Morning Briefing
Summaries of health policy coverage from major news organizations
Last Day To Enroll In Medicare: Watch Out For Drug Coverage
Dallas Morning News: Medicare Open Enrollment Deadline Is Tuesday
Open enrollment for next year’s Medicare coverage started last month and continues through Dec. 7. Nationwide, over 3,800 plans are available, the highest number ever, the Kaiser Family Foundation says. Anyone signing up for Medicare gets to choose either “original Medicare” or a Medicare Advantage plan. Original Medicare consists of Part A (hospital services) and Part B (medical services), so many people on Original Medicare buy a prescription drug plan and a supplemental policy to help cover expenses. Medicare Advantage plans (sometimes referred to as Part C) are more of a one-stop-shop option, often covering vision, hearing and/or dental care, and they also include prescription drug coverage. (Schnurman, 12/6)
The Philadelphia Inquirer: Medicare Changes Must Be Made By Dec. 7 For The 2022 Plan Year, Including Your Part D Prescription Plan
Ever-rising health-care costs are most burdensome to people who are low income or uninsured. But health-care affordability is an issue that cuts across generations and income levels: About 2.6 million Medicare beneficiaries skipped or delayed filling a medication prescription because of cost. Medicare, the publicly funded health program for adults 65 and older and people with disabilities, is often characterized by good coverage with low out-of-pocket costs. But according to analysis by Robert Wood Johnson researchers, out-of-pocket costs for Medicare beneficiaries vary greatly, depending on your medical needs and the type of plan you choose. (Gantz, 12/6)
In more Medicare news —
Stat: Targeting Prices For Accelerated Approval Drugs May Have Limited Impact On Overall Drug Spending
As U.S. regulators approve more medicines under a so-called accelerated approval pathway, Medicare and Medicaid continue to spend more on treatments that come to market through an accelerated approval pathway, even though the clinical benefits remain unproven, according to two new analyses. Accelerated approval refers to early endorsements of medicines that treat serious conditions and fill an unmet medical need based on a surrogate marker that is “reasonably likely” to predict clinical benefits. From 1992 through 2020, the U.S. Food and Drug Administration issued more than 250 accelerated approvals, mostly cancer treatments. (Silverman, 12/6)
Modern Healthcare: At-Home Primary Care Demo Hasn't Saved Medicare Money, Study Finds
A demonstration aimed at offering Medicare beneficiaries better primary care services at home and cutting costs hasn't led to program savings or substantially improved care, an independent analysis found. The sixth year of the demonstration known as Independence at Home reduced total Medicare expenditures by an estimated 1% per beneficiary per month in 2019, according to research published by the consulting firm Mathematica last week. Earlier Mathematica evaluations of the program through its fourth year found that savings weren't statistically significant. Though year five in 2018 did result in lower costs, those were driven by a single site that left the program after that year. (Goldman, 12/6)
Bloomberg Law: Justices Pass On Case Over Doctor’s Medicare Billing Start Date
The U.S. Supreme Court on Monday declined to hear a doctor’s dispute with the Department of Health and Human Services over its alleged failure to pay out seven years of Medicare claims after a program contractor mistakenly deactivated the doctor from Medicare billing privileges. The case would have offered the justices the chance to reexamine how much deference courts should grant to agency interpretations of ambiguous regulations. (Brown, 12/6)
Stat: Major Telehealth Players Unite Ahead Of Tough Lobbying Battle
Major players in the telehealth space have united to create a supergroup of sorts, ahead of a looming lobbying fight. Giants like CVS, Walmart, and Amazon are teaming up with lobbying powerhouses like Teladoc and the American Hospital Association, along with major hospital systems including Johns Hopkins. They have a huge financial interest in making sure the telehealth regulations that were loosened during the pandemic and the Medicare pay rates that were boosted for the same reason stay that way. AARP, which advocates for older adults, also joined the group. (Cohrs, 12/7)
