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What We’re Reading: FDA to Cut Nicotine Levels; Insulin Pricing Bill; DaVita Loses Dialysis Case
The FDA plans to set a maximum nicotine level in cigarettes and tobacco products to reduce addictiveness; a bipartisan bill would place a $35 monthly cap on insulin for patients with private insurance or Medicare; the Supreme Court ruled that an Ohio hospital’s employee health plan did not violate federal law by limiting coverage for outpatient dialysis.
FDA Plans to Cut Nicotine Levels in Cigarettes, Tobacco Products
The FDA announced plans Tuesday to reduce the addictiveness of cigarettes and other combusted tobacco products by establishing a maximum nicotine level. In a statement, the agency said the proposed rule will aim to make cigarettes and tobacco products minimally or nonaddictive, and therefore reduce use, addiction, and death from smoking. According to the FDA, smoking-attributed diseases are a leading cause of preventable death in the United States, with approximately 480,000 premature deaths each year. The rule is expected to be issued in May 2023, when the FDA will seek public comment, The New York Times reported.
Senators Announce Bill to Cap Insulin Costs
Two senators announced a bipartisan bill aiming to curb insulin costs by placing a $35 monthly cap for patients with private insurance or Medicare, The Washington Post reported. While the bill, from Democrat Jeanne Shaheen, New Hamshire, and Republican Susan Collins, Maine, will not apply to individuals without insurance, it will work to make insulin more accessible in general by looking into previous authorization requirements that forced patients to work harder to get insurers to cover their medications. The senators behind the bill are also focusing on how insurers and middlemen have raised drug costs at point of sale.
Supreme Court Rules Against DaVita in Dialysis Coverage Case
The Supreme Court ruled Tuesday that Marietta Memorial Hospital’s employee health plan did not violate federal law by offering limited coverage for outpatient dialysis, Roll Call reported. This 7-2 ruling rejected dialysis provider DaVita’s claims that the Ohio hospital violated the Medicare Secondary Payer Act by discriminating against patients with end-stage kidney disease by reimbursing them at low rates, pushing them to switch to Medicare. Lawyers for DaVita said this decision may lead to other similar private health plans to limit dialysis coverage, also forcing patients to switch to Medicare.
Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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More Care Doesn't Equal Happier Patients in Traditional Medicare
March 17th 2025Data on care satisfaction, ease managing care, and out-of-pocket spending were the outcomes of interest for this new analysis that investigated the relationship between healthcare utilization and beneficiary experience within traditional Medicare.
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The Impact of Cost Sharing on High-Value Care
March 14th 2025Michael Chernew, PhD, professor of health care policy and director of the Healthcare Markets and Regulation Lab, Harvard Medical School, shares how cost-sharing policies shape access to critical health care services and influence value-based insurance design.
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