Morning Briefing
Summaries of health policy coverage from major news organizations
Providers, Insurers Urge CMS To Exercise Caution In Fraud Crackdown
Modern Healthcare: CMS Healthcare Fraud Push Draws Caution From Hospitals, Insurers
As federal regulators continue broadening their healthcare fraud crackdown, providers and insurers want them to move cautiously. The Centers for Medicare and Medicaid Services issued a formal request for information in February to solicit recommendations for an anti-fraud campaign dubbed Comprehensive Regulations to Uncover Suspicious Healthcare, or CRUSH. CMS asked about issues such as blocking Medicare-banned providers from participating in Medicare Advantage; using artificial intelligence in Medicare Advantage oversight; and improving identity verification for Medicare-enrolled providers and suppliers. (Early, 5/15)
Politico: Hospitals Are Taking The Fall For High Health Care Costs
Two of the most powerful lobbies in the country are turning on a third in the hopes of deflecting Washington’s wrath and securing bigger shares of the $5 trillion Americans spend on health care each year. Drugmakers and insurers are aiming to take advantage of lawmakers’ worries about affordability to convince them it’s the hospitals they should regulate, and not them, if they want to bring down Americans’ bills. Some of the changes the drugmakers and insurers are pursuing would pad their own profits. (Chu, 5/17)
KFF Health News: Kids Keep Getting Stuck In Hospitals, Even After Being Cleared For Discharge
Overwhelmed by the demands of caregiving, Quette dialed 911 when she found her teenage son downstairs in their kitchen struggling to breathe. He had rolled his wheelchair to the oven to keep himself warm as he tried to regulate his temperature, she recalled, and was drenched in sweat from an apparent infection. (Anthony, 5/18)
Modern Healthcare: GE HealthCare, Philips Raise Prices Amid War In Iran
Providers could face higher prices for medical devices and supplies as a result of the war in Iran. Major medtech companies said during recent earning calls that rising oil, transportation and component costs are driving the inflationary pressure, though most indicated they are not seeing widespread supply disruptions or shortages. The price increases come at a time when the companies are launching new products. At the same time, providers are looking to cut costs amid approximately $1 trillion in federal Medicaid funding cuts and other policy changes under the tax bill the Trump administration signed into law in 2025. (Dubinsky, 5/15)
Pharmaceutical developments —
Bloomberg: Astra’s Potential Blockbuster Blood Pressure Pill Approved In US
AstraZeneca Plc’s new hypertension pill won US Food and Drug Administration approval in a boost for the drugmaker that’s seeking to garner more than $5 billion in annual sales from the medicine. The drug, called Baxfendy, significantly lowered blood pressure when added to other hypertension medicines in clinical trials. The regulator cleared it for patients who aren’t adequately controlled with existing treatments. (Furlong, 5/18)
The New York Times: Medicare Coverage For GLP-1 Weight Loss Drugs: Cost, Eligibility And What To Know
Millions of older Americans may have access for the first time to obesity drugs at a low price of $50 a month starting in July under a Medicare pilot program. While Medicare Part D already covers some GLP-1 medications for conditions like diabetes, cardiovascular disease and sleep apnea, the government program for people 65 and older had prohibited coverage solely for obesity. Now, more people on Medicare will be eligible, including those who are most overweight and those with both obesity and conditions like prediabetes or uncontrolled hypertension. (Miller, 5/15)
More from the health industry —
Bloomberg: UnitedHealth Tracks Workers’ AI Use In Push To Transform Company
UnitedHealth Group Inc. is tracking how often some employees use artificial intelligence tools as part of a push to embed the technology throughout its operations, according to people familiar with the matter. The company is monitoring whether some workers in its Optum services division perform at least one query a day with programs such as OpenAI’s ChatGPT or Microsoft Corp.’s Copilot, said the people, who asked not to be named discussing internal operations. (Tozzi and Fletcher, 5/15)
Modern Healthcare: Kinderhook Industries Completes $1.1B Acquisition Of Enhabit
Private equity firm Kinderhook Industries has closed its $1.1 billion acquisition of Enhabit Home Health and Hospice. Enhabit’s common stock will no longer be listed on the New York Stock Exchange, the companies said in a Friday news release announcing the deal’s completion. Enhabit shareholders voted Tuesday to accept Kinderhook’s offer of $13.80 per share in cash. (Eastabrook, 5/15)
Bloomberg: Elliott Builds Stake In Life-Science Firm Bio-Rad, WSJ Says
Activist investor Elliott Investment Management has built a sizable stake in Bio-Rad Laboratories to boost the firm’s underperforming stock price, the Wall Street Journal reported, citing people familiar with the matter. The exact size of Elliott’s stake in Bio-Rad, a supplier of life-science tools, was unclear, the Journal said. Bio-Rad has a market value of about $6.7 billion. The firm’s stock has dropped more than 70% since a peak in late 2021. (Yilun Chen, 5/18)
