Morning Briefing
Summaries of health policy coverage from major news organizations
Insurers Evaluate New Expensive Cholesterol Drugs For Possible Preferred Designation Deals
Modern Healthcare: Insurers To Begin Review Of Coverage For Costly Cholesterol Drugs
Now that the Food and Drug Administration has given the OK to two pricey drugs that treat high cholesterol, health insurers and pharmacy benefit managers are evaluating if one drug should receive preferred coverage over the other. In exchange for the preferred designation, drugmakers offer price discounts on their products. A flurry of these types of deals occurred this year with high-cost hepatitis C drugs. (Herman, 8/28)
Modern Healthcare: Billing Squeeze: Hospitals In Middle As Insurers And Doctors Battle Over Out-Of-Network Charges
When Dr. Kelly Kyanko was giving birth to her second son a couple of years ago, there were signs her baby was facing a higher risk of complications after delivery. A pediatrician was called in, and everything turned out fine for mother and newborn baby. But after she left the hospital, Kyanko faced a surprise $636 bill from the pediatrician that her insurer, UnitedHealthcare, did not cover. Before her delivery, she had checked to make sure the hospital and the OB-GYN were in her plan's network. She had no way of knowing, however, that the consulting pediatrician was out-of-network. (Herman, 8/28)
NBC News: How To Deal With The Pain Of A Surprise Medical Bill
When it comes to "bill shock," a surprise medical expense can be particularly damaging. Over the past two years, nearly one-third of privately insured Americans has received an unexpected medical bill where their health plan paid less than expected, according to a May survey from the Consumer Reports National Research Center. (Grant, 8/28)
The Fiscal Times: Millions Facing A Hefty Increase In Medicare Premiums In 2016
Nearly a third of the roughly 50 million elderly Americans who depend on Medicare for their physician care and other health services could see their premiums jump by 52 percent or more next year. That’s because of a quirk in the law that punishes wealthier beneficiaries and others any time the Social Security Administration fails to boost the annual cost of living adjustment. (Pianin, 8/30)
