News for Insurers
Top stories summarized by our editors
5/20/2019

A study in JAMA Network Open found that each additional 12-ounce sugary beverage consumed was associated with a 15% increased risk of coronary heart disease mortality and an 11% increased risk of all-cause mortality. Based on 13,440 individuals ages 45 or older, researchers found that 100% fruit juices were linked to an even higher mortality risk, with each additional 12 ounces associated with a 28% higher risk of CHD mortality and a 24% higher risk of all-cause mortality.

5/20/2019

A Government Accountability Office report found the CMS is not doing enough to ensure the public knows about major changes to Medicaid, particularly the implementation of work rules through Section 1115 waivers. To improve transparency and avoid inconsistencies, the report urges the CMS to create standard transparency rules for new waivers, extension requests and major changes under Section 1115.

5/20/2019

Smokers who continued the habit after a stroke, using up to 20 cigarettes each day, were at a 68% increased risk for a repeat stroke, compared with nonsmokers, according to findings published in the Journal of the American Heart Association. However, those who quit smoking after their stroke were 29% less likely to experience another stroke than those who continued smoking, according to the study of 3,069 stroke survivors.

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Reuters
5/20/2019

Medicare Part D plans will not be allowed to exclude drugs in protected classes from their formularies, and plans will be required to include information on lower-cost alternatives in monthly explanation of benefits reports sent to patients. Part D plans will be allowed to require prior authorization before covering some therapies.

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CNBC
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Part D
5/20/2019

Researchers found that people whose diet consisted mostly of highly processed foods had an average weight gain of about 0.9 kilograms over two weeks and consumed around 500 calories more daily, compared with losing that same amount of weight over two weeks after eating a diet of minimally processed foods. The findings were published in the journal Cell Metabolism and based on 20 healthy adults.

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CNN
5/20/2019

A JD Power survey of nearly 30,000 commercial health insurance recipients showed satisfaction with commercial health coverage climbed consistently, driven especially by plan coverage and benefits. The report identified areas for continued improvement and found that perceptions that insurance providers are actively trying to contain out-of-pocket costs and supporting coordinated care contributed to substantial increases in satisfaction.

5/20/2019

The CMS said Friday it would delay a final national coverage determination for chimeric antigen receptor T-cell therapies for cancer treatment such as Novartis' Kymriah and Gilead Sciences' Yescarta. The agency didn't give any reason for the delay in finalizing the proposal, released in February.

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Gilead Sciences
5/20/2019

The number of emergency department patients who left California hospitals after seeing a doctor but before their care was complete jumped 57% from 2012 to 2017, while the median wait before admission from the ED increased by 15 minutes to 336 minutes. Experts said the increase in patients leaving against medical advice could be attributed to overcrowding, with ED trips in the state up by nearly 20% from 2012 to 2017.

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Kaiser Health News
5/20/2019

The FDA has approved Takeda Pharmaceutical's Gattex, or teduglutide, injection as a treatment for pediatric patients at least 1 year old with short bowel syndrome who need additional nutrition or fluids via intravenous feeding. The drug was previously approved for adult patients with SBS.

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Pharmacy Times online
5/20/2019

A bill that supporters say would protect patients from unexpected out-of-network medical bills for emergency and non-emergency services was introduced by a bipartisan group of senators led by Sens. Bill Cassidy, R-La., and Maggie Hassan, D-N.H. The STOP Surprise Medical Bills Act would include an arbitration process and final payments would be based on "commercially-reasonable rates for that geographic area," according to Hassan's office.