Rose Meltzer

Author's posts

Report: To halt rising Part D costs, shift liability to drug companies and insurers

While the federal government would still pick up most of the tab, shifting the burden of high-cost patients would reduce out-of-pocket costs for beneficiaries, says the American Action Forum.

Ways and Means Committee targets physician burden with Medicare Red Tape Relief Project

The committee has spent the last year working to understand what “regulatory burden” means to providers. Now, it wants to act to help them.

Ohio cracks down on PBM contracts after audit shows egregious spread pricing in Medicaid

PBMs collected $224.8 million from taxpayers last year through the model, including more than $208 million on generic drugs. The state will no longer permit it, forcing PBMs to restructure their contracts.

KMG sale cost Humana nearly $800M

With the sale of KMG, Humana is no longer involved in the commercial long-term care industry. But the net loss was minimized by a healthy tax break.

Grassley urges ‘careful analysis’ of healthcare mergers, citing drug supply chain consolidation

Some suspect the Senate Judiciary Committee, which he chairs, will hold hearings about the pending CVS-Aetna and Cigna-Express Scripts deals in the near future.

After weeks of vocal opposition, Carl Icahn halts fight against Cigna-Express Scripts deal

Prominent investor Carl Icahn justified his retreat from opposing the deal by pointing to recommendations from Institutional Shareholder Services and Glass Lewis.

Google parent Alphabet invests $375M in Oscar Health

Google has 14 years on Oscar, but both companies focus on reaching consumers in a technologically advanced, disruptive way.

DOJ expands Medicare Fraud Strike Force to Newark and Philadelphia

The Justice Department selected the cities for the Strike Force’s newest division due to the prominence of fraud, including illegal opioid distribution, in the region.

CMS’ ACO proposal resurfaces discord over pace of risk-based models

Although some ACOs may leave the program, the goal should be quality over quantity, says former Obama health IT official Farzad Mostashari. But NAACOs says Track 1 ACOs need more time to get their bearings.

Payer Roundup—UnitedHealthcare may buy Genoa; Mississippi quietly amends work requirements

Specialty pharmacy operator Genoa could be worth as much as much as $2.5 billion. Meanwhile, a rule CMS recently proposed could prevent people from becoming home healthcare workers, even though the U.S. will soon need millions more.