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Morning Briefing

Summaries of health policy coverage from major news organizations

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Tuesday, May 30 2023

Full Issue

Study: Medicare Drug Negotiations May Resist Some Legal Challenges

A new report suggests that plans by drugmakers to sue Medicare over its efforts to negotiate prescription drug prices may fail in some cases, with parts of the law likely to prove resistant to challenges. Meanwhile, The Hill examines concerns millions are losing Medicaid coverage.

Drugmakers have already hinted at suing Medicare over its new efforts to negotiate prescription drug prices. A new report by nonpartisan congressional researchers suggests there are at least some parts of the law that can’t be challenged — but they caution it would ultimately be up to the courts to decide. (Wilkerson, 5/30)

Federal legislation passed during the pandemic prohibited states from terminating a Medicaid enrollee’s coverage until the end of the public health emergency, which enabled the federal program to grow and contributed to a record-low national uninsured rate. These provisions have concluded, however, and it’s become apparent that beneficiaries were not made aware of the change. (Choi, 5/29)

In other news concerning the Biden administration —

Congress wants the Biden administration to move faster on addressing the gender gap in vehicle crash testing — something safety advocates have urged for years amid soaring traffic fatalities. The crash tests that regulators use to rate vehicles’ safety don’t use female test dummies in the driver’s seat in a key test, and in the tests where they are used, the dummies are less-accurate, scaled-down male versions. Advocates say the discrepancy means that hundreds of women needlessly die in crashes every year. (Guo, 5/29)

A court-appointed monitor said in January that child migrants held in medical isolation may be overlooked when Border Patrol stations get too crowded, a warning issued five months before an 8-year-old girl with a heart condition died in custody during an unusually busy period in the same Texas region he inspected. (Gonzalez and Spagat, 5/26)

Also —

While insurance companies say a relatively small percentage of medication and services require approval, critics, including the American Medical Association (AMA), say prior authorization is overused, costs providers time and money, and delays treatment to patients with mental health and substance use disorders who are vulnerable to relapse when experiencing interruptions in care. The bill before the D.C. Council, introduced by Brooke Pinto (D-Ward 2), would set deadlines for insurers to respond to prior authorization requests and appeals, allow denials only by a District-licensed physician with the same specialty as the patient’s doctor, make approvals last at least a year and honor approvals for 60 days when a patient changes plans. (Portnoy, 5/28)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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