Nationwide, Congress, insurers, and others continue to wrestle with the costs of healthcare. What is good for some consumers may be bad for others, and a bipartisan coalition is asking the Trump Administration to consider this while they work on legislation regarding drug pricing. Other actions are trying to reduce ‘surprise’ bills from providers, while United is shifting rebates to their consumers. This and more in this week’s Innovation Partners BioBlog.
Insurers, hospitals diverge on how Congress should address surprise medical bills
Have you ever received a surprise bill from a healthcare provider? It’s an issue affecting many Americans. Leaders from several healthcare organizations sent a letter to Speaker Nancy Pelosi and other House leaders on Monday calling for legislation that would block physicians from sending surprise bills in case of emergency or when a patient had no choice in their provider. The letter, sent by America’s Health Insurance Plans (AHIP), also asks facilities to be required to inform patients of their doctors’ network status and consent for out-of-network care.
Bipartisan coalition asks Trump admin to withdraw drug pricing proposals
The White House is facing difficulties reversing long-standing policies around drug pricing. The problem? Reversing policies might negative impact some patients while making medicine affordable to other. A bipartisan coalition of lawmakers has approached the Trump Administration, asking them to set aside some of its potential legislation impacting drug prices.
Direct enrollment leaves consumers exposed, says CBPP
A new report from the Center on Budget and Policy Priorities warns that direct enrollment in health insurance coverage can be deceptive and may be opening consumers to privacy issues. Many direct enrollment platforms offer coverage that does not comply with the Affordable Care Act, misleading consumers into thinking they have obtained appropriate coverage. Also, some people with Medicaid may face additional hurdle during the application process.
CMS Updates Drug Dashboards with Prescription Drug Pricing and Spending Data
The Centers for Medicare & Medicaid Services (CMS) updated its Drug Spending Dashboards with data for 2017. This Administration’s version of the drug dashboards, first released in May of last year, adds information on the manufacturers that are responsible for price increases and includes pricing and spending data for thousands more drugs across Medicare Parts B and D and Medicaid.
Avalere: State-run reinsurance reduces premiums by 20%
According to new data published by Avalere, state-run reinsurance reduces premiums by 19.9% on average in the first year. The combination of state and federal funds being paid to insurance companies to offset losses can help avoid statewide premium increases, while also reducing the number of uninsured. Currently, seven states have created reinsurance programs using Section 1332 of the Affordable Care Act (ACA)—or pass-through funding—including Arkansas, Minnesota, Oregon, Maine, Maryland, New Jersey and Wisconsin.
MedPAC wants to boost Medicare acute-care hospital payments 2.8%
Medicare payment advisors are anticipated to request from Congress an increase of payments to hospitals by 2.8%, with some of the increase going to fund a revamped quality program. The Medicare Payment Advisory Commission made the recommendation in its March report to Congress expected to be released on Friday, the executive director of the commission said. It is rare for MedPAC to call for a payment above current law, but the panel was concerned that high-quality hospitals were losing money under Medicare.
UnitedHealthcare Will Expand a Drug Discount Program Aimed at Lowering Consumer Costs
UnitedHealthcare recently announced it plans to expand a program that passes drug discounts directly to consumers. This move may mean lower costs, especially for those who have high deductibles and other out-of-pocket expenses. United plans to put the program in action in 2020 and requires all new employer clients to be part of the new program.