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The James Group Newsletter Vol. 6, Num. 4: Express Scripts, House Votes Rebuked, $40M Taxpayer Buyout, Surprise Medical Bills, AR Vote to Keep Medicaid Plan, Medicaid Expansion, Walgreens Lowers 2019 Expectations, US Borrowed $88B for HC in 2018, Robotics Gives Mobility to Disabled Children, Don't Forget Sunscreen Around Eyes, Seizure Risk: E-Cigs, Stem Cell Research, Health Plans Use of Medicare on Hospital Bills

 

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April 4, 2019 

Volume 6, Number 4

In This Issue

Express Scripts Offer Lower Insulin Costs

House Votes to Rebuke

UMC Needs $40M Taxpayer Bailout

Surprise Medical Bills

AR Vote to Keep Medicaid Plan

Medicaid Expansion

Walgreens Lowers 2019 Expectations

US Borrowed $88B to Pay for HC Last Year

Robotics Team Gives Mobility to Disabled Children

Don’t Forget Sunscreen Around Eyes

Seizure Risk: E-Cigs

Stem Cell Research

Health Plans Use Of Medicare on Hospital Bills

TJG On Facebook

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This newsletter is provided for informational purposes only. It is not intended for legal or tax advice, nor does it create an attorney/client relationship between The James Group, LLC and any readers or recipients. Readers should consult counsel of his or her own choosing to discuss how these matters relate to their individual circumstances. Reproduction of any kind is prohibited without the express written consent of The James Group, LLC.

The Wall Street Journal: Express Scripts To Offer A Way To Lower Insulin Costs
The cap, if picked up by employers, would save the average patient about $15 a month, or 40%, and even more for patients covered under a typical high-deductible health plan, according to Express Scripts. Patients could start benefiting from the lower out-of-pocket costs in the next few months, depending on when employers decide to opt-in, a company spokesman said. The offering will include all insulin types, including those made by Eli Lilly & Co., Novo Nordisk AS and Sanofi SA, three of the biggest makers of diabetes drugs. Express Scripts and Cigna insure about 700,000 patients taking insulin, said Glen Stettin, chief innovation officer at Express Scripts. (Walker, 4/3)

Source: The Wall Street Journal

The Washington Post: House Votes To Rebuke Trump’s Attempt At A Court-Ordered Destruction Of Obamacare
The resolution passed 240 to 186, with eight Republicans joining the chamber’s Democrats in rebuking Trump. One Democrat, Rep. Collin C. Peterson (Minn.), broke ranks and voted against the resolution. With Wednesday’s vote, Democrats were seeking to put Republicans on record as siding with Trump in his attempt to use the courts to overturn the ACA, known as Obamacare, including politically popular provisions that protect people with preexisting conditions and allow individuals to remain on their parents’ insurance plans until age 26. (Wagner, 4/3)

Source: The Washington Post

The Washington Post: United Medical Center Needs $40 Million Taxpayer Bailout, D.C. Officials Say
The District’s only public hospital will require a $40 million taxpayer subsidy to stay afloat, city officials have determined, the latest and largest in a series of government bailouts for the struggling facility over the last several years. United Medical Center — the only hospital east of the Anacostia River and a key provider of medical services for low-income residents of Southeast Washington — is running a projected annual operating deficit of tens of millions of dollars, hospital officials testified at a D.C. Council health committee hearing Tuesday. (Jamison, 3/26)

Source: The Washington Post

Kaiser Health News: Fixing Surprise Medical Bill Problem Shouldn’t Fall To Consumers, Panel Told
One point drew clear agreement Tuesday during a House subcommittee hearing: When it comes to the problem of surprise medical bills, the solution must protect patients — not demand that they be great negotiators. “It is the providers and insurers, not patients, who should bear the burden of settling on a fair payment,” said Frederick Isasi, the executive director of Families USA. He was one of the witnesses who testified before the House Health, Employment, Labor and Pensions subcommittee of the Education & Labor Committee. (Bluth, 4/2)

Source: Kaiser Health News

The Associated Press: Arkansas Lawmakers Vote To Keep Medicaid Plan After Ruling
Arkansas lawmakers voted Tuesday to keep the state's Medicaid expansion another year, days after a court decision blocking the state from enforcing a work requirement put the program's future in limbo. The majority-Republican House voted 75-18 for the budget for Medicaid and the expansion program, sending the legislation to GOP Gov. Asa Hutchinson. The Senate-backed bill on Friday fell short nearly two dozen votes of the 75 needed in the 100-member House to win final approval. (4/2)

Source: The Associated Press

Kaiser Health News: Medicaid Expansion Boosts Hospital Bottom Lines — And Prices
The Medicaid expansion promoted by the Affordable Care Act was a boon for St. Mary’s Medical Center, the largest hospital in western Colorado. Since 2014, the number of uninsured patients it served dropped by more than half, saving the nonprofit hospital more than $3 million a year. But the Grand Junction hospital’s prices did not go down. “St. Mary’s is still way too costly,” said Mike Stahl, CEO of Hilltop Community Resources, which provides insurance to about half of its nearly 600 employees and their families in western Colorado. (Galewitz, 3/27)

Source: Kaiser Health News

The Associated Press: Walgreens Lowers 2019 Expectations After 2Q Forecast Miss
Walgreens slashed its 2019 forecast and missed second-quarter expectations with a performance that sent its shares plunging Tuesday and helped knock down the Dow Jones Industrial Average. Company leaders told analysts that challenges they had been expecting like reimbursement cuts and lower price increases for branded drugs hit Walgreens much sooner than they anticipated. (4/2)


Source: The Associated Press

The New York Times: Americans Borrowed $88 Billion To Pay For Health Care Last Year, Survey Finds
Americans borrowed an estimated $88 billion over the last year to pay for health care, according to a survey released on Tuesday by Gallup and the nonprofit West Health. The survey also found that one in four Americans have skipped treatment because of the cost, and that nearly half fear bankruptcy in the event of a health emergency. There was a partisan divide when respondents were asked whether they believed that the American health care system is among the best in the world: Among Republicans, 67 percent of respondents said they believed so; that number was 38 percent among Democrats. (Zraick, 4/2)

Source: The New York Times

The New York Times: A Robotics Team Built A Toddler A Wheelchair. Now He’s Chasing His Corgis Around.
It took Rogue Robotics to get Cillian Jackson his wheels. At an age when most children are careening across the living room, 2-year-old Cillian was stuck, held back by a genetic condition that delays his physical and cognitive development and a Catch-22 requirement from his family’s insurance provider. Then a tip from Cillian’s physical therapist led his parents, Krissy and Tyler Jackson, who live in Farmington, Minn., to a website that provided a model for retrofitting toy cars to give mobility to children with disabilities. (Malkin, 4/3)

Source: The New York Times

NPR: Many Miss Sunscreen Around Eyes And Other Spots Vulnerable To Skin Cancer
You may not be thin-skinned, but your eyelids certainly are. The fragile tissue is the thinnest on the body, less than 1 millimeter thick. While crepe-thin skin is great for blinking, it makes the area especially vulnerable to the sun's UV rays. Five to 10 percent of skin cancers occur on the eyelid. Unfortunately, that same patch of sensitive skin is the area where we're most likely to skimp on sun protection, according to a study published Wednesday in PLOS One. (Ellis, 4/3)

Source: NPR

The Associated Press: US Investigates Seizure Risk With Electronic Cigarettes
U.S. health officials are investigating whether electronic cigarettes may trigger seizures in some people who use the nicotine-vaping devices. The Food and Drug Administration said Wednesday it has reviewed 35 reports of seizures among e-cigarettes users, mainly in young people. Regulators stressed it's not yet clear whether vaping is responsible. But they said they're concerned and encouraged the public to report information about the issue. (4/3)

Source: The Associated Press

The Washington Post: FDA Sends Letters To 20 Companies In Attempt To Rein In Stem Cell Industry
The letters are part of an ongoing attempt by the FDA to rein in the booming industry , which critics say has injured dozens of patients and cheated thousands more. In recent years, hundreds of clinics have have popped up selling stem cell procedures — not covered by insurance, unproven by science and unauthorized by the government — that purveyors claim can treat ailments ranging from creaky knees to Alzheimer’s, Crohn’s disease and multiple sclerosis. (Wan and McGinley, 4/3)

Source: The Washington Post

Kaiser Health News: Health Plans For State Employees Use Medicare’s Hammer On Hospital Bills
States. They’re just as perplexed as the rest of us over the ever-rising cost of health care premiums. Now some states are moving to control costs of state employee health plans. And it’s triggering alarm from the hospital industry. The strategy: Use Medicare reimbursement rates to recalibrate how they pay hospitals.  If the gamble pays off, more private-sector employers could start doing the same thing. “Government workers will get it first, then everyone else will see the savings and demand it,” said Glenn Melnick, a hospital finance expert and professor at the University of Southern California. “This is the camel’s nose. It will just grow and grow.” (Appleby, 3/21)

Source: Kaiser Health News

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