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What We’re Reading: Free HIV Medication; MA Anticompetitive Regulations; Surge in Syphilis Cases
Medicare may cover full cost of preexposure prophylaxis drugs; rules aim to prevent excessive compensation in Medicare Advantage (MA) market; health officials advocate for widespread syphilis testing and intervention.
Free Preventive Medication to Protect Older Americans From HIV
The Biden administration has introduced a proposed federal policy to enhance the prevention of HIV in older Americans by offering free preventive medication, specifically preexposure prophylaxis drugs (PrEP), according to ABC News. Under this plan, Medicare would fully cover the cost of PrEP, including long-acting injectables, for those 65 years and older. With older Americans making up a significant portion of those already living with HIV, this policy shift aims to reduce infections among this age group. However, it also underscores the need for more equitable access to PrEP for those under 65, especially women and people of color, to further combat the HIV epidemic in the United States.
Tighter Regulations to Curb Anticompetitive Practices in Medicare Advantage Market
The Biden administration is introducing stricter regulations to address anticompetitive practices within the Medicare Advantage (MA) market, with a focus on limiting excessive compensation to agents and brokers, according to The Hill. CMS aims to enhance the selection and enrollment of Medicare beneficiaries in plans that align with their health care needs, rather than financial incentives for agents and brokers. The proposed rule would eliminate current frameworks allowing separate payments, redefine compensation definitions, and establish a fixed compensation amount of $632 per MA enrollment, promoting better alignment with statutory requirements. If finalized, these rules would come into effect by 2025.
Alarming Surge in Congenital Syphilis Cases Spurs Urgent Prevention Measures
US health officials are deeply concerned about the significant increase in congenital syphilis cases, with more than 3700 babies born with the disease in 2022, marking a 10-fold increase from a decade ago and a 32% rise from 2021, according to the Associated Press. The CDC is urging intensified prevention measures, emphasizing the importance of encouraging women of childbearing age and their partners to undergo syphilis testing. This surge in congenital syphilis is linked to a simultaneous rise in primary and secondary syphilis cases in adults and has been exacerbated by difficulties in accessing the main treatment, benzathine penicillin injections, due to supply shortages. The CDC's data indicate that more than half of the congenital syphilis cases involve mothers who tested positive during pregnancy but did not receive proper treatment, underscoring the need for proactive intervention.
CMS' 340B Repayment Proposal May Harm Vulnerable Hospitals, Reward Those With Higher Revenues
April 26th 2024The 340B hospitals not receiving an offsetting lump-sum payment from CMS following 2018-2022 cuts later ruled unlawful are disproportionately rural, publicly owned, and nonacademic, according to a new study.
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Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
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Kaiser Permanente was hit by a data breach in mid-April, impacting 13.4 million health plan members; GlaxoSmithKline (GSK) sued Pfizer and BioNTech for allegedly infringing on its messenger RNA technology patents in the companies’ COVID-19 vaccines; the CDC announced the first-known HIV cases transmitted via cosmetic injections.
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Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
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Mental Health Diagnoses, Care Challenges Rise Among US Youth, Report Finds
April 26th 2024While behavioral health care utilization has been rising, the treatment landscape has been worsening. New findings show that 20% of youths did not receive any form of treatment within 3 months of their initial behavioral health diagnosis.
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