Public Policy Weekly Clips: July 6, 2016

July 6, 2016 · Paul Cotton

NCQA gives a rundown of the best national, state and private sector health care articles from the week. Here are our picks for today’s Public Policy Weekly Clips.



CMS’ Conway promised unspecified adjustments to the proposed value-based Part B drug demo.

CMMI chose over 3K oncologists in 200 groups & 17 insurers for its Oncology Care Model demo.

Harvard Pilgrim, Novartis & Eli Lilly agreed to value-based payments to be adjusted on drugs’ efficacy.

Doctors at for-profit or southern hospitals are more likely to accept manufacturers’ promotional gifts.

Prescription opioid misuse has more than doubled to over 45% of adults since the early 2000s.

Co-prescribing the anti-overdose medication naloxone with opioids reduces opioid-related ED visits.

FDA approved Gilead’s slightly cheaper hepatitis C drug that treats all 6 forms of the disease.

USPSTF is inviting comments on whether there is sufficient evidence to assess benefits/harms of pelvic exams.

Getting systolic pressure below 120 vs. 140 lowers cardic events & death in patients 75 & older.

1/3 of elderly patients with irreversible, advanced disease got unnecessary care the last 2 weeks of life.

Physicians accommodate advanced-care wishes of cancer or dementia patients more than others.

Out-of-pocket hospital costs rose more than twice as fast as overall health spending from 2009-13.

House Democrats are seeking a briefing from Theranos over ongoing investigation of the company.

Nearly 60M Americans spend a total of $30.2B a year on alternative medicine.

Over half (56%) of physicians using EHR’s report burnout vs. under half (44%) of those not using them.

McKesson & Change Healthcare are forming a new $3.4B health IT company.

Four Senate Democratic women argued Wednesday that proposed Zika bill undermines women’s health.

The Supreme Court struck down a Texas law placing undue burden on women’s access to abortions.

7 Democratic Senators are urging DOJ to block pending mergers of large health insurance companies.

Doctors, hospitals, and health advocates remain split over California proposal to legalize marijuana.



Kentucky Gov. Matt Bevin announced the state’s Section 1115 demonstration waiver proposal which includes widely criticized premiums & work for Medicaid expansion enrollees.

Indiana backed off proposal to cut Medicaid payments to home health providers.

Louisiana Medicaid has enrolled more than 220,000 additional individuals since expansion.

New York announced housing, transportation, and nutritional support for HIV+ individuals in NYC.

New York passed a bill redefining safety net hospitals to ensure they receive sufficient Medicaid funding.

Ohio Medicaid added Licensed Independent Chemical Dependency Counselors as eligible providers.

Tennessee’s Medicaid managed care waiver was granted a two-month temporary extension by CMS.


California passed legislation requiring drug manufacturers to notify purchasers when prices increase.

Massachusetts Medicaid announced a new rebate program for hepatitis C medications.


Illinois’ health insurance co-op is suing the federal government over payments related to the ACA.


The President and CEO of Bronx-based Affinity Health Plan, Glenn McFarlane, has resigned.

BCBS of Minnesota, the state’s largest insurer, will drop individual plans due to extreme financial losses.

Hospital system Catholic Health Initiatives is looking to sell its health plan subsidiary after heavy losses.

Carolinas HealthCare System formed a clinically integrated network that will include 2,300 physicians.

Anthem and its pharmacy manager is facing a class action lawsuit for overcharging patients for drugs.

Dave Jones, California’s insurance commissioner, recommended the DOJ block Aetna-Humana merger.

Cost of hospital stays in recent years have risen up to 37%, including $1,000 out of pocket.

75% of U.S. employers ranked stress as their top health and productivity concern.

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