were 103,294 deaths from diabetes in 2021, up more than 17% from 87,647 deaths in 2019 before the pandemic. Provisional data reported so far for 2024 have tallied 94,294 diabetes deaths last year.