Morning Briefing
Summaries of health policy coverage from major news organizations
Report: Top Republicans Want To Halt Medicare Drug-Price Negotiations
Axios: Hill GOP Sets Sights On Scrapping Drug Price Talks
The Trump campaign's populist rhetoric on drug pricing is colliding with more traditional GOP concerns in Congress about heavy-handed government squelching pharmaceutical innovation. The tension surfaced this week when multiple high-ranking Republicans told Axios they want to repeal the Inflation Reduction Act's Medicare drug price negotiations next year if they prevail in the elections. (Sullivan, 9/17)
Other news about the high cost of health care —
Crain's Chicago Business: Walgreens To Pay $107M Fine For Prescription Billing Fraud Claims
Walgreens Boots Alliance has agreed to pay a $106.8 million fine to the U.S. Department of Justice to settle allegations that it billed government healthcare programs for prescriptions never dispensed. In a statement today, the DOJ said Deerfield-based Walgreens had allegedly violated the False Claims Act and state statues between 2009 and 2020 when it submitted false claims for payment to federal healthcare programs like Medicare and Medicaid for prescriptions that it processed but were never picked up by patients. (Davis, 9/13)
Stat: What Pharma Companies And Insurers Think About Medicare’s Plan To Cover Digital Treatments
In July, Medicare proposed to start paying for some mental health apps, in a move applauded by the developers of those treatments after years of struggling to find adoption among clinicians and patients. But it wasn’t only the startups and their supporters that took notice — some of the largest pharma and health care companies in the country, like Pfizer and CVS Health, weighed in on the proposal during the comment period, arguing for modifications that suit their vision for how digital treatments ought to be valued. (Aguilar, 9/17)
Modern Healthcare: Medicare TEAM Bundled Payment Model Triggers Preparations
Hospitals are in countdown mode for a new mandatory Medicare bundled payment model, and there’s lots left to do. As part of the 2025 reimbursement rule for inpatient hospitals, the Centers for Medicare and Medicaid Services finalized a payment experiment called the Transforming Episode Accountability Model, or TEAM, which establishes episode-based payments for lower-extremity joint replacements, femur fracture surgeries, spinal fusions, coronary artery bypass grafts and major bowel procedures at nearly 700 hospitals. (Early, 9/16)
North Carolina Health News: Copays Pose A Barrier For Incarcerated People Seeking Medical Care
Prisons are constitutionally mandated to provide health care to incarcerated people, but that doesn’t mean it has to be provided for free. And in North Carolina — along with almost 40 other states — the costs can add up when prison systems charge incarcerated people a copay for select health care services. (Crumpler, 9/17)
In related news —
Stat: Shawn Bishop To Leave Senate Finance Committee
Shawn Bishop, a Democratic staffer who has played a major role on some of the most impactful health care laws of the past 20 years, is leaving the Senate Finance Committee next month, according to five sources familiar with the departure. (Wilkerson and Zhang, 9/16)
