Lawmakers Not Actually Exempt From AHCA
Reporters scrutinizing the American Health Care Act (AHCA), which passed yesterday in the House, noticed the bill exempted members of Congress from its provisions. According to The New York Times, however, experts say this exemption was written to comply with the complex legislative rules on the budget reconciliation process, which is how the bill was passed. Shortly before the vote on the AHCA, the House unanimously voted to approve a separate bill that nullified the exemption.
Georgia Moves to Restrict Number of Addiction Treatment Centers
In response to Georgians’ complaints that their state is too crowded with addiction treatment centers that attract patients from out of state, Governor Nathan Deal signed legislation that would restrict the number of drug treatment facilities in each of the state’s regions. The Associated Press reports that the law also requires new treatment centers to prove a need for their services before they open. Addiction recovery advocates worry the law perpetuates harmful stigma and will restrict access to treatment for those seeking help with a substance abuse problem.
Anthem Turns to Supreme Court to Review Merger Decision
Anthem isn’t giving up on its $54 billion merger with Cigna, even after a federal court upheld a lower ruling that blocked the merger on the grounds that it would have anticompetitive effects on the insurance market. Modern Healthcare reports that the insurer will file a petition asking the US Supreme Court to take up the case. However, there is no guarantee the appeal will actually reach the nation's highest court: the Supreme Court hears oral arguments for just 80 cases out of the 7000 to 8000 such petitions it receives every term.
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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