Public Policy Weekly Clips: May 17, 2016

May 17, 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.


The administration will appeal a federal court ruling striking down ACA cost sharing subsidies.

Aetna plans to stay in its current 15 ACA Marketplaces & may expand to more states.

More than 650, mostly rural counties may have just one Marketplace insurer in 2017.

HHS finalized ACA non-discrimination rules, including pregnancy, gender identity and sex stereotyping.

CMS’ Slavitt told a Ways & Means hearing that small practices will not be harmed under MACRA.

The HHS IG says over 10% of Medicare FFS payments totaling $125B from fiscal 2013-15 were improper.

GAO says CMS needs to recoup more from Medicare Advantage plans for inflated risk scores.

CMS is proposing to require Medicare Advantage plans to report data on case re-openings.

ONC will give $1.25M in grants to up to 12 organizations to develop ways to improve interoperability.

The White House says House opioid legislation that provides no new funding “lacks substance.”

Use of brand name drugs instead of generics cost $73B from 2010-12, $24.6B of that out-of-pocket.

Cigna sealed value-based deals that include discounts if costly PCSK9 cholesterol drugs don’t get results.

Senate Finance says physician-owned device distributorships are an “inherent conflict of interest.”

Consolidation is driving up health care prices, with average inpatient costs $2K higher monopoly areas.

If 10% of smokers quit the US could save $63B the next year from fewer heart attacks, strokes, etc.

Mining closed malpractice claims is helping to find ways to avoid errors that commonly cause lawsuits.

Several new prostate cancer tests strive to tell whether tumors need treatment or can be left alone.

Breast cancer patients who try alternative medicine may delay chemotherapy & lower survival odds

Rapidly increasing blood pressure in middle-age is linked with higher risk of stroke & death.

Walgreens’ website will connect users to Mental Health America’s online screening center.

HHS & AARP issued a challenge for ideas on easier to understand medical bill designs.

ABIM’s new MOC option offers shorter but more frequent assessments & more feedback.


Alabama’s legislature voted to postpone its move to provider-lead managed care in Medicaid.

California’s active purchasing reduces ACA market concentration’s impact so premiums will rise 8%.

Iowa’s legislature passed a bill to increase oversight of its new Medicaid managed care program.

Maryland is the first state to require insurers to offer birth control with no out-of-pocket cost.

Missouri got CMS approval to expand Medicaid dental coverage to adults.

Vermont may become the first state to require drug makers to explain price increases.

Wisconsin medical prices are 81% higher than the national average, 2nd only to Alaska.


National commercial market health costs grew 6.5% in 2015, 50% faster than in 2014.

Small businesses prove to be among the most elusive populations to serve, despite ACA efforts to do so.

Only 13% of midsize employers offer at least one HDHP compared to over 50% of large employers.

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