February 2017 - FRMC

Department

Managed Care Q&A

Can “Travel Practice” Help Cut Orthopedic Surgery Costs?

02/15/2017

David Costill

Jim Polsfut, CEO of the North American Specialty Hospital recently said, "The bottom line for employers: even after factoring in the cost of travel and accommodations for the patient… the savings are significant."

Jim Polsfut, CEO of the North...

02/15/2017

First Report Managed Care

News Connection

FDA Issues Biosimilar Interchangeability Guidance

02/15/2017

Last month, the FDA released its guidance for drugmakers attempting to gain approval for interchangeability between a biosimilar and reference product.

Last month, the FDA released its...

02/15/2017

First Report Managed Care

News Connection

California Lawmaker Introduces Bill to Ban Prescription Drug Coupons

02/15/2017

California assemblyman Jim Wood, DDS, introduced legislation that would prohibit the use of prescription drug coupons for medications with cheaper alternatives.

California assemblyman Jim Wood,...

02/15/2017

First Report Managed Care

News Connection

Senate Confirms Tom Price as HHS Secretary

02/15/2017

The US Senate officially confirmed Representative Tom Price, MD, to head the Department of Health and Human Services, with a 52-48 vote.

The US Senate officially...

02/15/2017

First Report Managed Care

News Connection

Repatha Reduces Cardiovascular Risk, Amgen Says

02/15/2017

Results from a recent trial showed that Repatha reduces the risk of cardiovascular events in patients with clinically evident atherosclerotic cardiovascular disease.

Results from a recent trial...

02/15/2017

First Report Managed Care

News Connection

FDA Approves Opdivo for Select Patients With Urothelial Carcinoma

02/15/2017

The FDA, under accelerated approval, has approved intravenous Opdivo (nivolumab, Bristol-Myers Squibb) for patients with locally advanced or metastatic urothelial carcinoma whose disease has progressed during or following platinum-containing...

The FDA, under accelerated...

02/15/2017

First Report Managed Care

News Connection

Ertugliflozin Monotherapy Effective for Glycemic Control in Type 2 Diabetes

02/15/2017

Used as monotherapy, ertugliflozin provides effective glycemic control for patients with type 2 diabetes inadequately treated by diet and exercise alone.

Used as monotherapy,...

02/15/2017

First Report Managed Care

News Connection

New Guideline for Managing Chest Pain in the ED Could Cut Overutilization Costs

02/15/2017

Up to one-third of patients with chest pain could be safely taken off emergency department heart monitors.

Up to one-third of patients with...

02/15/2017

First Report Managed Care

News Connection

Some Physicians Charge Up to 6 Times What Medicare Pays

02/15/2017

Physicians, on average, charge roughly 2.5 times the amount Medicare actually pays, with some specialists—anesthesiologists, emergency physicians, and radiologists among them—charging up to 6 times what Medicare pays for the same service.

Physicians, on average, charge...

02/15/2017

First Report Managed Care

Department

Big Data: Moving Toward the Information Revolution

02/15/2017

Jose Almeida, MD

The big data revolution in health care is significant because with health care costs increasing every year, the demand for a big data driven system is skyrocketing.

The big data revolution in...

02/15/2017

First Report Managed Care

Behind the Bill

SCOTUS Takes on the Nondelegation Doctrine: Surprising Reactions and What They Mean for Agency Power

04/02/2025

Katie Hayes, MJ

The Supreme Court recently heard arguments in Federal Communication Commission (FCC) v Consumers’ Research, a case that I covered in February and one that could dramatically reshape federal agency authority through the nondelegation...

The Supreme Court recently heard...

04/02/2025

First Report Managed Care

Behind the Bill

Dr Oz’s Prescription for Making Medicaid “Viable at Every Level”

03/26/2025

Katie Hayes, MJ

On Tuesday, March 25, 2025, the Senate Finance Committee voted to advance Dr Mehmet Oz in his confirmation as the next head of the Centers for Medicare and Medicaid Services (CMS).1 The full Senate vote is expected “soon” (whatever that...

On Tuesday, March 25, 2025, the...

03/26/2025

First Report Managed Care

Behind the Bill

The $880 Billion Question Continues: Dr Oz's Confirmation and the Future of Medicaid

03/19/2025

Katie Hayes, MJ

Last week, I explored the $880 billion question facing Congress—whether lawmakers could achieve their budget goals without cutting Medicaid. This week, that question took center stage as Dr Mehmet Oz, President Trump's nominee to lead the...

Last week, I explored the $880...

03/19/2025

First Report Managed Care

Behind the Bill

The $880 Billion Question: Can Congress Cut Spending Without Touching Medicaid?

03/12/2025

Katie Hayes, MJ

I’d like to step away from administrative law for a moment to provide a quick update on Medicaid. With news coming from all sides, what does the future of Medicaid actually look like? The House of Representatives narrowly passed a budget...

I’d like to step away from...

03/12/2025

First Report Managed Care

Behind the Bill

RFK Jr’s Public Comment Ban: The Silent Shift in Health Care Rulemaking

03/05/2025

Katie Hayes, MJ

The erosion of administrative law continues, and with it, the dismantling of decades-long precedent. In June, the Supreme Court overturned a 40-year-old doctrine that allowed federal agencies to interpret their own ambiguous statutes. Later...

The erosion of administrative...

03/05/2025

First Report Managed Care

Behind the Bill

Prevention Over Pills? The First 2 Weeks of Health Care’s New Direction

02/26/2025

Katie Hayes, MJ

The dust has barely settled from Robert F Kennedy Jr’s confirmation as Secretary of Health and Human Services (HHS), but the changes are already coming fast and furious—a key theme of the Trump Administration’s actions within the last several...

The dust has barely settled from...

02/26/2025

First Report Managed Care

Behind the Bill

The Nondelegation Doctrine: The Next Constitutional Showdown (Part 2)

02/19/2025

Katie Hayes, MJ

Last week, I explored the potential revival of the nondelegation doctrine through Federal Communication Commission v Consumers’ Research. Today, I want to examine what this could mean for health care regulation by considering the parallels...

Last week, I explored the...

02/19/2025

First Report Managed Care

Behind the Bill

The Nondelegation Doctrine: The Next Constitutional Showdown (Part 1)

02/12/2025

Katie Hayes, MJ

Just when you thought the dust had settled from the Chevron decision, the Supreme Court is gearing up to hear arguments in Federal Communications Commission v Consumers' Research next month, potentially reviving the long-dormant nondelegation...

Just when you thought the dust...

02/12/2025

First Report Managed Care

Behind the Bill

No, President Trump Did Not Actually Sign an Executive Order That Would Increase Drug Costs for Beneficiaries

02/05/2025

Katie Hayes, MJ

On inauguration day, President Trump issued an executive order rescinding several Biden-era health care initiatives, including 3 experimental drug pricing models developed by the Center for Medicare and Medicaid Innovation (CMMI). Oh boy did...

On inauguration day, President...

02/05/2025

First Report Managed Care

Behind the Bill

Robert F. Kennedy Jr’s Confirmation and the Unexpected Turn in the Drug Pricing Debate

01/29/2025

Katie Hayes, MJ

The Plot Thickens in Drug Pricing Drama Just when you thought the drug pricing debate couldn't get more interesting, Robert F. Kennedy Jr adds an unexpected twist. During closed-door Senate meetings, President Trump’s US Department of...

The Plot Thickens in Drug...

01/29/2025

First Report Managed Care