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Pelosi unveils bill to lower Rx drug prices. But will it pass Congress?

September 20, 2019


House Speaker Nancy Pelosi (D-Calif.) on Thursday unveiled a highly anticipated bill that aims to reduce prescription drug prices in the United States by giving the HHS secretary the authority to negotiate Medicare payments for certain drugs and establishing a drug price ceiling for the negotiations based on the prices paid for the drugs in other countries.

A monthly subscription to an air ambulance? Regulators say it might be too good to be true.

September 18, 2019


Some air ambulance companies are selling membership subscriptions that promise patients will pay no out-of-pocket costs if they use the transportation services, but state regulators—and some larger air ambulance companies—are skeptical of the memberships' no-cost guarantee.

Insurers to pay a record $1.3B in rebates to consumers, employers under ACA

September 12, 2019


Health insurance companies this month are expected to begin paying an estimated $1.3 billion in rebates across the individual, small group, and large group insurance markets under the Affordable Care Act's medical loss ratio requirement, according to a Kaiser Family Foundation analysis published Tuesday.

The uninsured rate is up for the first time in nearly a decade, Census data shows

September 11, 2019


New data from the U.S. Census Bureau show the country's uninsured rate increased from 7.9% in 2017 to 8.5% in 2018, marking the first year-to-year increase reflected in Census data since 2008 to 2009, when the United States was at the highest point of the Great Recession.

How does Pelosi want to lower Rx prices? Leaked bill offers clues.

September 11, 2019


House Speaker Nancy Pelosi (D-Calif.) as early as this week could release a bill to tackle rising prescription drug costs—and a summary of the bill obtained by media outlets suggests Pelosi is considering allowing HHS to negotiate drug prices for certain treatments and establishing a drug price ceiling based on the prices paid for the drugs in other countries.

Did California's provider payment rate-setting law work? It's complicated, research suggests.

September 5, 2019


A California law touted as a national model for addressing so-called "surprise" medical bills has led to fewer surprise bills for patients and lower payment rates for in-network and out-of-network physicians—but it might be driving physician group consolidation, according to recent research.

CMS awards $10M in grants for ACA navigators

September 5, 2019


CMS on Friday announced it has awarded $10 million in grants to 34 Affordable Care Act navigators for the 2020 and 2021 open enrollment periods.

CMS rejects Idaho's proposal to limit voter-approved Medicaid expansion

September 4, 2019


CMS on Thursday rejected Idaho's request to expand the state's Medicaid program, but allow individuals who are eligible for the expanded program to remain enrolled in Affordable Care Act exchange plans.

Medicare Part D spending on MS drugs increased tenfold as prices spiked, study suggests

September 3, 2019


Rising prices for multiple sclerosis drugs drove a more than sevenfold increase in out-of-pocket costs for Medicare Part D beneficiaries over a decade, according to a study published last week in JAMA Neurology.

A controversy erupts: Should we give up hope on biosimilars?

August 28, 2019


Two experts in a Wall Street Journal opinion piece published last week argued that it is time to abandon biosimilars in favor of leveraging federal price regulation to create more affordable biologic drugs—but the piece drew a rebuttal from former FDA Commissioner Scott Gottlieb, who argued Congress could enact policy changes to make biosmilars more competitive with their biologic counterparts.

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