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What We’re Reading: Exceptions for Abortions May Prove Impractical; Supreme Court Sides With HHS; Juul Can Sell Temporarily
Exceptions for rape and incest in states with trigger laws outlawing abortion may be impossible to implement effectively; Supreme Court determines Medicare’s payments are lawful in a blow to hospitals that had pay cuts; a court ruled that Juul could continue selling e-cigarettes temporarily.
Abortion Allowances Difficult to Effectively Implement
In the wake of Friday’s Supreme Court ruling overturning Roe v Wade, some providers believe that, in states with trigger laws outlawing abortions except for special cases such as rape and incest, it will be difficult to prove that a woman needs an abortion for those reasons, putting health care providers at risk of a prison sentence. The impracticality of these exemptions could prompt abortion clinics to move across state lines, which would lead to millions of women losing access in their state. Abortion rights advocates believe some ob-gyns with a private practice could provide a prescription to abortion pills for women who are pregnant due to incest or rape.
Supreme Court Decides Medicare Payments Are Legal
The Supreme Court ruled in a 5-4 decision that the Medicare payment system for safety-net providers was lawful, which is a major setback for hospitals that have experienced pay cuts. The ruling allows HHS to continue making disproportionate share payments to hospitals that serve many low-income patients based on the number of patients treated who meet the basic criteria for Medicare, regardless of primary insurance. The majority opinion, written by Justice Elena Kagan, claimed that the point of the statute was not to pay as much money as possible to the hospitals but instead to compensate hospitals for serving low-income patients.
Federal Court Allows Continuing Sale of Juuls
A federal court in Florida ruled that Juul could continue to sell its e-cigarettes while it awaits the results of a challenge to an FDA ban on its products. The company, which was ordered to shut down all US sales on June 23 and is reportedly considering bankruptcy, plans to challenge the ban this week. The ruling gives Juul at least 2 weeks to continue sales while the court reviews the full request by Juul for an emergency stay, which will not be processed until at least mid-July. The FDA had banned Juul products because of concerns about toxicology data from the company.
Urticaria Diagnosis Challenged by Overlapping Pruritic Skin Conditions
April 23rd 2025Urticaria is complicated to diagnose by its symptomatic overlap with other skin conditions and the frequent misclassification in literature of distinct pathologies like vasculitic urticaria and bullous pemphigus.
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New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
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ACOs’ Focus on Rooting Out Fraud Aligns With CMS Vision Under Oz
April 23rd 2025Accountable care organizations (ACOs) are increasingly playing the role of data sleuths as they identify and report trends of anomalous billing in hopes of salvaging their shared savings. This mission dovetails with that of CMS, which under the new administration plans to prioritize rooting out fraud, waste, and abuse.
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