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Joe Paduda’s Tuesday catch-up

January 21, 2015 by The Insurance 411Leave a Comment

Here’s what happened over the MLK weekend…

Kudos to Sen. Amy Klobuchar (D Minn) for her efforts to reduce Medicare drug prices.  She introduced a bill that would allow CMS to negotiate drug prices, a seeming no-brainer.  Reasons to support the bill:

  • reduces Medicare recipients’ drug costs
  • reduces taxpayers costs
  • reduces the Federal deficit

Reasons to oppose the bill:

  • Big pharma, which donates gazillions to politicians, hates it.

Speaking of which, two states are suing Bug Pharma for damages associated with opioid abuse.  A lawsuit against Purdue, manufacturer of OxyContin, is proceeding in Kentucky – a state that has been devastated by opioid abuse.  The big drug maker missed a crucial deadline to file papers in the case, putting them in a even tenuous position.

Their neighbor to the north is suing a dozen pharma distributors and manufacturers, claiming the firms failed to implement adequate anti-diversion controls.  The suit was filed by the former Attorney General. This one is…complicated, as the current West Virginia Attorney General used to be a lobbyist for a big drug distributor that may be added to the suit. And, his wife is currently a lobbyist for one of the companies that is named in the suit.

Meanwhile, the explosive growth in heroin usage continues, driven in large part by folks who got addicted to prescription drugs and now seek their highs from heroin.  Which is even more deadly than Oxy; the CDC reports deaths were up 39% in 2013.

WCRI Annual Meeting

is coming up!  Scheduled for March 5-6 in Boston, the agenda includes details on WCRI’s new research on the costs and consequences of physician dispensing of drugs; the impact of the Affordable Care Act on workers’ comp, and a deep dive into the effect of low fee schedules on medical prices.  Among other luminaries, CWCI President Alex Swedlow will be there talking about the impact of doc dispensing on return to work.

The estimable Ramona Tanabe will review the “State of the States”, a must-see for payers focused on specific jurisdictions.

If you haven’t signed up yet, do it here now before it fills up – which is always does.

 Implementing Health Reform

First, the big news is…there isn’t any news about the Federal Exchange site crashing.  You can almost hear the sighs of relief coming from the White House and CMS.

A couple of items reform-related:

The percentage of people who had problems paying a medical bill declined from 41% in 2012 to 35% last year.

Even better, fewer people are avoiding medical care due to the cost; the percentage dropped from 43% to 36%.

Hiring!

Ascential Care is looking for case management staff in several jurisdictions. Contact info http://ascentialcare.com/connect/.

 

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