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A Closer Look at the CMS Roundup: Health Equity Conference, Blogs, and Future Initiatives
03/27/2024
Don't miss out on the latest updates from CMS, including the upcoming Health Equity Conference, value-based care strategy insights, and expanded coverage for personal care services in hospital settings.
Don't miss out on the latest updates from CMS, including the upcoming Health Equity Conference, value-based care strategy insights, and expanded coverage for personal care services in hospital settings.
Don't miss out on the latest...
03/27/2024
First Report Managed Care
News
Health Care Administration Inefficiencies: Lessons from the 2024 Medallion Report
03/26/2024
Discover the impact of manual processes and staffing challenges on payer enrollment and credentialing workflows in the 2024 State of Payer Enrollment and Credentialing Report by Medallion.
Discover the impact of manual processes and staffing challenges on payer enrollment and credentialing workflows in the 2024 State of Payer Enrollment and Credentialing Report by Medallion.
Discover the impact of manual...
03/26/2024
First Report Managed Care
News
Understanding Clostridioides difficile Genetics
03/26/2024

By Emry Lloyd

By Emry Lloyd
Clostridioides difficile is a bacterium that causes gastrointestinal issues in patients. This article describes how physicians can understand Clostridioides difficile and its makeup to determine how to treat or manage infection.
Clostridioides difficile is a bacterium that causes gastrointestinal issues in patients. This article describes how physicians can understand Clostridioides difficile and its makeup to determine how to treat or manage infection.
Clostridioides difficile is a...
03/26/2024
First Report Managed Care
News
Trial to Test CAR T-Cell Therapy for Refractory Progressive MS
03/18/2024
An autologous, fully human CD19 chimeric antigen receptor (CAR) T-cell product candidate recently received clearance from the US Food and Drug Administration (FDA) as an investigational new drug for the treatment of patients with refractory...
An autologous, fully human CD19 chimeric antigen receptor (CAR) T-cell product candidate recently received clearance from the US Food and Drug Administration (FDA) as an investigational new drug for the treatment of patients with refractory...
An autologous, fully human CD19...
03/18/2024
First Report Managed Care
News
Two-Step Testing Linked With Lower Rate of CDI Treatment in Colonized Patients
03/14/2024
Switching to two-step algorithm testing for Clostridioides difficile infection correlated with lower rates of treatment, helping to differentiate colonization from active infection, according to a study published in Clinical Microbiology and...
Switching to two-step algorithm testing for Clostridioides difficile infection correlated with lower rates of treatment, helping to differentiate colonization from active infection, according to a study published in Clinical Microbiology and...
Switching to two-step algorithm...
03/14/2024
First Report Managed Care
News
Task Force Publishes Target-To-Treat Guidance for GCA and PMR
03/12/2024
An international task force recently published the first target-to-treat (T2T) recommendations for patients with giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) in the Annals of the Rheumatic Diseases.
An international task force recently published the first target-to-treat (T2T) recommendations for patients with giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) in the Annals of the Rheumatic Diseases.
An international task force...
03/12/2024
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News
Justice Department Launches UnitedHealth Antitrust Investigation
03/05/2024
The Justice Department is investigating UnitedHealth’s ownership of the largest US health care insurer and its relationship with doctor groups and drug benefits amid concerns of potential antitrust violations.
The Justice Department is investigating UnitedHealth’s ownership of the largest US health care insurer and its relationship with doctor groups and drug benefits amid concerns of potential antitrust violations.
The Justice Department is...
03/05/2024
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News
Balancing Medicare Advantage Denials for Patients With Diabetic Macular Edema
03/04/2024

Emry Lloyd

Emry Lloyd
Every year, millions of necessary medical service claims are denied by health care providers; policymakers want to balance these denials for those who need care and how this affects patients with diabetic macular edema.
Every year, millions of necessary medical service claims are denied by health care providers; policymakers want to balance these denials for those who need care and how this affects patients with diabetic macular edema.
Every year, millions of...
03/04/2024
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News
Who Will Benefit Under the Medicare Part D Out-of-Pocket Spending Cap?
02/27/2024
Starting in 2024, Medicare Part D enrollees could benefit from a cap placed on out-of-pocket drug spending, thanks to a provision in the Inflation Reduction Act of 2022 (IRA).
Starting in 2024, Medicare Part D enrollees could benefit from a cap placed on out-of-pocket drug spending, thanks to a provision in the Inflation Reduction Act of 2022 (IRA).
Starting in 2024, Medicare Part...
02/27/2024
First Report Managed Care
News
Alternative Funding Programs: A Tempting Choice Laden With Risks
02/26/2024
The escalating concern over specialty drug costs for employers and health plan executives is driven by significant spending increases, reaching $315 billion in 2022, with specialty drugs comprising 50% of total spending despite their low...
The escalating concern over specialty drug costs for employers and health plan executives is driven by significant spending increases, reaching $315 billion in 2022, with specialty drugs comprising 50% of total spending despite their low...
The escalating concern over...
02/26/2024
First Report Managed Care

Behind the Bill

Behind the Bill
The Nondelegation Doctrine: The Next Constitutional Showdown (Part 1)
02/12/2025
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
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
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
Behind the Bill
Medicare Drug Negotiations 2.0: New Administration, Same Mission?
01/22/2025
Last week brought 2 major developments in health care policy: President Trump's inauguration and the Centers for Medicare and Medicaid Services’ (CMS) announcement of 15 additional drugs selected for Medicare price negotiations. While these...
Last week brought 2 major developments in health care policy: President Trump's inauguration and the Centers for Medicare and Medicaid Services’ (CMS) announcement of 15 additional drugs selected for Medicare price negotiations. While these...
Last week brought 2 major...
01/22/2025
First Report Managed Care
Behind the Bill
The First 100 Days: Health Care's Critical Deadlines in 2025
01/15/2025
The 119th Congress faces immediate health care deadlines amid significant leadership transitions. While much attention focuses on high-profile nominations like Dr Oz for Centers for Medicare and Medicaid Services (CMS) Administrator and...
The 119th Congress faces immediate health care deadlines amid significant leadership transitions. While much attention focuses on high-profile nominations like Dr Oz for Centers for Medicare and Medicaid Services (CMS) Administrator and...
The 119th Congress faces...
01/15/2025
First Report Managed Care
Behind the Bill
Trump's Executive Orders in a Post-Chevron World: Implications for Health Care Policy
01/08/2025
Happy New Year! As we dive into 2025, it’s clear that this year promises to bring significant changes to health care. With President-elect Donald Trump's inauguration just weeks away, the spotlight is already shifting to how his...
Happy New Year! As we dive into 2025, it’s clear that this year promises to bring significant changes to health care. With President-elect Donald Trump's inauguration just weeks away, the spotlight is already shifting to how his...
Happy New Year! As we dive into...
01/08/2025
First Report Managed Care
Behind the Bill
A Tale of Two Congresses—Health Care Policy in the 117th vs 118th
12/18/2024
The 118th Congress is wrapping up with a whimper rather than a bang when it comes to health care legislation, particularly compared to its predecessor's transformative impact on pharmaceutical policy. As we reflect on these past 4 years, the...
The 118th Congress is wrapping up with a whimper rather than a bang when it comes to health care legislation, particularly compared to its predecessor's transformative impact on pharmaceutical policy. As we reflect on these past 4 years, the...
The 118th Congress is wrapping...
12/18/2024
First Report Managed Care
Behind the Bill
Medicare Privatization Under New CMS Leadership: What's Really at Stake
12/11/2024
After writing about Dr Oz's potential impact on Medicare drug negotiations last week, I found myself diving deeper into an aspect of his nomination that deserves closer attention: his vision for Medicare's future. A letter from Senate...
After writing about Dr Oz's potential impact on Medicare drug negotiations last week, I found myself diving deeper into an aspect of his nomination that deserves closer attention: his vision for Medicare's future. A letter from Senate...
After writing about Dr Oz's...
12/11/2024
First Report Managed Care
Behind the Bill
Medicare Drug Negotiations Under New CMS Leadership
12/04/2024
President-elect Donald Trump nominated Dr Mehmet Oz to lead the Centers for Medicare & Medicaid Services (CMS). With this potential change in leadership, are there any implications for Medicare’s drug price negotiation program,...
President-elect Donald Trump nominated Dr Mehmet Oz to lead the Centers for Medicare & Medicaid Services (CMS). With this potential change in leadership, are there any implications for Medicare’s drug price negotiation program,...
President-elect Donald Trump...
12/04/2024
First Report Managed Care
Behind the Bill

When Recess Isn’t a Break: What NLRB v Canning Means for HHS
11/20/2024
As Robert F. Kennedy Jr’s nomination for Secretary of Health and Human Services (HHS) moves through the Senate, there’s growing discussion about whether a recess appointment could be used to bypass confirmation challenges. The Supreme Court’s...
As Robert F. Kennedy Jr’s nomination for Secretary of Health and Human Services (HHS) moves through the Senate, there’s growing discussion about whether a recess appointment could be used to bypass confirmation challenges. The Supreme Court’s...
As Robert F. Kennedy Jr’s...
11/20/2024
First Report Managed Care

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