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Big ACA Plan Price Hikes Expected
Preliminary filings by insurers on the Affordable Care Act (ACA) exchanges indicate premiums for the coming year will be 15 percent higher over last year, the biggest increase since 2018. An analysis by Peterson-KFF noted two factors insurers have already cited to justify higher premiums: the elimination of premium tax credits and imposition of tariffs…
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Florida Takes New Approach to Hospital Price Transparency: Subpoenas
Florida Attorney General James Ulthmeier has taken action against several hospital systems in his state, including subpoenas, to ensure they are complying with President Donald Trump’s executive order requiring hospitals to provide “clear, accurate and actionable health care pricing information.” Ulthmeier issued subpoenas on May 30 to Southern Baptist of Florida and AdventHealth, the Orlando…
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Medicare Advantage ‘Coding’ Loopholes Targeted in New Bill
Responding to criticisms lodged against an otherwise popular program among seniors, Senators Bill Cassidy, M.D. (R-LA) and Jeff Merkley (D-OR) introduced a bill to improve the way Medicare Advantage (MA) providers determine patients’ health risks, to eliminate overpayment. The bipartisan No Unreasonable Payments, Coding, and Diagnoses for the Elderly (No UPCODE) Act aims at saving…
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Senate Considers Ending More-Expensive Hospital Rates Under Medicare
The U.S. Senate is considering legislation that would mandate “site-neutral” reimbursement in Medicare, eliminating the rule that pays hospitals more for services that can often be provided at a lower cost elsewhere. The Congressional Budget Office estimates implementing site-neutral payments for hospital outpatient departments could save taxpayers roughly $157 billion over 10 years. Over that…
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New Iowa Law Reins in Pharmacy Benefit Managers
A new law in Iowa requires pharmacy benefit managers (PBMs) to reimburse pharmacies based on average state or national drug prices instead of negotiated rates and stops PBMs from favoring a specific pharmacy to fill a prescription. Gov. Kim Reynolds of Iowa signed the bill on June 11, saying it was necessary to improve accountability…
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CVS Faces Lawsuits for Using Patient Database to Evade PBM Law
Pharmacy giant CVS is facing several lawsuits over allegedly sending text messages to customers in its prescription database to stop the state of Louisiana from enacting a law that would have threatened the company’s pharmacy benefit management (PBM) business. House Bill 358 would have banned ownership of a pharmacy and a PBM by the same…
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HHS Cracks Down on Removing Organs from Patients Declared Brain Dead
HHS Secretary Robert F. Kennedy announced a move to tighten oversight of the practice of removing vital organs from neurologically impaired patients. In a July 21 news release, Kennedy announced a “major initiative” toward reforming the organ transplant system. “Our findings show that hospitals allowed the organ procurement process to begin when patients showed signs…
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AMA Rejects Doctor-Assisted Suicide Despite More State Approvals
With several states having approved physician-assisted suicide, the American Medical Association (AMA) staked out a firm position opposing the practice. Reaffirming its long-held position at the annual meeting of its House of Delegates, which took place from June 6 to 11 in Chicago, the AMA “overwhelmingly rejected” a proposed change in policy, according to the…
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Medicaid Cuts Would Cause Thousands of Deaths, Study Claims
While the U.S. Senate was debating the One Big Beautiful Bill Act (OBBBA), a study published in the Annals of Internal Medicine projected cuts to Medicaid could lead to 16,642 premature deaths. Researchers from Harvard Medical School and the City University of New York based their projections on an estimate from the Congressional Budget Office…
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Mental Health Counseling Student Exposes Sexualized Course Content
A graduate student in marriage and family therapy at Santa Clara University is facing difficulty graduating after she requested an alternative class assignment requiring a “comprehensive sexual autobiography” that would be uploaded online and graded. “What began as a simple accommodation request in a required course called Human Sexuality turned into a case study in…
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