Allison Inserro

Three pain societies have come together to create consensus guidelines for the use of ketamine for both acute and chronic pain.

In a closely watched case testing an idea pushed by the Trump administration, a federal judge Friday blocked Kentucky’s Medicaid waiver, which required many beneficiaries to work, volunteer, or train for a job as a condition of coverage. Judge James E. Boasberg of Federal District Court for the District of Columbia ruled that CMS' approval of the plan had been “arbitrary and capricious.”

CMS is launching a demonstration of its Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI), which pushes Medicare Advantage (MA) providers into taking on more risk. The demonstration, which has to be approved and adopted, would waive Merit-based Incentive Payment System (MIPS) requirements for doctors opting into the new program.

Payers have been rolling out disease management programs as a way to both control costs and improve outcomes for patients with chronic diseases, such as chronic obstructive pulmonary disease, asthma, diabetes, and others. But what happens to health outcomes when components of care considered COPD disease management in the United States are considered part of usual care elsewhere in the world?

Total and per capita annual growth rates in Medicare are trending higher than their historically low levels of the past few years, the Henry J. Kaiser Family Foundation reported recently in a review of Medicare data, creating an uncertain environment for future sustainability.

Oklahoma’s Medicaid program is the first to win approval from CMS to negotiate supplemental rebate agreements involving value-based purchasing (VBP) arrangements with drug manufacturers, with the aim of producing extra rebates for the state if clinical outcomes are not reached. Separately, CMS denied an application from Massachusetts requesting the ability to exclude certain Medicaid-covered outpatient drugs through a closed formulary.

States may be underestimating the effect of opioid-related overdose deaths because of incomplete cause-of-death reporting on death certificates, indicating that the mortality from opioids may be higher than it appears, according to an analysis published Wednesday.

With Medicaid expanding, CMS said it is unveiling increased and stricter oversight of the program.

The United States Preventive Services Task Force (USPSTF) updated its 2011 recommendation about osteoporosis screening, recommending that women over the age of 65 years continue to get screened and issuing new information about how clinicians should use screening tools to evaluate women younger than 65 years at high risk for developing the bone disease.

A new study from the Healthcare Financial Management Association, Leavitt Partners, and McManis Consulting found that the penetration of value-based payment (VBP) models is not yet enough to generate cost savings and is also not affecting clinical quality outcomes at the market level.

The risk of autism spectrum disorder (ASD) in children was higher in mothers with type 1 diabetes (T1D), a recent study found.

Using the example of low back pain, a study in JAMA Open suggests insurers could help to reduce opioid overuse by expanding access to nonopioid alternatives through improved coverage and reimbursement policies.

As CMS proposes to alter how it reports patient safety data, the Leapfrog Group released a report saying more hospitals are reporting infections since 2015.

CMS Administrator Seema Verma said the agency is seeking public comment on the so-called Stark Law, which was enacted to prevent independent physicians from referring Medicare patients to facilities where they have a financial benefit. The agency said it was focusing, among other things, on how the law may impede care coordination.

The Justice Department said that Healogics, a Florida-based wound care chain, agreed to pay up to $22.51 million to settle allegations that it violated the False Claims Act by knowingly causing wound care centers to bill Medicare for medically unnecessary and unreasonable hyperbaric oxygen (HBO) therapy.

How many uninsured people in the United States are eligible for coverage under the Affordable Care Act (ACA)? A new analysis from the Kaiser Family Foundation (KFF) found that 14.8 million people could gain coverage, either through Medicaid or by enrolling in a marketplace plan.

Compared with the general population, adults who survive an opioid overdose are 24 times more likely to die during the year after the incident from a variety of mental health and medical conditions, including from substance use–associated diseases and suicide, according to a study published in JAMA Psychiatry.

Health insurer Humana and pharmacy chain Walgreens announced Tuesday they are opening joint primary care clinics for senior citizens in Kansas City, Missouri. Separately, a report from America’s Health Insurance Plans (AHIP) found that Medicare Advantage populations continue to be more diverse and represent a larger share of low-income seniors than traditional fee-for-service (FFS) Medicare beneficiaries.

Having adenoids or tonsils removed in childhood is a fairly common operation, but little is known about the long-term effects. A new study found that removal significantly increased the risk of respiratory, allergic, and infectious diseases later in life, and that the long-term risks of these surgeries deserve careful consideration.

Even though patients with advanced chronic obstructive pulmonary disease (COPD) can suffer from the same distressing symptoms as those with end-stage cancer, they are less likely to receive palliative care than those with other terminal illnesses, a recent study found.

For true comprehensive community wellness to take place, barriers must end between the old silos of what is considered “healthcare” and what is considered public health, in order to improve health outcomes and curb rising costs, according to a new report from The Health Care Transformation Task Force and The Public Health Leadership Forum.

With the growing worldwide burden of chronic obstructive pulmonary disease (COPD), researchers in Australia recently reviewed literature looking for the best models to predict this disease, in an effort to identify new preventive strategies. Out of thousands of articles, the common denominator boiled down to one thing: smoking.

As Puerto Rico begins to update mortality statistics from 2017 that strengthen prior reports that the death toll from Hurricane Maria was much higher than first reported, a recent article by the Commonwealth Fund says there are 3 factors that worsened the death toll in Puerto Rico after last year's hurricane: an inadequate response, a poorer health baseline, and inadequate funding.

Major medical groups as well as patient advocacy groups filed friend-of-the-court briefs Thursday in Texas v. Azar, the lawsuit that seeks to overturn the Affordable Care Act (ACA), warning about the damage that would occur to American healthcare if the ACA is reversed by the courts. In addition, legal experts who have previously disagreed with each other about legal and policy questions about the ACA united in another filing, saying the arguments of both "the plaintiff States and the United States on the severability of the insurance mandate from the other provisions of the ACA are inconsistent with settled law."

A recent study aimed to determine the clinical and laboratory parameters associated with increased fracture risk in patients on holidays from taking bisphosphonates (BP) for osteoporosis.

Writing in a blog post for Health Affairs, a former Obama administration official for CMS urges the Trump administration to drop a budget proposal to allow states to end payment for the Medicaid non-emergency medical transportation benefit.

CMS said it will not update its overall hospital quality star ratings on Hospital Compare as it planned to in July, and will instead seek feedback on planned changes from an expert panel and other stakeholders. Two industry groups, the American Hospital Association and America’s Essential Hospitals, both welcomed the move.

The National Institutes of Health (NIH) outlined its research goals for improving treatment for opioid use and abuse, as well as creating better, safer therapies for chronic pain.

HHS Secretary Alex Azar appeared before a Senate committee to talk about the president's plan to lower drug prices, with legislators peppering him with questions about when prices would start to fall for US patients, which possible actions do or don’t need Congressional authority, transparency issues, and other points. Some senators also asked about the Department of Justice decision last week to not defend the Affordable Care Act in a Texas lawsuit.

Biotechnology firm Pfenex recently reported results from its phase 3 PF708-301 study, which showed comparable overall profiles between its biosimiliar drug candidate PF708 and Eli Lilly’s teriparatide (Forteo) for osteoporosis.