First Edition: June 18, 2014
Today's headlines include a report that the cost of health law subsidies may push the measure's overall price tag beyond projections.
Kaiser Health News: FAQ: Hospital Observation Care Can Be Costly For Medicare Patients
Writing for Kaiser Health News, Susan Jaffe reports: “Some seniors think Medicare made a mistake. Others are stunned when they find out that being in a hospital for days doesn't always mean they were actually admitted. Instead, they received observation care, considered by Medicare to be an outpatient service. The observation designation means they can have higher out-of-pocket expenses and fewer Medicare benefits. Yet, a government investigation found that observation patients often have the same health problems as those who are admitted” (Jaffe, updated 6/18). Check out the FAQ.
Kaiser Health News: Capsules: Enroll America Pushes Ahead To Second Enrollment Period; Insurer Begins Huge Palliative Care Program
Now on Kaiser Health News’ blog, Lisa Gillespie reports on Enroll America’s meeting: “Enroll America convened a national conference this week in Washington to review the strategies that proved successful during the inaugural Affordable Care Act open enrollment period and to gear up for the next one, which will start Nov. 15. Organizers also want to ensure that the navigators and organizations working toward enrollment maintain their energy — despite reports of backlogged Medicaid applications and continuing struggles in some state-run exchanges” (Gillespie, 6/18).
Also on Capsules, Marissa Evans reports on a new palliative care program: “Cambia Health Solutions, which includes Regence Blue Cross Blue Shield, will offer training to providers and additional benefits for policyholders: more than 2.2 million members in Cambia’s family of health plan companies in Oregon, Washington, Idaho and Utah. Palliative care improves the quality of life by managing pain and other problems for people who have serious life-threatening medical conditions, such as cancer, heart and kidney failure. It differs from hospice care, especially because patients do not necessarily have less than six months to live” (Evans, 6/17). Check out what else is on the blog.
Los Angeles Times: Obamacare Subsidies Push Cost Of Health Law Above Projections
The large subsidies for health insurance that helped fuel the successful drive to sign up some 8 million Americans for coverage under the Affordable Care Act may push the cost of the law considerably above current projections, a new federal report indicates. Nearly 9 in 10 Americans who bought health coverage on the federal government’s healthcare marketplaces received government assistance to offset their premiums (Levey, 6/17).
Los Angeles Times: Young Adults Healthier After Passage Of Obamacare, Study Finds
Expanding the number of young adults with health insurance appears to have improved their health and saved them money, according to a new study that is among the first to measure the effect of the healthcare law that President Obama signed four years ago. Starting in 2010, the Affordable Care Act allowed adults under age 26 to remain on their parents’ health plans, the first coverage expansion to take effect under the law (Levey, 6/17).
The Washington Post’s The Fact Checker: Old Obamacare Claims Don’t Age Well In New Crossroads GPS Ad
This advertisement from the pro-GOP group Crossroads GPS is almost like an oldies record of top tunes lambasting the Affordable Care Act—and it has the same dated feel as well. Just about everything in this ad has been called into question before, with the exception of its opening scenes—which highlight that our colleagues at PolitiFact had deemed President Obama’s promise that you could keep your health-care plan the “Lie of the Year.” No argument about that – Obama’s statement was also one of the Biggest Pinocchios of 2013—but even the Lie of the Year reference seems dated. (We have seen it in what feels like a gadzillion ads.) Let’s look at the other elements of this ad (Kessler, 6/17).
The Associated Press: Lawmakers Urge Medicare Cover Cancer Test
More than 130 lawmakers are urging the Obama administration to expand coverage for a lung-cancer test under Medicare that could cost the program billons, calling the screening important for vulnerable seniors. In a letter to the Centers for Medicare and Medicaid Services, the lawmakers called for a timely decision on coverage for low-dose CT scans for older patients at higher risk of developing lung cancer (6/17).
The Wall Street Journal: Drug Delays Cost U.S. Health-Care Payers Millions Of Dollars
Delays to an Indian company's generic versions of three blockbuster drugs annually cost U.S. health-care payers millions of dollars—and preserve millions of dollars in revenue for the makers of the brand-name versions. AstraZeneca's heartburn drug Nexium is the most recent big drug to face delays to its generic version. Key patents on the U.K. company's "purple pill," which ranks among the world's best-selling prescription drugs, expired at the end of May, but manufacturing problems at India's Ranbaxy Laboratories have prevented the launch of an expected generic rival (Plumridge and McLain, 6/17).
The Associated Press: 1,000-A-Pill Sovaldi Jolts U.S. Health Care System
Leading medical societies recommend the drug as a first-line treatment, and patients are clamoring for it. But insurance companies and state Medicaid programs are gagging on the price. In Oregon, officials propose to limit how many low-income patients can get Sovaldi. Yet if Sovaldi didn’t exist, insurers would still be paying in the mid-to-high five figures to treat the most common kind of hepatitis C, a new pricing survey indicates. Some of the older alternatives involve more side effects, and are less likely to provide cures (6/17).
The Wall Street Journal: Novartis Business Overhaul To Lift Profitability
Swiss pharmaceutical giant Novartis on Wednesday offered details of how its sweeping business overhaul would boost its performance, saying its core operating profit margin would have been more than two percentage points higher if the changes had been implemented last year. Basel-based Novartis is in the midst of a series of transactions worth roughly $25 billion that includes the sale of its vaccines business to GlaxoSmithKline and its animal health business to Eli Lilly. Novartis is also buying Glaxo's oncology business as part of the deals (Revill, 6/18).
Politico: House VA Bill Advances
The House moved closer on Tuesday to giving veterans stuck on federal wait lists for medical care the freedom to visit private providers. The Rules Committee approved legislation that would allow veterans who live far from a Department of Veterans Affairs’ medical facility or who have been delayed longer than the VA’s “standard” wait time for treatment to seek care from a private doctor (French, 6/17).
The Associated Press: New Jersey Hospital To Offer Veterans Priority
Veterans will go to the front of the line at a private New Jersey health care system under a new program being started in response to problems with the federal Veterans Administration’s health system. Under the initiative announced Tuesday, veterans living in the seven southern New Jersey counties are being promised same-day primary care appointments and help from health care navigators at Cooper University Health Care. Veterans would be served at the hospital in Camden and at system clinics in southern New Jersey (6/17).
The New York Times: Governors Unite To Fight Heroin In New England
Facing a heroin crisis that they say has reached epidemic proportions, the governors of five New England states met here on Tuesday to devise a regional strategy to combat the rise in overdoses and deaths from opioid abuse (Seelye, 6/17).
Los Angeles Times: IPC The Hospitalist Defrauded Medicare And Medicaid, U.S. Lawsuit Says
In a lawsuit filed Monday in Chicago, federal lawyers said IPC The Hospitalist Co. bilked Medicare and Medicaid by billing for more expensive care than was provided. The company assigns doctors to hospitals in 28 states, then bills insurers, including government programs, for treatment they provide. The company reported $610 million in revenue last year (Pfeifer, 6/17).
Los Angeles Times: Bill Requiring Health Labels On Sugary Drinks Fails In Assembly Panel
proposal to affix health warning labels to sugary drinks, including sodas and sports drinks, failed to win sufficient support in a key Assembly panel Tuesday. The measure would have required sugary drinks sold in California to be labeled with a warning that sugar contributes to obesity, diabetes and tooth decay (Mason, 6/17).
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