Morning Breakouts

Latest KFF Health News Stories

HHS Cracks Down On Drug Companies Taking Advantage Of Loophole In Medicaid’s Complex Payment Structure

Morning Briefing

The new guidance, which officials say will cut back on the companies’ “abusive behavior,” concerns the rebates that drug makers have to pay back to states when a patient receives one of their medicines. In other pharmaceutical news: the administration is preparing to put action behind its rhetoric on drug pricing; some say Medicare’s new negotiating powers could lead to increased hospitalizations; and more.

In Latest Swipe At Health Law, ACO Program That Failed To Save Government Billions Will Be Overhauled

Morning Briefing

Accountable care organizations were set up under the Affordable Care Act with the intention of improving quality and efficiency. But government data shows that they’ve fallen short of the savings that were projected. “After six years of experience, the time has come to put real ‘accountability’ in Accountable Care Organizations,” CMS Administrator Seema Verma said in a statement. “Medicare cannot afford to support programs with weak incentives that do not deliver value.”

‘End Family Fire’: Advocates Want To Curb Children’s Deaths From Accidental Shootings By Giving The Problem A Name

Morning Briefing

“Just like the term ‘designated driver’ changed perceptions about drinking and driving, the term ‘Family Fire’ will help create public awareness to change attitudes and actions around this important matter,” said Kris Brown, co-president of the Brady Campaign to Prevent Gun Violence. In other public health news: online dating, dementia, sperm count, suicide, and heart health.

Insys To Pay $150M To Settle Criminal, Civil Investigation Into Marketing Techniques For Its Opioids

Morning Briefing

The company has figured prominently in the ongoing federal investigation into drugmakers’ role in the opioid epidemic because several former executives and employees have been arrested in connection with allegations of bribing doctors to boost sales of Subsys, its product that contains fentanyl. News on the crisis comes out of New York and Massachusetts, as well.

CVS Wants Pharma To Stop Pointing Fingers At The Middlemen When It Comes To High Drug Prices

Morning Briefing

“Drug manufacturers want you to believe that increasing drug prices are a result of them happy to pay rebates and that PBMs are retaining these rebates. And this is simply not true,” said Larry Merlo, the CEO of CVS, which owns Caremark, one of the biggest pharmacy-benefit managers. Meanwhile, the American Medical Association speaks out against CVS’ attempts to acquire insurer Aetna. And Rite Aid and Albertsons call off their merger.

Medicare’s Power To Negotiate Drug Prices Will Harm Patients With Chronic Illnesses, Advocates Warn

Morning Briefing

Medicare Advantage’s negotiating tool — requiring patients to try lower-cost treatments before the more expensive ones — is derided as a “fail first” process to those who oppose the strategy. “Consumers may have to go through one or more drugs before they can get a particular treatment they really need,” said Ellen Albritton, a senior policy analyst at Families USA. Meanwhile, there are already signals that implementing the new rules is going to be complicated.