Category: FierceMarkets

Anthem partners with Samsung, American Well on telehealth offering

A new partnership between Anthem, American Well and Samsung will make it easier for 74 million members to access virtual consultations on Samsung Galaxy phones.

Payer Roundup—After advocating for AHPs for years, NFIB says it will not establish one

NFIB says the Trump administration’s new AHP policy wouldn’t really help them. Plus, amid news of rising premiums across the nation, a new study suggests state individual mandates could be the cure.

AHIP: Rebates not driving rise in drug pricing

A recent analysis prepared on behalf of America’s Health Insurance Plans (AHIP) indicates that drug rebates have not been the primary driver of rising drug prices—as some advocates have claimed.

Medicare Advantage plans taking advantage of new policies that give them flexibility

“High-touch” services can improve satisfaction among patients with serious or advanced illnesses while reducing costs, a new paper from Duke-Margolis says.

New Mexico Health Connections to appeal portions of risk adjustment ruling regardless of pending decision

As a New Mexico district judge weighs a request from CMS to reconsider the court’s risk adjustment ruling, the lead attorney for New Mexico Health Connections said the insurer plans to appeal portions of the court’s February ruling.

CMS revives Kentucky waiver debate, puzzling legal experts

CMS plans to open a second 30-day comment period on Kentucky’s Medicaid work requirement waiver, a move that has experts scratching their heads, especially as numbers from Arkansas’ work requirement demonstration roll in.

CMS readies potential fix to risk adjustment payments

The Office of Management and Budget is reviewing an interim final rule from CMS on the “ratification and reissuance of the methodology” for the risk adjustment program, a sign the agency may be preparing to unfreeze the payments.

In a blow to PBMs, Trump administration mulling overhaul to drug rebate safe harbor protections 

The Trump administration is considering a proposal to overhaul safe harbor protections for pharmaceutical company rebates, a plan that could lead to a significant shift in how drug prices are determined. 

Altarum: Growth in spending on privately insured patients outpacing Medicaid, Medicare

A new analysis from the Altarum Institute found that spending and price growth among the privately insured sped up in 2017 and the first half of 2018 compared to public payers. It’s a reversal from prior trends when private spending growth was near or …

GAO finds 340B hospitals are mostly rural or qualify for DSH payments

Amid increased scrutiny of the 340B drug discount program, the Government Accountability Office has released a report diving into the characteristics of hospitals in the program.