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Insurer ’s Risk Corridor Payment Claims Dismissed; New ACA Reg From OSHA
While politicians, the media, and the public actively debate the future of the Affordable Care Act, litigation over the ACA and implementation of the law go on. On November 10, Judge Charles Lettow of the United States Court of Claims dismissed all claims brought by Land of Lincoln Mutual Health Insurance Company in its lawsuit against the United States. This is the first decision on the merits in one of the nearly a dozen lawsuits brought by insurers claiming that the government violated its legal obligations when it failed to pay marketplace insurers the money they believe they are owed under the Affordable Care Act’s ...
Source: Health Affairs Blog - November 14, 2016 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage retaliation risk corridor payments Source Type: blogs

Insurer ’s Risk Corridor Payment Claims Dismissed; New ACA Reg From OSHA (Updated)
October 17, 2016 Update: Marketplace Enrollment Snapshot Although the future of the Affordable Care Act is murky at this point, Americans need health care coverage and are signing up for it on the marketplaces. On November 16, 2016 the Centers for Medicare and Medicaid Services released their first biweekly enrollment snapshot, covering the 12 days from November 1 to 12, 2016. During that period over one million consumers selected plans, including about 250,000 new enrollees and 760,000 returning enrollees. The applications covered over two million individuals. About 4.5 million individuals visited Healthcare.gov and two m...
Source: Health Affairs Blog - November 14, 2016 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage retaliation risk corridor payments Source Type: blogs

Trumping En Masse Through the Revolving Door - the Trump Advisory and Transition Teams
We have frequently posted on therevolving door as a type of severe conflict of interest, if not corruption, affecting health care.  Our posts have covered various cases of people going from influential positions in or related to health care and some anti-health corporations, and government positions that make health care policy or regulate health care. Donald J Trump, the president elect, has pledged to " drain the swamp, " that is, to generally reduce crony capitalism, conflicts of interest, the revolving door, and government corruption (e.g., lookhere.)  However, it appears that his campaign advisory/ tran...
Source: Health Care Renewal - November 18, 2016 Category: Health Management Tags: Altria Celgene Cerberus conflicts of interest Donald Trump Pfizer PhRMA Purdue Pharma revolving doors Source Type: blogs

American Healthcare Rackets: Monopolies, Oligopolies, Cartels and Kindred Plunderbunds
By NORTIN HADLER, MD The Healthcare Dollar, the Healthcare Industry and the Healthcare System are shibboleths. All are parlance. All render terms such as Healthcare Profession, Service Profession, and Healthcare Professionals quaint. All drive linguistic determinism: if it’s labeled so, it must be so. Furthermore, all have become jingoistic. This is our dollar, our industry, our system and don’t dare tread on us. These are shibboleths that engender considerable cognitive dissonance. If healthcare is no longer a service profession but an industry that transfers wealth in a systematic fashion, shouldn’t it comply with ...
Source: The Health Care Blog - November 25, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Health Wonk Review Archives: 2006-2016
December 1, 2016 - Hank Stern at InsureBlog November 11, 2016 - Joe Paduda - Managed Care Matters Post-election special November 3, 2016 - Brad Wright at Wright on Health October 20, 2016 - Peggy Salvatore - Health System Ed Blog October 6, 2016 - Joe Paduda - Managed Care Matters Sept 22, 2016 -Louise Norris - Colorado Health Insurance Insider September 8, 2016 - David Williams - Health Business Blog August 18, 2016 - Jason Shafrin - Healthcare Economist July 21, 2016 - Steve Anderson - medicareresources.org blog June 16, 2016 - Christopher Fleming at Health Affairs Blog June 2, 2016 - David Harlow - Healt...
Source: Health Wonk Review - November 1, 2016 Category: Health Management Source Type: blogs

The Top 15 Health Affairs Blog Posts of 2016
As 2016 winds down, we’ve compiled our most-read blog posts from the past year. For policy makers in health and health care as well as those who track and study their efforts, the last 12 months have been a whirlwind: premium increases, provider and insurer consolidation, final rules on MACRA, insurers leaving the marketplaces, co-ops going out of business, and most recently the stunning outcome of a national election that has the potential to dramatically change the trajectory of US health policy. 1. Day One And Beyond: What Trump’s Election Means For The ACA Timothy Jost Just hours after the 2016 presidential electi...
Source: Health Affairs Blog - December 22, 2016 Category: Health Management Authors: Health Affairs Tags: Elsewhere@ Health Affairs HATop10 Most-Read Source Type: blogs

Mylan Fiasco May Be “The Shot Heard Round the World”
By NIRAN AL-AGBA, MD The Mylan EpiPen debacle may have inadvertently weakened the grip Big Pharma on U.S. lawmakers.  Last week, a bill proposed by Senator Bernie Sanders was narrowly rejected by a vote of 52-46.  Unexpectedly, 12 Republicans and 1 Independent voted with Senator Sanders in favor of allowing pharmacists and distributors to import cheaper prescription drugs from Canada and other foreign countries (something typically favored by Democrats.)  The winds of change are starting to blow in the bipartisan direction when it comes to the pharmaceutical industry.     U.S. Healthcare needs a revolution ; ‘the s...
Source: The Health Care Blog - January 23, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

The Oxford Handbook of U.S. Health Law
is now available. Part I An Overview of the Legal Governance of HealthcareRelating Health Law to Health Policy: A Frictional Account - William M. Sage The Relationship between Bioethics and U.S. Health Law: Past, Present, and Future - I. Glenn Cohen What Health Reform Reveals about Health Law - Allison K. Hoffman A View from a Friend and Neighbor: A Canadian Perspective on U.S. Healthcare and the Affordable Care Act - Colleen Flood and Bryan Thomas Healthcare Federalism - Abigail R. Moncrieff and Joseph Lawless Part II Caring and Receiving Care A. Access to HealthcareAccessing Hospitals and Health Professionals - Eleanor ...
Source: blog.bioethics.net - January 26, 2017 Category: Medical Ethics Authors: Thaddeus Mason Pope, JD, PhD Tags: Health Care medical futility blog syndicated Source Type: blogs

ACA Round-Up: Open Enrollment Ends, Issa Introduces A FEHB-Based Replacement Plan
The second week of the Trump administration has proven to be relatively quiet for health reform as we await the confirmation of a new Health and Human Services Secretary. Rep. Tom Price (R-GA) moved one step closer to the Secretary’s office when Senate Finance Committee Republicans suspended committee rules and voted unanimously to favorably advance his nomination to the full Senate, despite the lack of a quorum resulting from the absence of Democrats who boycotted due to dissatisfaction over Price’s answers regarding certain investment and business dealings. And House and Senate committees continue to hold hea...
Source: Health Affairs Blog - February 1, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage FEHB open enrollment Source Type: blogs

ACA Round-Up: Open Enrollment Ends, Issa Introduces FEHB-Based Replacement Plan
The second week of the Trump administration has proven to be relatively quiet for health reform as we await the confirmation of a new Health and Human Services Secretary. Rep. Tom Price (R-GA) moved one step closer to the Secretary’s office when Senate Finance Committee Republicans suspended committee rules and voted unanimously to favorably advance his nomination to the full Senate, despite the lack of a quorum resulting from the absence of Democrats who boycotted due to dissatisfaction over Price’s answers regarding certain investment and business dealings. And House and Senate committees continue to hold hea...
Source: Health Affairs Blog - February 1, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage FEHB open enrollment Source Type: blogs

ACA Enrollment Final Numbers for 2017 —A Cautionary Tale for Trump and Republicans
By STEVEN FINDLAY For the record and as we crawl chaotically towards repeal & replace or repair, the final numbers on ACA enrollment for 2017 are in.  They reflect coverage in the 39 states that operate through healthcare.gov plus the 11 states and DC that run their own insurance exchanges.     A total 12.2 million people signed up.  That’s 3% to 4% fewer than last year.  HHS and the Associated Press (AP) put enrollment through healthcare.gov at 9.2 million; AP puts the number of enrollees in the 11 states plus DC at 3 million. Of the 9.2 million who signed up through healthcare.gov, 6.2 million were returning ...
Source: The Health Care Blog - February 12, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Health Wonk Review Archives: 2006-2016
February 9, 2017 - Steve Anderson - medicareresources.org January 26, 2017 - Joe Paduda at Managed Care Matters January12, 2017 - Julie Ferguson - Workers Comp Insider December 1, 2016 - Hank Stern at InsureBlog November 11, 2016 - Joe Paduda - Managed Care Matters Post-election special November 3, 2016 - Brad Wright at Wright on Health October 20, 2016 - Peggy Salvatore - Health System Ed Blog October 6, 2016 - Joe Paduda - Managed Care Matters Sept 22, 2016 -Louise Norris - Colorado Health Insurance Insider September 8, 2016 - David Williams - Health Business Blog August 18, 2016 - Jason Shafrin - Health...
Source: Health Wonk Review - January 11, 2017 Category: Health Management Source Type: blogs

In (Gasp) Defense of the Coronary Stent
By ANISH KOKA, MD A kerfuffle ensued recently when an oncologist and expert on evidence based medicine took the field of cardiology to task over the evidence for placement of the ubiquitous coronary stent.  What started with a lengthy article in Propublica that included coronary stenting for stable coronary disease as a prime example of a procedure done without evidence to back it up turned into this fiery twitter exchange between Drs. Kirtane (cardiology) and Prasad (oncology). The crux of the debate revolves around placement of coronary stents in patients with stable coronary artery disease.  Stable coronary artery d...
Source: The Health Care Blog - March 6, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Health Wonk Review Archives: 2006-2016
March 9, 2017 - Peggy Salvatore - Health System Ed Blog February 23, 2017 - David Williams - Health Business Blog February 9, 2017 - Steve Anderson - medicareresources.org January 26, 2017 - Joe Paduda at Managed Care Matters January12, 2017 - Julie Ferguson - Workers Comp Insider December 1, 2016 - Hank Stern at InsureBlog November 11, 2016 - Joe Paduda - Managed Care Matters Post-election special November 3, 2016 - Brad Wright at Wright on Health October 20, 2016 - Peggy Salvatore - Health System Ed Blog October 6, 2016 - Joe Paduda - Managed Care Matters Sept 22, 2016 -Louise Norris - Colorado Health Ins...
Source: Health Wonk Review - February 8, 2017 Category: Health Management Source Type: blogs

Did Medical Darwinism Doom the GOP Health Plan?
By MICHAEL L. MILLENSON “We are now contemplating, Heaven save the mark, a bill that would tax the well for the benefit of the ill.” Although the quote reads like it could be part of the Republican repeal-and-replace assault against the Affordable Care Act (ACA), it’s actually from a 1949 editorial in The New York State Journal of Medicine denouncing health insurance itself. Indeed, the attacks on the ACA seem to have revived a survival-of-the-fittest attitude most of us thought had vanished in America long ago. Yet, again and again, there it was in plain sight, as when House Speaker Paul Ryan (R-WI) declared: “T...
Source: The Health Care Blog - March 29, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized AHCA Darwin Millenson Ryan Source Type: blogs