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November 2011 - FRMC

Department

News Connection
Patients with Gout Treated with Febuxostat Compared with Those Treated with Allopurinol
02/09/2012
Mary Beth Nierengarten
Patients with gout treated with febuxostat have more comorbidities and higher mean baseline serum uric acid levels compared with patients treated with allopurinol.
Patients with gout treated with febuxostat have more comorbidities and higher mean baseline serum uric acid levels compared with patients treated with allopurinol.
Patients with gout treated with...
02/09/2012
First Report Managed Care
Healthcare Reform and Changes in Medicaid
11/29/2011
Trisha Lee
Medicaid is a low-income family health insurance program funded jointly by federal and state governments.
Medicaid is a low-income family health insurance program funded jointly by federal and state governments.
Medicaid is a low-income family...
11/29/2011
First Report Managed Care
Prostate Cancer Treatments Pose Challenges for Managed Care
11/29/2011
Tim Casey
Atlanta—With the introduction of several new therapies, the treatment for castration-resistant prostate cancer (CRPC) has gone through a dramatic shift in recent years. By the end of the decade, the market for prostate cancer is expected to...
Atlanta—With the introduction of several new therapies, the treatment for castration-resistant prostate cancer (CRPC) has gone through a dramatic shift in recent years. By the end of the decade, the market for prostate cancer is expected to...
Atlanta—With the introduction of...
11/29/2011
First Report Managed Care
Guideline for Pharmacy Claims Audits Could Add Consistency to the Process
11/29/2011
Jill Sederstorm
A guideline for pharmacy claims audits could help improve collaboration and minimize friction between managed care organizations and community pharmacists.
A guideline for pharmacy claims audits could help improve collaboration and minimize friction between managed care organizations and community pharmacists.
A guideline for pharmacy claims...
11/29/2011
First Report Managed Care
Specialty Medications Becoming More Popular
11/29/2011
Tim Casey
Atlanta—Although <1% of patients use specialty medications, they account for 15% of drug spending. The trend is expected to continue, as numerous expensive specialty drugs have recently been approved by the US Food and Drug Administration...
Atlanta—Although <1% of patients use specialty medications, they account for 15% of drug spending. The trend is expected to continue, as numerous expensive specialty drugs have recently been approved by the US Food and Drug Administration...
Atlanta—Although <1% of...
11/29/2011
First Report Managed Care
Pharmacy and the Medicare Star Rating System
11/29/2011
Tori Socha
Atlanta—The Star Rating System created by the Centers for Medicare & Medicaid Services was added to Medicare programs to help educate beneficiaries about quality of care and increase the transparency of quality data available to consumers....
Atlanta—The Star Rating System created by the Centers for Medicare & Medicaid Services was added to Medicare programs to help educate beneficiaries about quality of care and increase the transparency of quality data available to consumers....
Atlanta—The Star Rating System...
11/29/2011
First Report Managed Care
Pharmacy Benefit Management Supported by Employer Case Study
11/29/2011
Kristina Woodworth
Atlanta—During a Managed Care Essentials session at the AMCP meeting, Kathleen Thompson, manager of total rewards, Matthews International, and Mara Pawlis, senior analytic consultant, CVS Caremark, presented Results of a PBM/Employer...
Atlanta—During a Managed Care Essentials session at the AMCP meeting, Kathleen Thompson, manager of total rewards, Matthews International, and Mara Pawlis, senior analytic consultant, CVS Caremark, presented Results of a PBM/Employer...
Atlanta—During a Managed Care...
11/29/2011
First Report Managed Care
Performance Measures to Enhance Care and Reduce Costs
11/29/2011
Tori Socha
Atlanta—The Patient Protection and Affordable Care Act of 2010 was designed to achieve 3 goals: better health, better care, and lower costs. The National Quality Forum (NQF) has convened the National Priorities Partnership (NPP), a...
Atlanta—The Patient Protection and Affordable Care Act of 2010 was designed to achieve 3 goals: better health, better care, and lower costs. The National Quality Forum (NQF) has convened the National Priorities Partnership (NPP), a...
Atlanta—The Patient Protection...
11/29/2011
First Report Managed Care
Partnership for Patients and Transitions of Care
11/29/2011
Tori Socha
Atlanta—The Partnership for Patients, a public–private initiative to improve hospital care and transitions of care, was launched in April 2011 by Kathleen Sebelius, secretary of the US Department of Health and Human Services, and Donald...
Atlanta—The Partnership for Patients, a public–private initiative to improve hospital care and transitions of care, was launched in April 2011 by Kathleen Sebelius, secretary of the US Department of Health and Human Services, and Donald...
Atlanta—The Partnership for...
11/29/2011
First Report Managed Care
Fraud, Waste, and Abuse Impact Costs, Care, and Safety
11/29/2011
Tori Socha
Atlanta—Each year, billions of dollars are lost to Medicare fraud. In addition to the financial burden, instances of waste and abuse jeopardize both quality of care and patient safety. Raising awareness of the problem is as important a tool...
Atlanta—Each year, billions of dollars are lost to Medicare fraud. In addition to the financial burden, instances of waste and abuse jeopardize both quality of care and patient safety. Raising awareness of the problem is as important a tool...
Atlanta—Each year, billions of...
11/29/2011
First Report Managed Care

Behind the Bill

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 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 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 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 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 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 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 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 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 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 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

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Interview
An Overview of Vitiligo: Prevalence, Comorbidities, and Available Therapies
05/30/2023
Maria Asimopoulos
Gary Owens, MD, president of Gary Owens Associates, reviews the prevalence and burden associated with vitiligo as well as coverage considerations for a range of treatment options. 
Gary Owens, MD, president of Gary Owens Associates, reviews the prevalence and burden associated with vitiligo as well as coverage considerations for a range of treatment options. 
Gary Owens, MD, president of...
05/30/2023
First Report Managed Care
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Substantial Annual Health Care Costs Associated With Hemophilia A
06/23/2023
Julie Gould
Researchers conducted a comprehensive literature review to investigate the direct and indirect costs associated with hemophilia A.
Researchers conducted a comprehensive literature review to investigate the direct and indirect costs associated with hemophilia A.
Researchers conducted a...
06/23/2023
First Report Managed Care
News
RSV Vaccination in US Older Adults Could Save Up to $1 Billion Per Season
07/24/2023
Jolynn Tumolo
"Our analysis provides contemporary estimates of the population-level RSV disease burden and insights into the economic value drivers for RSV vaccination," said researchers. 
"Our analysis provides contemporary estimates of the population-level RSV disease burden and insights into the economic value drivers for RSV vaccination," said researchers. 
"Our analysis provides...
07/24/2023
First Report Managed Care
News
Hospital-Onset CDI Incidence, Antibiotic Use Drop With Two-Step Testing
08/16/2023
Jolynn Tumolo
The implementation of two-step testing for Clostridioides difficile infection may lead to a decrease in hospital-onset CDI and antibiotic use, suggesting improved diagnostic specificity and indirect reassurance against underdiagnosis and...
The implementation of two-step testing for Clostridioides difficile infection may lead to a decrease in hospital-onset CDI and antibiotic use, suggesting improved diagnostic specificity and indirect reassurance against underdiagnosis and...
The implementation of two-step...
08/16/2023
First Report Managed Care

November 2011 Volume 8 Issue 11

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