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What We're Reading: Industry Ties to Research; Balance Billing Woes; Marijuana Research Stalled
Memorial Sloan Kettering Cancer Center’s chief executive emailed all staff telling them they “need to do a better job” of disclosing industry relationships in the wake of a published report that the cancer center’s chief medical officer failed to disclose his extensive industry ties; the remedy to balance billing (the surprise bills patients receive after their insurance plan has paid the contracted amount with a provider) may lie at the federal or state level or possibly the courts; marijuana health research applications are stalled at the Drug Enforcement Administration, 2 years after it began taking the requests.
MSKCC Tells Staff to Improve Disclosures of Industry Ties to Faculty
Memorial Sloan Kettering Cancer Center’s chief executive emailed all staff telling them they “need to do a better job” of disclosing industry relationships in the wake of a published report that the cancer center’s chief medical officer failed to disclose his extensive industry ties in dozens of research articles since 2013. The New York Times said the email referred to an article published over the weekend by the paper and ProPublica. The article found that José Baselga, MD, had received millions of dollars in consulting fees and ownership interests in healthcare companies, but he did not mention those ties in appearances at scientific conferences and in journal articles.
Protections for Balance Billing Don't Apply to Self-Funded Plans
The remedy to balance billing (the surprise bills patients receive after their insurance plan has paid the contracted amount with a provider) may lie at the federal or state level or possibly the courts, Kaiser Health News reported. Kaiser examined one facet of the issue as it applies to self-funded plans under the federal Employee Retirement Income Security Act of 1974, or ERISA. ERISA does not prohibit balance billing, even as more states move to protect consumers against surprise medical bills.
DOJ Not Processing Applications for Marijuana Health Research, Lawmakers Say
Marijuana health research applications are stalled at the Drug Enforcement Administration, 2 years after it began taking the requests, The Wall Street Journal reported. The Department of Justice, led by Attorney General Jeff Sessions, a longtime critic of marijuana use, is not eager to process the applications, leading to bipartisan frustration. Researchers, including those working with veterans, want to study a wider variety of marijuana to know if it can be effective in alleviating pain, fighting seizures, combating depression, or relieving posttraumatic stress.
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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