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What We're Reading: CMS Nixes Medicare Drug Pricing Rule; 5 More States Sue Purdue; Bariatric Surgery Benefits
The Trump administration is backing off a proposal that would have allowed private Medicare plans to refuse to pay for certain drugs for chronic conditions that experience steep price hikes; 5 more states have sued Purdue Pharma, alleging the company llegally marketed and sold opioids; bariatric surgery may offer more benefits for adolescents than adults.
CMS Backs Off Proposal to Ease Protections on Protected Classes of Drugs
The Trump administration is backing off a proposal to ease protections on 6 protected classes of drugs, reported STAT. The proposal would have allowed private Medicare plans to refuse to pay for certain drugs for chronic conditions that experience steep price hikes. The administration argued the move would help lower drug prices by giving these plans more leverage over high-cost drugs. The 6 classes include antidepressants, antipsychotics, anticonvulsants, immunosuppressants for treatment of transplant rejection, antiretrovirals, and antineoplastics.
More States Sue Purdue Pharma Over Opioid Epidemic
Five states are suing Purdue Pharma, claiming the company illegally marketed and sold opioids. The 5 states—Iowa, Kansas, Maryland, West Virginia, and Wisconsin—join 39 other states in filing lawsuits against Purdue Pharma and its executives, including the former president, Richard Sackler, and his family, according to Reuters. Last week, a North Dakota judge threw out the state’s lawsuit that accused the company of overstating the benefits and trivializing the risks of long-term opioid use. Purdue Pharma called the new lawsuits “misleading attacks.”
Bariatric Surgery May Be More Effective for Adolescents
While bariatric surgery results in comparable weight loss among adolescents and adults, adolescents may reap more benefits from the surgery. According to a study published in the New England Journal of Medicine, after 5 years of surgery, adolescents had remission of diabetes (86% vs 53%) and hypertension (68% vs 41%) more often than adults. However, more adolescents than adults had abdominal reoperations (19 vs 10 reoperations per 500 person-years) The researchers compared the effects of the surgery among 161 adolescents between 2006 and 2012 and 396 adults between 2006 and 2009.
Hospital Participation in Medicare ACOs: No Change in Admission Practices and Spending
August 19th 2025Hospital accountable care organization (ACO) participation did not impact emergency department admission rates, length of stay, or costs, suggesting limited effectiveness in reducing spending for unplanned admissions and challenging hospital-led ACO cost-saving strategies.
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Laundromats as a New Frontier in Community Health, Medicaid Outreach
May 29th 2025Lindsey Leininger, PhD, and Allister Chang, MPA, highlight the potential of laundromats as accessible, community-based settings to support Medicaid outreach, foster trust, and connect families with essential health and social services.
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Care Quality Metrics in Medicare During COVID-19 Pandemic
August 12th 2025Medicare Advantage outperformed traditional Medicare on clinical quality measures before and during the COVID-19 pandemic; mid-pandemic, however, traditional Medicare narrowed the gap on some in-person screenings.
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