Judge Dismisses PhRMA Lawsuit Challenging Medicare Drug Price Negotiations
In an early legal test of the Medicare drug pricing negotiation program, a federal district judge tossed out a suit from the drug industry's lobbying organization PhRMA, the National Infusion Center Association, and the Global Colon Cancer Association.
Stat:
PhRMA Lawsuit Over Medicare Drug Price Negotiation Tossed
A federal district judge on Monday granted the Biden administration’s request to dismiss a lawsuit challenging Medicare’s new drug price negotiation program from the drug industry lobbying organization PhRMA. The move is an early but positive sign for the Biden administration in a legal fight that could stretch for years, as a host of major drugmakers, including Merck, Bristol Myers Squibb, and Johnson & Johnson, have also filed lawsuits over the constitutionality of Medicare’s new powers. (Cohrs, 2/12)
KFF Health News:
In Fight Over Medicare Payments, The Hospital Lobby Shows Its Strength
In the battle to control health care costs, hospitals are deploying their political power to protect their bottom lines. The point of contention: For decades, Medicare has paid hospitals — including hospital-owned physician practices that may not be physically located in a hospital building — about double the rates it pays other doctors and facilities for the same services, such as mammograms, colonoscopies, and blood tests. (Galewitz and DeGuzman, 2/13)
Modern Healthcare:
Medicare Surge Has Providers Bracing For More Baby Boomers
Tampa General Hospital decreased sepsis mortality rates by nearly 10%, reduced emergency department utilization by close to two-thirds and slashed more than $1 million in costs over a two-year period. The hospital set up a command center that uses predictive, artificial intelligence-backed analytics that flags potential early indicators of diseases like sepsis and tracks a patient's treatment. (Kacik, 2/12)
Modern Healthcare:
Private Equity Medicare Advantage Investment Slumps: PESP Report
Private equity investment in Medicare Advantage has declined in recent years amid rising interest rates and an unfavorable regulatory environment, according to a report the Private Equity Stakeholder Project published Tuesday. These investor groups inked just four Medicare Advantage-related deals in 2023, the second-lowest total during the seven years the Private Equity Stakeholder Project has tracked such transactions. (Tepper, 2/13)
The Wall Street Journal:
Your Medicare Plan Might Not Include As Many Freebies Next Year
Medicare Advantage is facing a bit of a disadvantage. The private plans have grown in popularity in recent years because many seniors like that they come with no monthly premiums and offer extra benefits, including vision and dental coverage as well as fitness memberships. (It also doesn’t hurt that the plans are marketed aggressively). Now, though, the industry is contending with pressure on both cost, as seniors who held back on procedures during the pandemic rush back, and revenue, as the Biden administration curtails payments to plans. (Wainer, 2/11)
In Medicaid news —
Axios:
More Than 2 Million People Dropped From Medicaid In Texas
More than 2 million people have been removed from Texas' Medicaid program since federal pandemic-era coverage protections were lifted last April, new state data shows. That's the most of any state and nearly equivalent to all of Houston — Texas' most populous city, with 2.3 million residents — losing coverage in less than a year. (Goldman, 2/13)
The Washington Post:
Medicaid’s Prescription For Health Includes Food And Housing In Some States
On Sundays, the Rev. Carl Nichols preaches at Big Zion AME Zion Church in little Kenansville on North Carolina’s coastal plain. Tuesdays to Fridays, he drives a cargo van on a daily 320-mile circuit along rural roads edged with pine and fields of tobacco, collards and corn. His mission: delivering boxes of food to people who cannot always afford their own. The minister, his wife, two grown daughters and three helpers make up a tiny nonprofit whose food deliveries are part of an experiment that places North Carolina at a leading edge of the new face of Medicaid. A pillar of the nation’s social safety net since the 1960s, Medicaid is the largest public source of health insurance. Now, it is becoming something more. (Goldstein, 2/12)
North Carolina Health News:
Prison System Works To Connect People To Medicaid Coverage Before Release
Danay Burke, 43, was released from prison on Nov. 1. Among the many tasks on her to-do list for reestablishing her life was to figure out how to manage her health care needs. But she left prison without health insurance, making that a difficult and costly prospect. (Crumpler, 2/13)
