CMS Finalizes Rule To Crack Down On Obamacare Plan-Switching Schemes
The final rule includes an update to the consent form agents and brokers provide to customers and also makes it easier for CMS to suspend agents and brokers who market exchange plans, Modern Healthcare reported. The policy changed after KFF Health News reported that brokers were switching people without their permission.
Modern Healthcare:
ACA Exchange Final Rule For 2026 Strengthens Broker Oversight
The Centers for Medicare and Medicaid Services is strengthening oversight of health insurance exchange brokers under a final rule issued Monday. The Notice of Benefit and Payment Parameters for 2026 makes it easier for CMS to suspend agents and brokers who market exchange plans. The agency drafted this policy after KFF Health News reported last April that some brokers were switching consumers into different plans without their permission. (Early, 1/13)
On the high cost of pharmaceuticals —
Bloomberg:
Lilly Asks Biden Administration To Pause Drug-Price Negotiations
Eli Lilly & Co. said it and other drugmakers will ask the Trump administration to pause drug-price negotiations, even as Biden-appointed officials prepare a new list of medicines that should be targeted. “They need to fix it” before negotiating down the price of more drugs, Lilly Chief Executive Officer Dave Ricks said on the sidelines of the JPMorgan Healthcare Conference in San Francisco, referring to the Inflation Reduction Act. (Muller, Koons and Wingrove, 1/13)
The Hill:
Patient Groups Call On Trump Administration To Let Medicare Cover Obesity Drugs
A coalition of obesity-related patient advocacy groups is calling on the incoming Trump administration to finalize a proposal that would allow Medicare to cover obesity medications. Led by the Obesity Care Advocacy Network (OCAN), more than 70 organizations said in a statement that addressing, treating and managing obesity is key to making America healthier. The groups pointed to a study that found if nothing is done, 213 million Americans will be overweight or obese by 2050. (Weixel, 1/13)
On the high cost of health care —
Bloomberg:
Pharma’s Big Meeting In US Draws Protests Over Healthcare Costs
The pharmaceutical industry’s biggest investment conference drew protesters in San Francisco Monday with signs reading “delay, deny, depose,” words prosecutors said were written on shell casings found at the scene of a health insurance executive’s killing last month. Across the street from the entrance of the Westin St. Francis in San Francisco where the JPMorgan Healthcare conference was being held, some two dozen protesters chanted “health care is a human right” and said drugmakers share blame with insurers for high costs and lack of access to care. (Kresge, 1/14)
Concord Monitor:
Study: Ambulance Transport In NH Can Cost Anywhere From $414 To $2,317
An independent study of ambulance trips in New Hampshire says that each call costs between $414 and $2,317, not including mileage, depending on level of care and where they take place. (Brooks, 1/13)
