About health insurance/insurers
CMS extends Medicaid waivers to 2025 “CMS will extend flexibilities designed to help states keep more eligible individuals enrolled in Medicaid through June 2025.
The waivers, previously set to expire at the end of 2024, will be extended for six more months, Daniel Tsai, deputy CMS administrator and director of the Center for Medicaid and CHIP services, wrote in a May 9 memo to states.”
Optum forgoes physician noncompetes at Oregon medical group “Optum's Eugene-based Oregon Medical Group will not enforce noncompete agreements for any departing physicians or advanced practice providers, ABC-affiliate KEZI reported May 10.
In March, the medical group dropped some patients due to a lack of available physicians, 32 of whom have departed from the organization over the last two years. Oregon Medical Group was purchased by Optum in 2020.”
State Agencies Could Be Obtaining Hundreds of Millions in Additional Medicaid Rebates Associated With Physician-Administered Drugs “State agencies could have invoiced and obtained rebates from the manufacturers for $225.7 million (Federal share) for physician-administered drugs reimbursed on a fee-for-service basis, and should have collected additional rebates associated with $236.2 million (Federal share) for physician-administered drugs administered to Medicaid managed-care organization enrollees…”
About hospitals and healthcare systems
Here's what the CEOs and CFOs of public for-profit health systems made in 2023 FYI
Prices Paid to Hospitals by Private Health Plans “Key Findings
Only Arkansas had an overall relative price below 170 percent of Medicare prices, while other states (California, Florida, Georgia, New York, South Carolina, West Virginia, and Wisconsin) had relative prices that were above 300 percent of Medicare prices.
In 2022, across all hospital inpatient and outpatient services (including both facility and related professional claims), employers and private insurers paid, on average, 254 percent of what Medicare would have paid for the same services at the same facilities.
State-level median prices have remained stable across the past three study rounds: 254 percent of Medicare prices in 2018 (Round 3), 246 percent in 2020 (Round 4), and 253 percent in 2022 (Round 5—the current study).
Prices for common outpatient services performed in ambulatory surgery centers (ASCs) averaged 171 percent of Medicare prices but would have averaged approximately 107 percent of Medicare prices if paid using Medicare payment rates for hospital outpatient departments (HOPDs).
Although relative prices are lower for ASC claims priced according to HOPD rules, HOPD prices are higher than ASC prices.
Commercial insurance prices for administered drugs received in a hospital setting averaged 278 percent of average sales price (ASP) compared with 106 percent of ASP paid by Medicare for administered drugs.
Very little variation in prices is explained by each hospital's share of patients covered by Medicare or Medicaid; a larger portion of price variation is explained by hospital market power.”
About pharma
Walgreens contacts potential buyers for $8.8 billion Boots chain “Walgreens Boots Alliance is reaching out to potential buyers of the $8.8 billion Boots drugstore chain in the UK, according to people familiar with the matter.”
Sanofi, Pfizer, AstraZeneca invest a combined €1.87B to bolster operations in France “Taking the bronze medal is AstraZeneca, which will spend 365 million euros ($394 million) to enhance its facilities at its manufacturing site in Dunkirk, France. Earning the silver is Pfizer with a pledge to invest 500 million euros ($540 million) over the next five years to bolster its R&D capabilities in France.But not to be outdone in its home country is gold-medal winner Sanofi. The Paris drugmaker has earmarked more than 1 billion euros ($1.1 billion) to increase its manufacturing capacity at three sites in France.”
Johnson & Johnson looks to offload remaining Kenvue stake in $3.75B deal “In a Monday securities filing, Kenvue revealed J&J's plan to offer 182.33 million shares of Kenvue in exchange for debt to be held by Goldman Sachs and J.P. Morgan Securities. The "debt-for-equity" exchange looks to be worth about $3.75 billion, based on Kenvue's Friday closing share price of $20.54.”
Patent Portfolios Protecting 10 Top-Selling Prescription Drugs “In this cross-sectional study of 1429 patents and patent applications protecting the 10 highest-revenue brand-name drugs in the US in 2021, almost three-quarters were filed after US Food and Drug (FDA) approval. Patents filed after FDA approval and those protecting parts of the drug other than the active ingredient contributed to dense patent thickets.”
About the public’s health
Survey: Trust in vaccines declines among teenagers, parents “Key takeaways:
Most parents and teenagers reported concerns about the safety of vaccines in general.
Only 46% of parents and 33% of teenagers felt it important to receive the latest COVID-19 vaccine.”
Federal dollars to increase bird flu testing for dairy cows, farm workers “The federal government Friday unveiled a major package of financial incentives to dairy farm owners — up to $28,000 per farm over the next four months — to encourage broader testing of cattle and expanded security measures to control a growing outbreak of the bird flu virus in cows.”
About healthcare IT
50-State Survey of Telehealth Insurance Laws FYI
About health technology
First person to receive a genetically modified pig kidney transplant dies nearly 2 months later “The first recipient of a genetically modified pig kidney transplant has died nearly two months after he underwent the procedure, his family and the hospital that performed the surgery said Saturday.
Richard “Rick” Slayman had the transplant at Massachusetts General Hospital in March at the age of 62. Surgeons said they believed the pig kidney would last for at least two years.”