The Daily Scan

April 20, 2018

Last Updated: 8:15 AM EST

 

Medicaid

  • The state of Kentucky initiated litigation against Johnson & Johnson on April 18, 2018 alleging that the company deployed a deceptive marketing campaign which contributed to and exacerbated the opioid crisis within the state. (KY.gov)

  • Both Michigan and Tennessee got one step closer to Medicaid work requirements on Thursday, with the Senates in both states passing approved bills onto their respective Governors. When the bill is signed in Michigan, Medicaid recipients will be required to work a minimum of 29 hours per week to maintain coverage. (DetroitNews.com and TimesFreePress.com)

  • Joan Alker, the Executive Director of Georgetown University’s Center for Children and Families and a scholar with a particular interest in Florida’s Medicaid program, is publicly critiquing Florida Governor Rick Scott’s budget allocation for the program. She, along with many providers in the state, claims that the estimated savings and number of beneficiaries who will be affected by changes is much greater than what was originally outlined. Representatives for Scott responded that the quality of care provided by the Florida Medicaid program is better than ever before. (TampaBay.com)

 

Medicare

  • On April 5, 2018, the U.S. Federal District Court for Massachusetts granted summary judgment to a Medicare beneficiary for coverage of a continuous glucose monitor (CGM). The court specifically found that Medicare’s denial of the CGM device was arbitrary and capricious. The CGM had previously been denied due to a finding that it did not constitute a medical device as it did not serve a medical purpose. Judge Gorton in ruling upon the Plaintiff’s motion for summary judgment found that the CGM device did fall within the definition of a medical device and also was established to be reasonable and necessary. (Lewis v. Azar, Dist. Court, D. Massachusetts 2018)

  • A report released Thursday from Fidelity Investments estimates that the average American couple, if retiring in 2018 at the age of 65, would need $280,000 to cover health care costs in retirement. This is a 2% increase from last year’s estimate. The estimate does not include long term care costs, dental services, and over the counter medication. The study also discusses that this estimate can vary greatly if the individuals choose to retire prior to becoming eligible for Medicare. (Fidelity Investments)

 

Private Sector

  • Independence Blue Cross (IBX) is teaming up with Comcast to launch a new consumer-oriented healthcare technology platform. Headquartered in Philadelphia, PA with over 8.5 million members, IBX hopes this collaboration will improve patient satisfaction, make care more easily accessible, and reduce costs. No timeline has been released for the project. (CNBC.com)

  • Health care companies have been engaging in an increasing number of transactions this year, reflecting a further degree of both vertical and horizontal consolidation of the industry. While both the number of mergers and deal values are up, they still fall below the banner year of 2015. (Bain.com)

 

 

 

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