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What We're Reading: Md. Takes Aim at Drug Prices; Molina Healthcare Breach; Treating Addicts
New Maryland Law Targets Drug Prices
A new law in Maryland represents the first of its kind to target steep price increases for generic drugs. According to The Wall Street Journal, the law not only prohibits “unconscionable” price hikes, but allows the state to sue companies to roll back some increases. The Republican governor expressed concern with the bill because of its vague definition of price gouging, but he allowed it to become law without his signature.
Potential Data Breach at Molina Healthcare
Molina Healthcare is investigating a potential data breach, but at this time is unsure how many patient records may have been exposed. In response to the potential breach, the insurer shut down its online patient portal, reported California Healthline. The potential breach involves a security vulnerability that exposed patient medical claims without any authentication—by changing a single number in the website address of an online medical claim, anyone could view another patient’s claims. The company covers 4.8 million lives in 12 states, plus Puerto Rico.
Getting Rich Off of Addiction Treatment
A new article from STAT highlights how brokers profit from recruiting addicts to drug rehab centers. These brokers arrange for young addicts from the Northeast and Midwest to get treatment in Florida, and in return earn tens of thousands of dollars a year. Unfortunately, according to law enforcement, these treatment centers often provide few services and sometimes are run by people with no expertise in drug addiction treatment.
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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