On July 26, 2023, the Senate Finance Committee held an open bipartisan executive session to discuss and vote on modernizing and creating increased accountability for Pharmacy Benefit Managers (PBMs)..
Menu
On July 26, 2023, the Senate Finance Committee held an open bipartisan executive session to discuss and vote on modernizing and creating increased accountability for Pharmacy Benefit Managers (PBMs)..
The Centers for Medicare and Medicaid Services (CMS) has temporarily paused the Medicaid redetermination process in a dozen states out of concern that too many enrollees may be losing their coverage for procedural reasons. Since a number of states resumed Medicaid redeterminations on April 1, over 3 million enrollees have lost coverage. Nearly three-quarters of the disenrollments have been for procedural reasons, which include administrative or paperwork errors in the renewal process. In some states, CMS has even reinstated Medicaid coverage for tens of thousands of enrollees. CMS plans to release state-level redetermination data in the next few weeks, and the agency is working with at least a dozen other states to address issues with the redetermination process.
Only 36% of 2,000 surveyed hospitals are in complete compliance with federal hospital price transparency rules, according to a study from Patient Rights Advocate. Additionally, 64% of hospitals reported having incomplete files, and 69% did not post usable files on their changes. However, the July study shows an improvement from the February 2023 study, which found 25% of hospitals to be in full compliance with the rule. Since January 1, 2021, hospitals have been required to make public their standard charges for items and services via a “consumer-friendly display” and a comprehensive, machine-readable format.
Over 85% of Americans can’t recall the new number for the national suicide hotline, according to a new YouGov poll. In contrast, 92% of Americans reportedly identified 911 as the correct number for emergency services. The polling comes just a year after the federal government revamped the National Suicide Prevention Lifeline and changed the number to 988 so that it would be easier for people to remember. Despite the low memory retention on 988, the hotline has seen its use climb since last year’s rollout, with a 33% percent increase in the combined number of calls, texts, and chats since May 2022. 988 engagement is likely to continue to grow, as the administration prepares to reach new communities by adding Spanish text and chat services.
The Food and Drug Administration (FDA) approved nirsevimab as the first drug to protect infants and toddlers from respiratory syncytial virus (RSV), the leading cause of hospitalization among babies under a year old in the US. Developed by AstraZeneca and Sanofi, nisevimab is not a vaccine – meaning instead of prompting the body to make antibodies, nisevimab includes antibodies that can bind to RSV and prevent it from infecting healthy cells. A Center for Disease Control and Prevention (CDC) advisory panel will meet on August 3 to discuss how the injectable antibody drug should be administered.
The fifth season of Love Island USA recently debuted, and one of this season’s contestants is 23-year-old Keenan Anunay, a Washington, DC native resident who still resides in the city. Currently a journalism major at Morehouse College in Atlanta, Keenan was initially paired off with Kay Kay, contestant from Texas who currently works as a travel nurse. Love Island USA season 5 airs this summer on Peacock.
FDA Approves First OTC Birth Control Pill
The Food and Drug Administration (FDA) approved the first-ever over-the-counter (OTC) birth control pill for all women of reproductive age. Called Opill, the drug will be available without a prescription at pharmacies, grocery stores, and convenience stores, as well as online. Perrigo, the drug’s manufacturer, estimates that the drug will be available to consumers within the first few months of 2024. While Perrigo has pledged to make the drug “accessible and affordable,” the company has yet to disclose the pill’s price. Opill’s approval comes amid growing legal and legislative battles over women’s access to abortion services since the overturning of Roe v. Wade last year.
White House Outlines Plan to Fight Tranq
The White House released a National Response Plan to coordinate a whole-of-government response to address the risky combination of fentanyl and xylazine. Known as “tranq,” xylazine is an easily obtainable veterinary medicine that a growing number of drug dealers are cutting with fentanyl to extend a user’s high. A recent study found overdose deaths from xylazine-laced fentanyl increased by 276% between January 2019 and June 2022. The plan contains six areas of focus that address testing, data collection, supply reduction, research, and scheduling. Administration officials say the plan’s goal is to reduce the number of xylazine-related deaths by 15% in three of four US census regions by 2025.
Administration Proposes New Limits on Short-Term Plans
The Biden administration issued a proposed rule to reverse Trump-era policies that expanded the availability of short-term, limited-duration (STLD) plans. According to the rule, STLD plans would be limited from a maximum of three years to just three months, and STLD plan providers would be required to communicate to consumers what the plans do and do not cover. STLD plans do not have to meet the same requirements as Affordable Care Act (ACA) plans, such as coverage of pre-existing conditions and some essential health benefits like prescription drugs. Stakeholders have until September 11, 2023 to comment on the proposed rule.
CDC: More ER Visits Tied to Cannabis Use
A growing number of young people are going to the emergency room (ER) for marijuana-related emergencies, according to data from the Centers for Disease Control and Prevention (CDC). These ER visits occur when children and adolescents consume toxic levels of cannabis, which can result in confusion, vomiting, seizures, or difficulty breathing. The data found the sharpest rise in marijuana-tied ER visits among children under age 11, which increased 214% between 2019 and 2022. According to the CDC, pandemic-related stresses may have driven more children to consume cannabis products as a coping mechanism. The CDC recommends that adults safely and securely store marijuana products to help prevent unintentional ingestions among minors.
ICYMI: Climate Protesters Disrupt Congressional Softball Game
A group of protesters opposed to fossil fuels disrupted the Congressional Women’s Softball Game for 10 minutes, prompting several softball players to throw an impromptu dance party. Founded in 2009, the Congressional Women’s Softball Game pits lawmakers against journalists in a match to raise money for young survivors of breast cancer. The game resumed after Capitol Police told the protesters they would face arrest if they did not leave the field. Journalists prevailed over the lawmakers 15-9 in a game that raised a record $588,000.
On July 13, 2023, the Centers for Medicare and Medicaid Services (CMS) released their outpatient hospital and ambulatory surgery center (ASC) payment proposed rule for Calendar Year (CY) 2024. The rule contains updates to payment rates, quality programs, and a discussion around a new intensive outpatient Medicare program.