CMS: Part D must support transparency at the pharmacy counter | 4.5M more people would gain coverage if 19 states expand Medicaid | At-risk youths should be warned against "13 Reasons Why," physicians say
May 21, 2018
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CMS: Part D must support transparency at the pharmacy counter
CMS Administrator Seema Verma warned Medicare Part D plan sponsors that they could face compliance action if they don't take steps to ensure that enrollees are paying for the lowest price available for medications, noting that plans should require network pharmacies to reveal any difference between the price of a drug under Part D and the price for its cheapest generic version. In a letter sent to plan sponsors, Verma said contract language prohibiting such disclosures is "unacceptable and contrary to our efforts to promote drug price transparency and lower drug prices."
Healthcare Finance (5/18) 
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4.5M more people would gain coverage if 19 states expand Medicaid
A report from the Robert Wood Johnson Foundation and the Urban Institute estimates that 4.5 million people would gain health care coverage if the 19 states that have not fully expanded Medicaid did so next year. The move would raise federal health care spending as much as $37.8 billion, while state Medicaid spending would grow as much as $3.0 billion, but the additional spending would be completely or mostly offset by savings in other areas, the report indicates.
Forbes (5/20) 
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Breaking down silos: managing reference data
Health plans must prioritize reliable and accurate reference data for analytics. Strategies that support management of reference data across the enterprise—and that break down silos of big data with a single source of truth—enable powerful analytics to reduce costs and improve services. Read more.
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Providers & Suppliers
At-risk youths should be warned against "13 Reasons Why," physicians say
Pediatricians should warn at-risk children and their parents against watching the Netflix series "13 Reasons Why," adhere to American Academy of Pediatrics recommendations that all patients ages 12 and older be screened for depression, and ask adolescents about their media consumption, according to an article in Pediatrics. Researchers said a review of records at one health system found that in the six months after the first season aired, the show was mentioned over 60 times by 31 youths, three-quarters of whom were receiving care related to a suicide attempt.
Reuters (5/18) 
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Medical Update
Study: Midday napping tied to blood glucose control in type 2 diabetes
A study in Sleep Medicine showed that patients with type 2 diabetes who slept for six hours or more at night and napped in the day had better blood glucose control than those who slept for less than five hours with no nap and those who had a longer nighttime sleep duration plus a daytime nap. Researchers evaluated almost 400 patients with diabetes or impaired glucose tolerance and found that poor sleep patterns were associated with poor blood glucose control in type 2 diabetes, but for those whose nighttime sleep duration is short, a midday nap may be beneficial.
Diabetes (UK) (5/18) 
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Middle-age adults may reduce heart failure risk through exercise
Researchers found that middle-age adults who received the recommended 150 minutes of moderate physical activity per week had a 31% reduced risk of developing heart failure over six years, compared with those who did not exercise. The findings in the journal Circulation, based on more than 11,000 adults, revealed that those who increased their physical activity levels during the study period experience an almost 12% reduction in heart failure risk, while those whose activity declined saw risk rise by 18%.
HealthDay News (5/18) 
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Clinical Data Extraction as a Service (CDEaaS)
Learn how Inovalon's CDEaaS solution - an automated, cost-efficient way to deliver a consolidated view of medical records - is helping healthcare organizations achieve millions of dollars in operational efficiencies per year. Click here for more.
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Emerging Trends
MED-EL's CI audio processor with wireless charging wins FDA nod
The FDA granted MED-EL USA approval for its Rondo 2 cochlear implant audio processor with wireless charging. The device, designed for people with hearing loss, has a battery life of 18 hours with an advanced wireless charging option and can connect to televisions and cellphones with the use of intelligent wireless accessories, as well as to Bluetooth neckloops and hearing induction loops.
Medical Devices Business Review (U.K.) (5/18) 
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Algorithm uses genomic data for expanded blood typing
Scientists have developed an algorithm they call bloodTyper that is capable of predicting a person's blood group, red blood cell antigen patterns and platelet antigen types based on their genome sequence data, according to a report in The Lancet Haematology, a development the authors say is important for those who need repeated transfusions. "This approach has the potential to be one of the first routine clinical uses of genomics for medical care for patients needing blood transfusion ... [that could] prevent serious or even fatal complications," said study co-first author Connie Westhoff.
GenomeWeb Daily News (free registration) (5/18) 
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The Future of Care Transitions is Here
naviHealth does more than transition patients. We're pushing an entire industry forward. A unique combination of quality clinical services and proprietary technology is Guiding the Way, so every patient receives the right amount of post-acute care, in the right setting, for the right amount of time. Learn more.
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Pharma News
Study finds rising improper pediatric ADHD drug exposures
Calls to US poison control centers for youths younger than 20 who were exposed to attention-deficit/hyperactivity disorder drugs totaled 156,365 from 2000 to 2014, with call volume rising by 60% during the same period, researchers reported in Pediatrics. Three-quarters of exposures involved children aged 12 or younger, while nearly 50% of exposures among teens involved intentional misuse of the drugs or possible suicide attempts.
U.S. News & World Report (5/21) 
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AZ's hyperkalemia drug wins FDA nod
The FDA approved AstraZeneca's Lokelma, or sodium zirconium cyclosilicate, as a treatment for adult patients with hyperkalemia.
BioCentury (5/18) 
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Policy Watch
CMS rejects Ohio's request for mandate exemption
The CMS has refused a request from Ohio to eliminate the Affordable Care Act's mandate that most Americans sign up for health coverage and said the state must provide a coverage program that is at least as comprehensive and affordable, and covers a comparable number of people, as the ACA. The state did not offer any such plan in its application or explain why it wanted the exemption from the mandate.
The Plain Dealer (Cleveland) (5/18) 
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Trump nominates acting Secretary Robert Wilkie to lead VA
President Donald Trump has nominated Robert Wilkie, the acting Veterans Affairs secretary, to serve as the agency's next leader. Wilkie, who is undersecretary of defense for personnel and readiness, has been the agency's acting secretary since the dismissal of David Shulkin in March.
CNN (5/18) 
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AHIP News
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At AHIP's National Conferences on Medicare, Medicaid & Duals, you'll participate in deep discussions about what matters most. We'll discuss payment reform, benefit design, the regulatory environment, community-based care, and more. Register today for Oct. 14-18 in Washington, D.C. But don't delay. The Super Saver discount is available right now.
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Care coordination is the single most important criteria influencing the member experience. Join us Wednesday, May 30, 1 to 2 p.m. ET to gain insights on improving key member experience metrics and learn how payers and labs can learn from one another and partner to co-design an improved member experience. Register now.
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