A new rule designed to drive down prices of physician-administered drugs may jeopardize Medicare Advantage enrollees’ access to needed care, patient advocates say. Starting this year, the Centers for Medicare and Medicaid Services is allowing Advantage plans to implement “step therapy” for drugs covered under Part B, which include many treatments for cancer and other serious conditions. That means the plans can require patients to try cheaper drugs before progressing to more expensive treatments. CMS says that the change will cut costs for Advantage plans as well as patients because plans will be required to pass along some of the savings to enrollees. But patient advocates and physician groups say that the move may delay -- or even completely derail -- necessary treatments for critically ill patients. As major Advantage plan providers such as UnitedHealthcare implement the change, enrollees need to read plan documents carefully to find out whether their insurer is … [Read more...] about Retirement: Cost-cutting rule could affect care
Critical illness insurance money saving expert
Congress asked to pass drug discount plan
Ricardo Alonso-Zaldivar Associated Press Published 1:22 PM EST Feb 1, 2019 Washington – The Trump administration’s top health official asked Congress on Friday to pass its new prescription drug discount plan and provide it to all patients, not just those covered by government programs like Medicare. The plan would take now-hidden rebates among industry players like drug companies and insurers and channel them directly to consumers when they go to pay for their medications. Patients with high drug copays stand to benefit from the proposal, while people who take no prescription drugs, or who rely on generics mainly, would probably pay somewhat more, since premiums are expected to rise. A day after unveiling the plan as a proposed regulation, Health and Human Services Secretary Alex Azar raised the stakes by calling on Congress to make it law and broaden it to include people covered by employer health insurance, not just Medicare and Medicaid beneficiaries. … [Read more...] about Congress asked to pass drug discount plan
How Detroit went broke: The answers may surprise you — and don’t blame Coleman Young
Nathan Bomey and John Gallagher Detroit Free Press Published 5:43 p.m. UTC May 24, 2018 Originally published Sept. 15, 2013 Detroit is broke, but it didn’t have to be. An in-depth Free Press analysis of the city’s financial history back to the 1950s shows that its elected officials and others charged with managing its finances repeatedly failed — or refused — to make the tough economic and political decisions that might have saved the city from financial ruin. Instead, amid a huge exodus of residents, plummeting tax revenues and skyrocketing home abandonment, Detroit’s leaders engaged in a billion-dollar borrowing binge, created new taxes and failed to cut expenses when they needed to. Simultaneously, they gifted workers and retirees with generous bonuses. And under pressure from unions and, sometimes, arbitrators, they failed to cut health care benefits — saddling the city with staggering costs that today threaten the safety and quality of … [Read more...] about How Detroit went broke: The answers may surprise you — and don’t blame Coleman Young