Are you ready to meet the challenge of managing member identities?

By Claire Thayer, August 31, 2017

Healthcare consumers believe that their providers and health plans are taking measures to protect their digital healthcare data, yet a recent Accenture survey on Healthcare Cybersecurity and Digital Trust finds that one of four health care consumers (26%) has experienced a breach of their digital healthcare data, which may include their Social Security number, contact information, electronic medical record or health  insurance ID. And, of these, half were victims of medical identity theft.  Following a breach one-quarter (25%) of those experiencing a breach changed their healthcare providers, 21 percent changed their health insurance company, and 34% lost trust in the organization.

This weeks’ edition of the MCOL Infographic, co-sponsored by LexisNexis, highlights some of the issues and challenges involved in actively managing member identities and impact of security breaches: 

MCOL’s weekly infoGraphoid is a benefit for MCOL Basic members and released each Wednesday as part of the MCOL Daily Factoid e-newsletter distribution service – find out more here.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week: Time Crunch Among Hurdles for Bipartisan Senate Push to Bolster ACA The leaders of a key Senate committee say they are cautiously optimistic about reaching a deal to shore up the Affordable Care Act’s individual marketplaces, but even with a bipartisan effort, it is far from certain whether they can hash out an agreement in time. Morning Consult Friday, August 18, 2017 EpiPen maker to settle on claims it overcharged taxpayers, agrees to have pricing practices reviewed Mylan will pay $465 million to settle claims that it overcharged states for its signature EpiPen, according to a Thursday Department of Justice press release. The company also signed an agreement with the federal government to enter into a review of its pricing practices. Stat News Thursday, August 17, 2017 Express Scripts to limit opioids, concerning doctors The nation’s largest pharmacy benefit manager will soon limit the number and strength of opioid drugs prescribed to first-time users as part of a wide-ranging effort to curb an epidemic affecting millions of Americans. Stat News Wednesday, August 16, 2017 Federal deficit will soar to $194 billion, premiums spike 20% if Trump nixes cost-sharing subsidies, CBO report says The federal deficit will soar by $194 billion over the next nine years and gross premiums for silver plans, the most popular, would spike 20 percent higher in 2018 and 25 percent higher by 2020 if President Trump follows through a proposal to eliminate the cost-sharing subsidies that allow low-income consumers to purchase and afford health plans on the individual ACA insurance exchanges, a report from the Congressional Budget Office said. Healthcare Finance News Tuesday, August 15, 2017 CMS cancels two mandatory pay models and scales back a third The CMS on Tuesday said it will toss two bundled payment models and cut down the number of providers required to participate in a third, citing providers' requests to have more input in the models' designs. Modern Healthcare Tuesday, August 15, 2017 These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week: Trump Plans to Declare Opioid Epidemic a National Emergency President Trump said on Thursday that he was preparing to officially declare the United States’ worsening epidemic of opioid overdoses as a national emergency, accepting an urgent recommendation from a national commission that he appointed. The New York Times Thursday, August 10, 2017 Early 2018 marketplace rates vary widely across states Health insurers selling individual plans next year on the federally operated marketplace, HealthCare.gov, have until Wednesday to finalize their rates. But early filings provide a good look at how the ACA marketplace is shaping up for 2018. Modern Healthcare Thursday, August 10, 2017 Bipartisan health policy coalition urges Congress to strengthen the ACA An unlikely coalition of liberal and conservative health-policy leaders is calling on Congress to strengthen the existing health-care law in a variety of ways to help Americans get and keep insurance. The Washington Post Wednesday, August 9, 2017 Taking A U-Turn On Benefits, Big Employers Vow To Continue Offering Health Insurance The shrinking unemployment rate has been a healthy turn for people with job-based benefits. Eager to attract help in a tight labor market and unsure of Obamacare’s future, large employers are newly committed to maintaining coverage for workers and often their families, according to new research and interviews with analysts. Kaiser Health News Tuesday, August 8, 2017 Large employers increasingly leaning on value-based contracts Instead of looking to reduce demand by shifting costs to employees, large employers are increasingly hoping to constrain health insurance cost growth through value-based contracts with providers, according to a survey released Tuesday by the National Business Group on Health. Modern Healthcare Tuesday, August 8, 2017 These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week: Millions More Uninsured Could Impact Health Of Those With Insurance, Too Much has been written lately about how individuals’ health could suffer if they lose insurance under the health proposals circulating in the U.S. House and Senate. But there is another consequence: creating millions more people without insurance could also adversely affect the health of people who remain insured. Kaiser Health News. Friday, July 14, 2017 Senate Republicans Unveil New Health Bill, but Divisions Remain Senate Republican leaders on Thursday unveiled a fresh proposal to repeal and replace the Affordable Care Act, revising their bill to help hold down insurance costs for consumers while allowing insurers to sell new low-cost, stripped down policies. The New York Times Friday, July 14, 2017 U.S. Charges 412, Including Doctors, in $1.3 Billion Health Fraud Hundreds of people nationwide, including dozens of doctors, have been charged in health care fraud prosecutions, accused of collectively defrauding the government of $1.3 billion, the Justice Department said on Thursday. The New York Times Thursday, July 13, 2017 Nursing Homes Move Into The Insurance Business Around the country, a handful of nursing home companies have begun selling their own private Medicare insurance policies, pledging close coordination and promising to give clinicians more authority to decide what treatments they will cover for each patient. Kaiser Health News. Thursday, July 13, 2017 Fewer exchange plans available in 2018, CMS says The Centers for Medicare and Medicaid Services has released what it calls further proof the Affordable Care Act is failing in data showing a 38 percent decrease in the number of health plans available in the individual market for the upcoming open enrollment period compared to this year. Healthcare Finance News. Monday, July 10, 2017 These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

by Claire Thayer, July 7, 2017

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

GOP leader says he'll rework health bill, but offers Plan B

Senate Majority Leader Mitch McConnell says he plans to produce a fresh bill in about a week scuttling and replacing much of President Barack Obama's health care law. But he's also acknowledging a Plan B if that effort continues to flounder.

AP News

Friday, July 7, 2017

States Move To Tighten Medicaid Enrollment, Even Without A New Health Law

No corner of the health care system would be harder hit than Medicaid, the federal-state health insurance program for the poor, if Republican leaders in Congress round up the votes to repeal major portions of the Affordable Care Act.

NPR News

Thursday, July 6, 2017

CMS won't delay controversial managed care requirements

The CMS is moving forward with controversial provisions from the mega managed-care rule that expands federal oversight over Medicaid programs after refusing several states' requests to delay implementation.

Modern Healthcare

Thursday, July 6, 2017

Should GOP Health Bill Prevail, Say Bye-Bye To Insurance Rebates

If Senate GOP leaders have their way, the check may not be in the mail. Many consumers collected unexpected rebates after the Affordable Care Act became law, possibly with a note explaining why: Their insurer spent more of their revenue from premiums on administration and profits than the law allowed, so it was payback time.

Kaiser Health News

Wednesday, July 5, 2017

What Tax Breaks? Those Promised In GOP Plans Go Mostly To Top 1%

There’s much talk on Capitol Hill about the tax cuts included in the Republican health plans, but unless you are a frequent user of tanning beds or have personal wealth that puts you in the top 1 percent, you might not feel much effect from them.

Kaiser Health News

Wednesday, July 5, 2017

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Trump further disrupts Obamacare repeal efforts

Just three days after running a widely praised meeting among GOP senators devoted to repealing Obamacare, President Donald Trump threw Senate Majority Leader Mitch McConnell's already ailing bill into further chaos Friday.

Politico. Friday, June 30, 2017

Men Wrote The Senate Health Care Bill. This Woman Could Stop It.

As Majority Leader Mitch McConnell (R-Ky.) tries to negotiate his way to a health bill that can win at least 50 Republican votes, there is one woman in the Senate who could stop the bill cold. She isn’t even a senator. Elizabeth MacDonough is the Senate’s parliamentarian, the first woman to hold that post, which involves advising senators on the chamber’s byzantine rules and procedures.

Kaiser Health News. Friday, June 30, 2017

Just 17 Percent Of Americans Approve Of Republican Senate Health Care Bill

Americans broadly disapprove of the Senate GOP's health care bill, and they're unhappy with how Republicans are handling the efforts to repeal and replace the Affordable Care Act, according to a new NPR/PBS NewsHour/Marist poll.

NPR. Wednesday, June 28, 2017

From Birth To Death, Medicaid Affects The Lives Of Millions

Medicaid is the government health care program for the poor. That's the shorthand explanation. But Medicaid is so much more than that — which is why it has become the focal point of the battle in Washington to repeal and replace the Affordable Care Act, also known as Obamacare. NPR. Tuesday, June 27, 2017

Tuesday, June 27, 2017

Senate And House Take Different Plans To Scrap Individual Mandate

The Affordable Care Act’s tax penalty for people who opt out of health insurance is one of the most loathed parts of the law, so it is no surprise that Republicans are keen to abolish it. But the penalty, called the individual mandate, plays a vital function: nudging healthy people into the insurance markets where their premiums help pay for the cost of care for the sick. Kaiser Health News. Monday, June 26, 2017

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members. 

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

The Health 202: McConnell will be a legislative wizard if health care passes

Senate Republicans have finally revealed their plan to revamp the Affordable Care Act. Now, they're just trying to pass it. There will be lots of twists and turns along the path to an anticipated vote next week -- and it's by no means assured the GOP will get there.

The Washington Post

Friday, June 23, 2017

Senate Health Care Bill Includes Deep Cuts to Medicaid

Senate Republicans, who for seven years have promised a repeal of the Affordable Care Act, took a major step on Thursday toward that goal, unveiling a bill to make deep cuts in Medicaid and end the law’s mandate that most Americans have health insurance.

New York Times

Thursday, June 22, 2017

Who Wins, Who Loses With Senate Health Care Bill

Republicans in the Senate on Thursday unveiled their plan to repeal and replace the Affordable Care Act — also known as Obamacare. The long-awaited plan marks a big step towards achieving one of the Republican party's major goals.

NPR

Thursday, June 22, 2017

Despite A Growing Appetite, Buffet-Style Flat-Fee Clinics Shutter In Seattle

In recent years, a small but growing number of practices embraced a buffet approach to primary care, offering patients unlimited services for a modest flat fee instead of billing them a la carte for every office visit and test. But after a pioneering practice shut its doors earlier this month, some question whether “direct primary care,” as it’s called, can succeed.

Kaiser Health News

Tuesday, June 20, 2017

GOP, Dem governors call for changes in House health bill

A group of Republican and Democratic governors are echoing President Donald Trump’s criticism of a House GOP health care bill, saying it threatens coverage for the most vulnerable. Instead, they’re asking Senate leaders to work together on an overhaul of Democrat Barack Obama’s health care law.

Associated Press

Friday, June 16, 2017
 

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members. 

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Senate likely to miss its Obamacare repeal deadline

Politico reports: Senate Republicans are getting dangerously close to missing their deadline to hold a Senate health care vote by month’s end, potentially derailing fulfillment of their 7-year-old campaign promise to repeal Obamacare. Friday, June 16, 2017

Cleveland Clinic jumps into insurance biz with Oscar Health

Modern Healthcare reports: While many health insurers are fleeing the individual market, health system Cleveland Clinic is jumping into the insurance business head first with the New York-based startup Oscar Health. Thursday, June 15, 2017

Price Clashes With Senators Over Path to Combat Opioid Crisis

Morning Consult reports: Health and Human Services Secretary Tom Price says combating the opioid crisis is one of his top priorities, a goal that has bipartisan support on Capitol Hill.

Thursday, June 15, 2017

Descent Into Secrecy: Senate Health Talks Speak To Steady Retreat From Transparency

Kaiser Health News reports: Congress struggling to finish a huge budget reconciliation bill. A GOP president pushing a major overhaul of federal payments for health insurance that could transform the lives of sick patients. Wednesday, June 14, 2017

With or without Washington, states are already remaking Medicaid

Politico reports: Medicaid is now the biggest health program in the country, covering more than 70 million people, or 1-in-5 Americans. Spending surpassed $545 billion in 2015. Yet Medicaid, “the other M,” is often overshadowed by Medicare. Monday, June 12, 2017

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Democrats home in on opioid crisis in bashing proposed Medicaid cuts

Health and Human Services Secretary Tom Price defended the White House’s proposed cuts to Medicaid in its 2018 budget blueprint before a pair of congressional committees on Thursday, parrying blows from Democrats furious over spending reductions they say President Trump pledged on the campaign trail never to approve. StatNews. June 8, 2017

If Insurance Market Crashes, Can Lawmakers Put The Pieces Back Together?

In his high-stakes strategy to overhaul the federal health law, President Donald Trump is threatening to upend the individual health insurance market with several key policies. But if the market actually breaks, could anyone put it back together again?

Kaiser Health News. June 8, 2017

Anthem Will Exit Health Insurance Exchange in Ohio

Anthem, one of the nation’s largest insurers and a major player in the individual insurance market created by the federal health care law, announced Tuesday that it would stop offering policies in the Ohio marketplace next year. NYTimes. June 6, 2017

Feds To Waive Penalties For Some Who Signed Up Late For Medicare

Each year, thousands of Americans miss their deadline to enroll in Medicare, and federal officials and consumer advocates worry that many of them mistakenly think they don’t need to sign up because they have purchased insurance on the health law’s marketplaces. That decision can leave them facing a lifetime of enrollment penalties. Kaiser Health News. June 6, 2017

VA to adopt new electronic health records system in bid to improve care

Veterans Affairs Secretary David Shulkin said Monday the department will be overhauling its electronic health records, adopting a commercial product used by the Pentagon that he hopes will improve care for veterans and reduce wait times for medical appointments.

Stat News.  June 5, 2017

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members. 

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

The Fate of 16.8 Million Medicaid Enrollees Rests On 20 GOP Senators From 14 States

The Senate is on the verge of debating legislation to repeal and “replace” the Affordable Care Act, and Medicaid is on the chopping block. Huffington Post, June 2, 2017

Trump Rule Could Deny Birth Control Coverage to Hundreds of Thousands of Women

The Trump administration has drafted a sweeping revision of the government’s contraception coverage mandate that could deny birth control benefits to hundreds of thousands of women who now receive them at no cost under the Affordable Care Act. The New York Times, June 1, 2017

Ohio Sues 5 Major Drug Companies For 'Fueling Opioid Epidemic'

The state of Ohio has sued five major drug manufacturers for their role in the opioid epidemic. In the lawsuit filed Wednesday, state Attorney General Mike DeWine alleges these five companies "helped unleash a health care crisis that has had far-reaching financial, social, and deadly consequences in the State of Ohio." NPR, May 31, 2017

How plan for California gov't health care might be funded

A pending state Senate bill would provide government-funded universal health care for California's 39 million residents. The bill faces a Friday deadline for passage out of the Senate if it is to be considered by the state Assembly. ABC News, May 31, 2017

Drug Rebates Reward Industry Players — And Often Hurt Patients

Medicare and its beneficiaries aren’t the winners in the behind-the-scenes rebate game played by drugmakers, health insurers and pharmacy benefit managers, according to a paper published Tuesday in JAMA Internal Medicine. Kaiser Health News, May 30, 2017

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members. 

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Top News From the Past Week as reported from key news services, and compiled by MCOL

Patient, Doctor Groups Say New CBO Score Reveals Health Care Bill's Flaws

Health care groups that represent doctors and patients are warning members of Congress that the House Republicans' plan to overhaul the Affordable Care Act would hurt people who need insurance most. NPR. Thursday, May 25, 2017

Senate to Start Drafting Health Care Bill Despite Policy Debates

Senate staffers will start to draft legislation that would repeal and replace significant parts of the Affordable Care Act next week, GOP senators said Thursday, despite the many differences among members of the caucus over policy. Morning Consult. Thursday, May 25, 2017

10 key points from the CBO report on Obamacare repeal

Here are some key facts and figures from the new CBO report on the American Health Care Act, the House-passed bill to repeal and replace Obamacare. CBO stressed the uncertainty of its estimates, given that it's hard to know which states would take up the chance to opt out of certain key parts of Obamacare. Politico Wednesday, May 24, 2017

Tab For Single-Payer Proposal In California Could Run $400 Billion

A proposed single-payer health system in California would cost about $400 billion annually, with up to half of that money coming from a new payroll tax on workers and employers, according to a state analysis. Kaiser Health News Tuesday, May 23, 2017.

Trump budget: $800 billion in Medicaid cuts

Donald Trump's budget that is expected to be unveiled on Tuesday will include $800 billion in cuts to Medicaid -- a move that underscores the President's resolve to significantly downsize the federal program even as Republican lawmakers are clashing over the issue in Congress. CNN Monday, May 22, 2017

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

House May Need to Vote Again on GOP Obamacare Repeal Bill

House Speaker Paul Ryan hasn’t yet sent the bill to the Senate because there’s a chance that parts of it may need to be redone, depending on how the Congressional Budget Office estimates its effects. House leaders want to make sure the bill conforms with Senate rules for reconciliation, a mechanism that allows Senate Republicans to pass the bill with a simple majority. Bloomberg News Friday, May 19, 2017

Price pushes Congress to follow Trump plan for more FDA user fees

HHS Secretary Tom Price pressed Congress to heed President Donald Trump's call to make the FDA rely more on industry fees — and less on taxpayer dollars — for product evaluations, as lawmakers continue work on extending the agency's user fee programs.

Politico. Wednesday, May 17, 2017

Hatch Says He’s Open to Keeping Obamacare’s Individual Mandate

Sen. Orrin Hatch (R-Utah) on Wednesday said he wouldn’t be opposed to delaying the repeal of the individual mandate in the Affordable Care Act, making him one of the most senior Republicans to float the idea. Morning Consult. Wednesday, May 17, 2017

UnitedHealth Doctored Medicare Records, Overbilled U.S. By $1 Billion, Feds Claim

The Justice Department on Tuesday accused giant insurer UnitedHealth Group of overcharging the federal government by more than $1 billion through its Medicare Advantage plans. Kaiser Health News. Wednesday, May 17, 2017

Bipartisan bill will be reintroduced to force pharma to justify price hikes

A bipartisan group of lawmakers will re-introduce a bill on Tuesday that would require drug makers to justify their pricing and provide a breakdown of their expenses before raising prices on some medicines. StatNews. Monday, May 15, 2017

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week: Industry Hopeful Senate Health Care Debate Focuses on Policy, Not Politics The health care industry is hopeful senators will be more receptive to outside groups than their House colleagues were, as the Senate takes the reins on overhauling the Affordable Care Act. Morning Consult. May 11, 2017 Senate GOP making tax credits look more like … Obamacare There’s growing support for making the tax credits more generous for poorer people. Senate Republicans are working on a potential breakthrough that could help push through an Obamacare repeal bill – by making insurance subsidies look a lot like Obamacare. Politico May 11, 2017 CMS Gives States Until 2022 To Meet Medicaid Standards Of Care The Trump administration has given states three extra years to carry out plans for helping elderly and disabled people receive Medicaid services without being forced to go into nursing homes. Kaiser Health News. May 11, 2017 Wednesday, May 10, 2017 Aetna Fully Exits Obamacare Exchanges With Pull-Out in Two States The New York Times reports: Health insurer Aetna Inc said on Wednesday it will exit the 2018 Obamacare individual insurance market in Delaware and Nebraska - the two remaining states where it offered the plans. NYTimes. May 10, 2017 Who will decide what the Senate’s health bill looks like? Follow the Medicaid-state senators. The Senate has broken into a series of “working groups” to begin writing its own version of legislation to replace the Affordable Care Act. There’s the leadership-driven group, a group of moderates and there was talk about a more conservative group before it was mostly absorbed into the leadership group. The Washington Post. May 9, 2017 These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week: Winners And Losers Under The House GOP Health Bill House Republicans have passed a bill to replace the Affordable Care Act. If it is signed into law, the American Health Care Act will affect access to health care for millions of people in the U.S. NPR. May 4, 2017 GOP Senators to Draft Their Own Obamacare Replacement Bill A top Senate Republican said Thursday that even though the House spent months on a health care bill that would repeal and replace the Affordable Care Act, the Senate will use that legislation as a starting point to draft a separate measure. Morning Consult. May 4, 2017. What’s in the AHCA: The Major Provisions of the Republican Health Bill The House health care bill up for a vote on Thursday would roll back the Affordable Care Act’s expansion of Medicaid, eliminate tax penalties for people who do not have health insurance and end taxes on certain high-income people, insurers, drug companies and manufacturers of medical devices to finance the current health law. NYTimes. May 4, 2017 Blue Shield CEO Says GOP’s ‘Flawed’ Health Bill Would Harm Sicker Consumers The chief executive of Blue Shield of California, the largest insurer on the state’s insurance marketplace, issued a blunt critique of the Republican health care bill, saying it would once more lock Americans with preexisting conditions out of affordable coverage. Kaiser Health News. May 3, 2017 NIH to get a $2 billion funding boost as Congress rebuffs Trump’s call for cuts The National Institutes of Health will get a $2 billion funding boost over the next five months, under a bipartisan spending deal reached late Sunday night in Congress. The agreement marks a sharp rejection of President Trump’s proposal to cut $1.2 billion from the medical research agency in the current fiscal year. Stat News May 1, 2017 These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week: U.S. appeals court blocks Anthem bid to merge with rival Cigna A U.S. appeals court blocked health insurer Anthem Inc's (ANTM.N) bid to merge with Cigna (CI.N) on Friday, upholding a lower court's decision that the $54 billion deal should not be allowed because it would lead to higher prices for healthcare. Reuters April 28, 2017 4 key questions surrounding Obamacare repeal House Republicans are mounting yet another effort to tear down Obamacare and remake the health care system — but the path to delivering on one of the GOP's longest-standing priorities remains complicated and fraught with uncertainty. Politico April 27, 2017 Amid budget talks, White House says it will continue ACA subsidies The White House on Wednesday pledged to continue payments critical to the success of Affordable Care Act exchanges, Politico reports. The pledge will come as a relief to insurers and providers after the administration’s earlier indication that it might withhold payments as a bargaining chip in this week’s budget negotiations. Stat News April 26, 2017 PBM Express Scripts loses biggest client Anthem Express Scripts said Monday that its biggest client, Anthem, will not renew its contract with the pharmacy benefit manager after the current agreement expires at the end of 2019. Modern Healthcare April 24, 2017 Health Care In America: An Employment Bonanza And A Runaway-Cost Crisis In many ways, the health care industry has been a great friend to the U.S. economy. Its plentiful jobs helped lift the country out of the Great Recession and, partly due to the Affordable Care Act, it now employs 1 in 9 Americans — up from 1 in 12 in 2000. Kaiser Health News April 24, 2017 These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week: Lawmakers revisiting requiring those on Medicaid to work A simple question — should adults who are able to work be required to do so to get taxpayer-provided health insurance? — could lead to major changes in the social safety net. AP News. Friday, April 21, 2017 How G.O.P. in 2 States Coaxed the Health Law to Success or Crisis In Oklahoma, which has raged against the Affordable Care Act, insurance premiums are among the nation’s highest. New Mexico, which oversees its marketplace, has one of the lowest average premium costs. The New York Times. Friday, April 21, 2017 White House pressures GOP leaders on Obamacare showdown next week A frantic and impatient White House is pressuring House GOP leaders for another showdown vote on repealing Obamacare next week so it can notch a legislative win before President Donald Trump’s first 100 days in office. Politico. Thursday, April 20, 2017 Sen. Grassley Demands Scrutiny Of Medicare Advantage Plans Sen. Chuck Grassley (R-Iowa) wants federal health officials to tighten scrutiny of private Medicare Advantage health plans amid ongoing concern that insurers overbill the government by billions of dollars every year. Kaiser Health News. Tuesday, April 18, 2017 G.O.P. Bill Would Make Medical Malpractice Suits Harder to Win Low-income people and older Americans would find it more difficult to win lawsuits for injuries caused by medical malpractice or defective drugs or medical devices under a bill drafted by House Republicans as part of their plan to replace the Affordable Care Act. The New York Times. Saturday, April 15, 2017 These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week: Bipartisan Senate Bill Takes Step Against Opioid Epidemic Morning Consult reports: A bipartisan Senate bill unveiled Thursday would impose strict limits on some opioid prescriptions, a small tweak to federal law that is part of an ongoing effort in Congress to curb overuse of the drugs. Morning Consult. Thursday, April 13, 2017 States Moving More Medicaid Patients To Managed Care Private health insurance companies stand to reap a bigger share of the Medicaid business as states deal with budget shortfalls and increased spending on medical care. Forbes. Thursday, April 13, 2017 Trump Signs Law Giving States Option To Deny Funding For Planned Parenthood President Trump quietly signed legislation Thursday that rolls back an Obama-era rule protecting certain federal funds for Planned Parenthood and other organizations that provide legal abortions. NPR. Thursday, April 13, 2017 Trump administration issues final rule on stricter Obamacare enrollment The Trump administration on Thursday issued a final rule that will shorten the Obamacare enrollment period and give insurers more of what they say they need in the individual insurance market, likely making it harder for some consumers to purchase insurance, healthcare experts said. Reuters. Thursday, April 13, 2017 Repeal, Replace … Revise: Your Guide To How A Trump Proposal Might Change ACA Insurance Repeal and replace is on-again, off-again, but that doesn’t mean the rules affecting your insurance will remain unchanged. The Trump administration’s proposed rule aimed at stabilizing the health law’s insurance marketplace could have rapid, dramatic effects on people who do not get insurance through work and buy it on the Affordable Care Act’s exchanges. Kaiser Health News. Thursday, April 13, 2017 These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week: No Obamacare cease-fire in red states The epic collapse of the Obamacare repeal bill created an odd opportunity for 19 states that have long shunned Medicaid expansion. Politico, Friday, March 31, 2017 Pence breaks tie, allowing Senate to revoke Obama order on abortion provider funding Vice President Mike Pence returned to the Senate Thursday afternoon -- the second time in one day -- to cast a tie-breaking vote on legislation to undo an Obama-era regulation on funding for abortion providers. The Hill, Thursday, March 30, 2017 House GOP Weighing Another Try on Obamacare Vote Next Week House Republicans are considering making another run next week at passing the health-care bill they abruptly pulled from the floor in an embarrassing setback to their efforts to repeal Obamacare. Bloomberg, Wednesday, March 29, 2017 Senators Demand Answers About Possible Probe Of HHS Secretary Price Nine senators are pushing U.S. Attorney General Jeff Sessions to reveal what he knows about a reported investigation into Health and Human Services Secretary Tom Price’s stock trades that a top federal prosecutor might have begun before being fired by the Trump administration this month. Kaiser Health News, Wednesday, March 29, 2017 Justice Department Joins Lawsuit Alleging Massive Medicare Fraud By UnitedHealth The Justice Department has joined a California whistleblower’s lawsuit that accuses insurance giant UnitedHealth Group of fraud in its popular Medicare Advantage health plans. Kaiser Health News Tuesday, March 28, 2017 These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

GOP’s 3-Bucket Strategy To Repeal And Replace Health Law Is Springing Leaks

Kaiser Health News reports: Republicans in Washington working to overhaul the Affordable Care Act say their strategy consists of “three buckets.” But it appears that all three may be leaking.

Price dodges on Medicaid rollback, immunization

Politico reports: Confronted by Medicaid recipients during a televised town hall event on CNN, Health and Human Services Secretary Tom Price offered few details Wednesday when asked to explain the reasoning behind the GOP's plan to roll back the health care program.

GOP Health Bill Narrowly Clears House Budget Committee

Morning Consult reports: The House Budget Committee on Thursday narrowly advanced the Republican health care bill to repeal and replace significant parts of the Affordable Care Act, with three Republicans voting against the measure.

By The Numbers: Trump’s Choice For FDA Chief Is Versatile, Entrenched In Pharma

Kaiser Health News reports: President Donald Trump’s pick to lead the Food and Drug Administration has deep ties to the pharmaceutical industry as a consultant, investor and board member. Scott Gottlieb, 44, also has worn many hats in a career that included two previous stints at the FDA, practicing as a physician, and writer/editor roles at prestigious medical journals.

Deciphering CBO’s Estimates On The GOP Health Bill

Kaiser Health News reports: The Congressional Budget Office is out with its estimate of what effects the Republican health bill, “The American Health Care Act,” would have on the nation’s health care system and how much it would cost the federal government. The GOP plan is designed to partially repeal and replace the Affordable Care Act passed during the Obama administration.

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members. 

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

To Save On Drug Costs, Insurer Wants To Steer You To ‘Preferred’ Pharmacies

Kaiser Health News reports: One of California’s largest insurers has proposed a change in the benefits of commercial plans next year that would require consumers to pay more for drugs at pharmacies outside an established network.

Kaiser Health News

Friday, March 10, 2017

What Hospitals Waste

ProPublica reports: Just outside Portland, Maine, there’s a 15,000-square-foot warehouse that’s packed with reasons the U.S. health care system costs so much: Shelves climb floor to ceiling, stacked with tubs overflowing with unopened packages of syringes, diabetes supplies and shiny surgical instruments that run hundreds of dollars apiece.

ProPublica

Thursday, March 9, 2017

Ryan brings out slideshow to sell GOP healthcare bill

The Hill reports: Jacket off and sleeves rolled up, Speaker Paul Ryan (R-Wis.) on Thursday ditched the podium and delivered a 25-minute TED Talk-like presentation on why the new GOP health bill represents the best, and perhaps only, chance to repeal ObamaCare.

The Hill

Thursday, March 9, 2017

Lawmakers take up Obamacare revision without an independent scorekeeper

The Washington Post reports: Two committees in the Republican-led House have begun drafting sweeping health legislation without the benefit of an objective estimate of its impact from the Congressional Budget Office (CBO) — a reckless move, critics say, considering that they are dealing with the well-being of tens of millions of Americans and an industry that accounts for close to one-fifth of the economy.

The Washington Post

Wednesday, March 8, 2017

Three Key Senators Ask GAO to Investigate Possible Abuses Of The Orphan Drug Act

Kaiser Health News reports: Building on weeks of mounting pressure to address high prescription drug prices, three influential U.S. senators have asked the government’s accountability arm to investigate potential abuses of the Orphan Drug Act.

Kaiser Health News

Tuesday, March 7, 2017

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.