Health experts are questioning the practice of allowing private insurers to manage public Medicaid contracts; doctors and scientists are urging a halt to a taxpayer-funded, $63 million medical trial based in part on the work of prominent Harvard Medical School scientist Piero Anversa; a Michigan pharmacist who refused to refill a woman’s miscarriage medication because he claimed he was a “good Catholic male” is no longer with Meijer.
Health experts are questioning the practice of allowing private insurers to manage public Medicaid contracts, due to a paucity of evidence that these contractors improve patient care or save government money, Kaiser Health News reported. When auditors, lawmakers, and regulators took the time to look, many concluded that Medicaid insurers fail to account for the dollars spent, deliver necessary care, or provide access to a sufficient number of doctors. Some lawmakers have begun to raise alarms even as oversight drags and the number of people covered by these plans continue to grow.Doctors and scientists are urging a halt to a taxpayer-funded, $63 million medical trial based in part on the work of prominent Harvard Medical School scientist Piero Anversa, The Washington Post reported. In the ongoing trial, cardiac stem cells are injected into the hearts of people with heart failure, in the hopes that those cells—alone or in combination with others—will improve patients’ heart function. Anversa’s work has been cast into doubt after Harvard disclosed a years-long investigation had identified “falsified and/or fabricated data” in 31 papers from his laboratory, without specifying which publications were affected. Critics of the study say sick people should not be subjected to the risks of an experiment whose underlying science has been called into question.
A Michigan pharmacist who refused to refill a woman’s miscarriage medication because he claimed he was a “good Catholic male” is no longer with Meijer, The Hill reported. The woman, Rachel Peterson, was prescribed misoprostol following a miscarriage about 11 weeks into her first pregnancy in July. Misoprostol is a drug used in combination with another drug to induce labor, but can also be used against stomach ulcers. The pharmacist told Peterson he did not believe she was having a miscarriage and reportedly refused to transfer it to another pharmacy. She eventually called a different Meijer location 3.5 hours away, where a pharmacist filled the prescription. Peterson filed a complaint through the American Civil Liberties Union of Michigan.
Navigating Sport-Related Neurospine Injuries, Surgery, and Managed Care
February 25th 2025On this episode of Managed Care Cast, we speak with Arthur L. Jenkins III, MD, FACS, CEO of Jenkins NeuroSpine, to explore the intersection of advanced surgical care for sport-related neurospine injuries and managed care systems.
Listen
Use of AI Lets Health System Find Lung Cancer at Early Stages
March 8th 2025Artificial intelligence (AI) helps a Sarasota, Florida, health system catch lung nodules that appear on CT scans for patients treated for scores of conditions, allowing them to be referred for a possible lung cancer diagnosis.
Read More
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