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Anthem, one of the nation's largest health insurers, is alleging that the drugmaker used a “creative, illegal, and fraudulent” scheme in pursuing reimbursement for the painkiller Subsys.
Through millions of newly insured patients, hospitals have raked in money since the Affordable Care Act was passed. But their spending on direct charity care has actually fallen.
“There is a general feeling that we’re on the front lines,” says Julie Mix McPeak, Tennessee’s insurance commissioner.
The program would likely become too costly for them to maintain. Meanwhile, a new report shows that the proposed legislation would cut Medicaid funding by as much as 39 percent. And media outlets report on other news on the program out of Pennsylvania, Montana, Michigan, California, Texas, Virginia and Ohio.
Regular screenings and preventive care are responsible for catching serious problems before they become expensive disasters. But with the cuts under the GOP's proposed legislation, some worry the progress made through the Affordable Care Act will be lost. Meanwhile, the Republicans' plan depends on young people buying insurance even though that lesson was already learned, and a look at the winners and losers under the plan.
Many Republicans, including President Donald Trump, say giving insurers the leeway to offer less-comprehensive plans will give people greater choice and cheaper options, but experts say it will skew the marketplace in favor of young, healthy people at the expense of sick people.
Despite their best efforts Vice President Mike Pence and Health and Human Services Secretary Tom Price did little to sway Republican governors, who are worried about the rollback of the Medicaid expansion, at their national conference.
Both moderate and conservative Republicans on the fence about the proposed legislation, with Sen. Susan Collins of Maine saying at least eight of her colleagues have expressed concerns.
Without Sen. John McCain (R-Ariz.) -- who had a craniotomy Friday -- Senate Majority Leader Mitch McConnell (R-Ky.) wouldn't have the 50 votes needed to get his legislation passed. To add to the timeline, the Congressional Budget Office announced Sunday that it would not release an updated score of the bill Monday, as originally expected.
Today's early morning highlights from the major news organizations.
Opinion writers offer their thoughts on a range of health issues.
Opinion writers reacted with tough talk to Senate Majority Leader Mitch McConnell's latest health bill tweaks. The Wall Street Journal, however, terms the bill a "net improvement over the Obamacare status quo."
Editorial pages examine the political dynamics involved in the debate surrounding the Senate GOP's efforts to pass a health bill.
Media outlets report on news from Minnesota, Massachusetts, Georgia, Missouri, California, Ohio, Michigan, Texas and Florida.
The hospital is telling patients that care quality has not suffered as a result of the walkout by its nurses union. But studies indicate that such work stoppages can have negative consequences.
Silicon Valley-based Bigfoot and Chicago-based Abbott Laboratories are teaming up on technology intended to help diabetics better monitor insulin intake and glucose levels throughout the day.
Doctor shopping -- obtaining large amounts of the drugs prescribed by four or more doctors and filled at four or more pharmacies -- also appears to be a major issue in the program.
“Not only does this data show that manufacturer performance is weak, by not revising its systems, the [Food and Drug Administration] is also missing an opportunity to enhance to post-marketing surveillance," said Thomas Moore, an ISMP senior scientist.
With the proposed changes, if a drug costs $84,000, CMS would pay just over $65,000, instead of $89,000.
“It’s a hurtful amendment, it’s not needed,” said Rep. Ileana Ros-Lehtinen (R-Fla), a noted advocate for LGBT rights who has a transgender son. “I view it as a personal issue, because as a mom I’m impacted, but it’s an issue of fairness for everyone."
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