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What We’re Reading: Cap on ACA Plans; CVS, Walgreens Settle Over Opioids; COVID-19 Diagnoses Rise After Thanksgiving
CMS plans to limit the number of nonstandardized Affordable Care Act (ACA) exchange plans offered by each insurer in 2024; CVS and Walgreens agree to settle on lawsuits revolving around their role in the opioid crisis; cases of COVID-19 rise during the holiday season as people meet with their families.
Limit on Number of ACA Exchange Plans
The Biden administration is looking to limit the number of nonstandardized Affordable Care Act (ACA) exchange plans that an insurer can offer to make it easier for enrollees to pick a plan, according to Fierce Healthcare. The proposal would limit the number of exchange plans offered to 2. The proposal also included plans to lower user fees and make changes to network adequacy standards in 2024. CMS had introduced standardized plan options in 2023 for consumers to choose from in small group markets and HealthCare.gov. CMS had previously expressed concern about the increase in plans that consumers could choose from.
CVS, Walgreens Agree to Settle in Opioid Lawsuit
A combined $10 billion will be paid by Walgreens and CVS in a lawsuit that sought to hold the companies accountable for the opioid crisis, according to The Associated Press. Finalized settlements over opioids have totaled more than $50 billion in recent years, with this current deal from Walgreens and CVS among the largest. Walmart, another pharmacy operator, had agreed to pay $3.1 billion just last month. Most of this money is set to be used to combat the opioid epidemic, which has been linked to more than 500,000 deaths in the United States within the past 2 decades.
Rise in COVID-19 Cases Comes Near the Holidays
State health officials are urging people to get vaccinated before the Christmas holidays as COVID-19 cases rise across the country, according to Politico. Positive tests for COVID-19 have risen 30% since Thanksgiving, and 30,000 patients are in the hospital. Health experts believe that the surge in COVID-19 may be milder compared with years past but worry about how hospitals will cope with the uptick in cases given staffing shortages and the strain of increasing respiratory syncytial virus and flu cases. Only 13% of Americans over the age of 5 years have received their updated booster vaccine.
PAH Treatment Outcomes Similar Regardless of Diagnosis Time
November 1st 2024The study findings underscore the importance of early initiation of macitentan and tadalafil among patients who have pulmonary arterial hypertension (PAH), and represent a shift in understanding of prognosis based on diagnosis timing.
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Exploring Racial, Ethnic Disparities in Cancer Care Prior Authorization Decisions
October 24th 2024On this episode of Managed Care Cast, we're talking with the author of a study published in the October 2024 issue of The American Journal of Managed Care® that explored prior authorization decisions in cancer care by race and ethnicity for commercially insured patients.
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