“This copay coupon scheme is both common and lucrative for pharmaceutical companies that sell expensive drugs. Here’s how it works: Drug manufacturers, directly or through nonprofit foundations, disburse money to subsidize patient copays as a form of what they seek to characterize as charity. […]
“The deal … would allow Kaiser Permanente to operate Medi-Cal plans in at least 32 counties without having to bid for the contracts. … It’s a significant policy change that hasn’t been vetted as a policy change.” Battle Lines Are […]
Breaking News in Healthcare Reform “The deal … would allow Kaiser Permanente to operate Medi-Cal plans in at least 32 counties without having to bid for the contracts. … It’s a significant policy change that hasn’t been vetted as a policy change.” Battle Lines […]
A new Health Justice Monitor commentary on fraudulent diagnostic upcoding and risk adjustments by Medicare Advantage insurers. Medicare Advantage Costly Diagnostic Upcoding By James G. Kahn, MD/MPH Summary Investigative reporting by Bloomberg highlights the work of whistleblowers and the federal […]
“The exponential growth in these private equity investments in recent years ‘has been associated with a host of trends that are negatively impacting the American people’ — including an increase in nursing home mortality rates….” Private Equity Ownership of […]
Breaking News in Healthcare Reform “While the cap is an important stopgap measure, other reforms to improve the affordability of insulin are urgently needed.” The Winners and Losers of the Proposed Insulin Cost Cap MedPage Today | Kao-Ping Chua, MD, PhD; Rena M. Conti, […]
“…the insurer wanted to ‘suspend growth during this special enrollment season’ and thus would stop paying commissions to brokers who enroll new people in coverage starting April 1. … ‘Why sell something I don’t get paid for?’” ACA Sign-Ups for Low-Income […]
“A few weeks ago, state regulators imposed a record $55 million in fines on L.A. Care, California’s largest Medi-Cal managed-care plan, for failing to ensure adequate care and allowing treatment delays that threatened enrollees’ health. Patient advocates hope the move signals stricter enforcement against other Medi-Cal insurers, […]
