The Daily Scan

April 17, 2018

Last Updated: 9:30 AM EST

Medicaid

  • A new report from PriceWaterhouseCooper explains that new Medicaid work and community engagement requirements could affect over 1.7 million beneficiaries in 10 states and warns of the implications for providers. Such implications include patient uncertainties about coverage and resulting disruptions in care, and the need for new technical and operational systems to confirm and monitor eligibility. (PWC.com)

 

  • A new report by the Bureau of Business and Economic Research at the University of Montana details the economic impact of Medicaid expansion in the state of Montana. Even if enrollment plateaus at current levels, the report estimates that the program would result in $350-400 million of spending each year, generating 5,000 jobs and $270 of personal income each year from 2018-2020. (MHCF.org)

 

Medicare

  • Senator Whitehouse from Rhode Island vows: “I will fight to my last breath all attempts to cut Medicare and Medicaid.” (Twitter)

 

  • On April 10, 2018, CMS posted the final decision memorandum which expands coverage of MRI’s for cardiac patients.  The memorandum stated that the agency determined that the evidence is sufficient to conclude that magnetic resonance imaging (MRI) for Medicare beneficiaries with an implanted pacemaker (PM), implantable cardioverter defibrillator (ICD), cardiac resynchronization therapy pacemaker (CRT-P), or cardiac resynchronization therapy defibrillator (CRT-D) is reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member under section 1862(a)(1)(A) of the Social Security Act under certain circumstances. (CMS.gov)

Private Sector

  • The upcoming gubernatorial election in California has the state starkly divided on the issue of single-payer healthcare. While Democratic candidate Gavin Newsom is leading with a moral argument for universal care, Republican candidate Antonio Villariagosa argues that a single-payer system would result in “financial calamity” and refuses to make promises to constituents he feels he can’t keep. (LATimes.com)

 

  • At a tax reform event yesterday, Secretary of Labor Alex Acosta revealed that the Trump administration hopes to move forward with a rule expanding Obamacare options, specifically to promote cost-savings via association health plans. (TheHill.com)

 

  • Pittsburgh-based Highmark Blue Cross Blue Shield announced today that they have entered into an outcomes based agreement with Astra Zeneca for the utilization of Symbicort for the treatment of Asthma and COPD. This contract will be initiated in the Highmark markets in Pennsylvania, West Virginia and Delaware. If the utilization of Symbicort for patients with Asthma or COPD does not deliver results in-line with the clinical trial results as furnished by Astra Zeneca, Astra Zeneca will provide a corresponding rebate. This initiative is representative of an increasing number of value based agreements which are being deployed by health insurers and government entities. (Highmark.com)

 

  • Senator Bernie Sanders (D-VT) introduced legislation today which seeks to hold pharmaceutical companies accountable for damages sustained as a consequence of the nationwide opioid crisis. The bill, “The Opioid Crisis Accountability Act of 2018” creates criminal liability for pharmaceutical company executives and further seeks to impose penalties on manufacturers who market, advertise or distribute opioid products. The penalty provision of the bill seeks to require the companies to reimburse the country for the economic burdens and losses sustained as a result of the distribution of their products. (Sanders.Senate.gov)

 

 

 

 

 

 

 

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