NEW YORK (Reuters)—Aetna Inc., the No. 3 U.S. health insurer, on Monday said that due to persistent financial losses on Obamacare plans, it will sell individual insurance on the government-run online marketplaces in only four states next year, down from the current 15 states. Aetna’s decision follows similar moves from UnitedHealth Group Inc. and Humana…
The ACR’s Advocacy at State Legislature Level in 2016 Focuses on Biosimilars, Step Therapy
A majority of state legislatures have concluded their work for 2016. The ACR’s state advocacy efforts continued to focus on policy benefiting rheumatologists and patients alike. The two dominant issues this year were biosimilar substitution and step therapy. Biosimilar Substitution Biosimilar substitution remains the most prevalent issue throughout the states. The ACR continues to monitor…
Health Has Improved in States That Expanded Low-Income Insurance Options
(Reuters Health)—In states that expanded either their Medicaid programs or private insurance options for low-income Americans, beneficiaries used more outpatient and preventive care and less emergency care. They also had better subjective overall health, compared with low-income residents of states with no expanded coverage. All states participate in Medicaid, a partnership with the federal government…
The ACR Continues Fight to Block Medicare Part B Demo Project: Rule Expected in Fall 2016
The ACR will seek Congressional action if the Medicare Part B demonstration project proposed by the Centers for Medicare & Medicaid Services (CMS) is not significantly altered by the agency. Today, Medicare Part B generally pays physicians and hospital outpatient departments the average sales price of a drug, plus a 6% add-on, minus reductions required…
The ACR and Partners Help Get Legislation Passed in New York to Limit Step Therapy
In June, state lawmakers in New York passed legislation on step therapy designed to help ensure patient access to the best and most appropriate care. Step therapy mandates that a patient with a specific condition receive prescribed drugs approved for that condition in the order that an insurance company determines it will cover as the…
U.S. Regulators Sue to Block Anthem-Cigna & Aetna-Humana Mergers
NEW YORK (Reuters)—U.S. antitrust officials on Thursday moved to block an unprecedented consolidation of the national health insurance market, filing suit against Anthem Inc.’s proposed purchase of Cigna Corp. and Aetna Inc.’s planned acquisition of Humana Inc. The U.S. Department of Justice (DOJ) says the two mergers would reduce competition, raise prices for consumers and…
ACR Advocacy at the State Level in 2016
A majority of state legislatures have concluded their work for 2016. The ACR’s state advocacy efforts continued to focus on policy benefiting rheumatologists and patients alike. The two dominant issues this year were biosimilar substitution and step therapy. Biosimilar Substitution Biosimilar substitution remains the most prevalent issue throughout the states. The ACR continues to monitor…
Medicare Advantage Grows, but Provider Choice Is Limited
CHICAGO (Reuters)—Medicare enrollees are moving in greater numbers than ever to the program’s managed care option as a way to save money. But the tradeoff is much less ability to use their preferred doctors and hospitals. Seniors can choose between traditional fee-for-service Medicare—which is accepted by most healthcare providers—or a Medicare Advantage plan. The latter…
White House Proposes Measures to Speed Genomic Test Development
WASHINGTON (Reuters)—The White House announced on Wednesday measures aimed at advancing President Barack Obama’s precision medicine initiative, including plans to speed the development of tests used to identify genetic mutations and guide medical treatment. The U.S. Food and Drug Administration said it planned to issue a proposal to create performance standards to guide development of…
U.S. Republicans Reject Democratic Funding Proposals for Opioids
WASHINGTON (Reuters) – Republican lawmakers in U.S. Congress on Wednesday rejected two Democratic amendments to provide nearly $1 billion in funding for bipartisan legislation intended to combat America’s opioid epidemic, aides said. The rejection, which came during a meeting of U.S. House of Representatives and Senate negotiators on the measure, could undermine Democratic support for…
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