- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
What We’re Reading: Free HIV Medication; MA Anticompetitive Regulations; Surge in Syphilis Cases
Medicare may cover full cost of preexposure prophylaxis drugs; rules aim to prevent excessive compensation in Medicare Advantage (MA) market; health officials advocate for widespread syphilis testing and intervention.
Free Preventive Medication to Protect Older Americans From HIV
The Biden administration has introduced a proposed federal policy to enhance the prevention of HIV in older Americans by offering free preventive medication, specifically preexposure prophylaxis drugs (PrEP), according to ABC News. Under this plan, Medicare would fully cover the cost of PrEP, including long-acting injectables, for those 65 years and older. With older Americans making up a significant portion of those already living with HIV, this policy shift aims to reduce infections among this age group. However, it also underscores the need for more equitable access to PrEP for those under 65, especially women and people of color, to further combat the HIV epidemic in the United States.
Tighter Regulations to Curb Anticompetitive Practices in Medicare Advantage Market
The Biden administration is introducing stricter regulations to address anticompetitive practices within the Medicare Advantage (MA) market, with a focus on limiting excessive compensation to agents and brokers, according to The Hill. CMS aims to enhance the selection and enrollment of Medicare beneficiaries in plans that align with their health care needs, rather than financial incentives for agents and brokers. The proposed rule would eliminate current frameworks allowing separate payments, redefine compensation definitions, and establish a fixed compensation amount of $632 per MA enrollment, promoting better alignment with statutory requirements. If finalized, these rules would come into effect by 2025.
Alarming Surge in Congenital Syphilis Cases Spurs Urgent Prevention Measures
US health officials are deeply concerned about the significant increase in congenital syphilis cases, with more than 3700 babies born with the disease in 2022, marking a 10-fold increase from a decade ago and a 32% rise from 2021, according to the Associated Press. The CDC is urging intensified prevention measures, emphasizing the importance of encouraging women of childbearing age and their partners to undergo syphilis testing. This surge in congenital syphilis is linked to a simultaneous rise in primary and secondary syphilis cases in adults and has been exacerbated by difficulties in accessing the main treatment, benzathine penicillin injections, due to supply shortages. The CDC's data indicate that more than half of the congenital syphilis cases involve mothers who tested positive during pregnancy but did not receive proper treatment, underscoring the need for proactive intervention.
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.
Listen
Global Status of HIV/AIDS Pandemic Takes Center Stage in Opening Session
March 10th 2025The Conference for Retroviruses and Opportunistic Infections 2025 opened with a session dedicated to informing attendees about the progress, and lack of progress, has been made in the fight against the HIV pandemic given the current political climate.
Read More
Myasthenia Gravis Care Overlooks Speech and Swallowing Dysfunction
March 9th 2025Myasthenia gravis is a neuromuscular junction disorder with a hallmark of progressive muscle weakness and frequent manifestation of otolaryngologic dysfunction, such as difficulty swallowing and speech disorder.
Read More
