Morning Consult Health, Presented by PhRMA: Arkansas to End Medicaid Coverage for 4,353 Who Didn’t Meet Work Requirements


Top Stories

  • Gov. Asa Hutchinson (R-Ark.) said 4,353 Medicaid beneficiaries in Arkansas will lose their coverage after failing to meet the state program’s work requirements, which mandated people subject to the rules to report 80 hours of work, job training, education or volunteering per month. Hutchinson said that the number of dropped enrollees is “higher than we would prefer” and that the reduction would save the state an estimated $30 million. (Bloomberg)
  • Data from the Department of Health and Human Services shows the number of migrant children in U.S. custody has risen more than fivefold since May 2017 to a record high of 12,800 children in shelters this month. The data suggests the surge is a consequence of fewer children being released to live with families and other sponsors, and people familiar with the shelter system say that stricter immigration enforcement has dissuaded relatives and family friends from sponsoring children. (The New York Times)
  • Nebraska’s Supreme Court ruled against a lawsuit seeking to keep a Medicaid expansion proposal off the general election ballot, clearing the way for Nebraskans to vote on the measure in November. (Omaha World-Herald)

Chart Review

Events Calendar (All Times Local)

Thursday
2018 CMS National Training Program Workshop – Region VIII 8:30 a.m.
FT Pharma Pricing and Value Summit featuring Alex Azar, Seema Verma 9 a.m.
National Committee on Vital and Health Statistics full committee meeting 9 a.m.
MACPAC Public Meeting 9:30 a.m.
House Committee on Veterans’ Affairs Legislative Hearing on H.R. 5413 and H.R. 6418 10 a.m.
House Energy and Commerce Subcommittee on Health hearing on examining barriers to expanding innovative, value-based care in Medicare 1:15 p.m.
AHIP: Redesign your payment integrity model to achieve savings 1 p.m.
Friday
National Committee on Vital and Health Statistics full committee meeting 9 a.m.
MACPAC Public Meeting 9:30 a.m.
FDA Unveils Plan to Combat Antibiotic Resistance 10 a.m.
Coalition for the Life Sciences: Our Own Worst Enemies: How Humans Host Dangerous Pathogens 12 p.m.
SPONSORED BY PHRMA

What if a couple of small fixes could protect seniors in the donut hole and save them money on out-of-pocket costs? They can. And Congress can make it happen.

Congress should act now to reduce out-of-pocket costs for seniors and leave them better off than the BBA changes alone.

General

Kavanaugh explains ‘abortion-inducing drugs’ remark amid backlash
Jordain Carney, The Hill

Supreme Court nominee Brett Kavanaugh told senators that he was summarizing the plaintiffs’ views in an ObamaCare case when he referred to birth control as “abortion-inducing drugs.” Kavanaugh’s use of the phrase during his confirmation hearing sparked days of backlash from Democrats and progressive groups, who argued the Supreme Court pick was trying to signal his own views.

Cancer will kill nearly 10 million people this year, report estimates
Jen Christensen, CNN

The number of people around the world who have cancer is “rapidly growing,” with 18.1 million new cases and 9.6 million deaths in 2018 alone, researchers estimate in a new report. By the end of the century, cancer will be the No. 1 killer globally and the single biggest barrier to increasing our life expectancy, according to the report, released Wednesday by the World’s Health Organization’s International Agency for Research on Cancer.

Trying To Protect Seniors, The Most Vulnerable, From Formidable Foe Florence
Liz Szabo et al., Kaiser Health News

Perhaps no other population is as vulnerable during a hurricane as frail, older adults, especially those who are homebound or living in nursing homes. With Hurricane Florence predicted to slam the North Carolina coast Friday, health officials are already scrambling to keep older residents safe.

Menendez Hammers Senate Opponent on Celgene Drugs
Elise Young, Bloomberg

U.S. Senator Bob Menendez’s latest re-election television advertisement steps up the attack on his Republican challenger, former Celgene Corp. chief executive Bob Hugin, for a $280 million legal settlement over the company’s cancer-drug marketing. The Democrat’s ad, the third in three weeks from the 64-year-old senior senator from New Jersey, follows months of mostly unanswered lobs from Hugin, also 64.

Residents see a failure at all levels of government
Scott Clement et al., The Washington Post

Puerto Ricans sharply rebuke President Trump, along with the federal and local governments, for last year’s response to Hurricane Maria, a devastating storm that created an enduring humanitarian crisis affecting nearly all aspects of life on the island territory, according to a new Washington Post-Kaiser Family Foundation poll. Nearly a year after Maria hit Puerto Rico, people say they are still struggling with basic necessities.

Separated families are suing the Trump administration over mental health treatment costs
Catherine E. Shoichet, CNN

The US government should cover mental health treatment costs for immigrant children who officials separated from their parents, a new lawsuit argues. The class-action lawsuit, filed by a group of lawyers in federal court this week, also seeks unspecified damages for children affected by the Trump administration’s now-reversed zero tolerance policy at the border.

Pramila Jayapal Is Starting The First Medicare For All PAC
Daniel Marans, Huffington Post

Rep. Pramila Jayapal (D-Wash.) is founding a political action committee to contribute money to congressional candidates who support single-payer health care, commonly known as Medicare for all. The PAC’s website, where donors can contribute online, went live Wednesday morning at passmedicareforall.org.

Seven U.S. states now have adult obesity rates of 35 percent or higher
Andrew Joseph, Stat News

Seven U.S. states now have adult obesity rates of 35 percent or higher, up from zero states just five years ago, according to federal data released Wednesday. The 2017 data, from the Centers for Disease Control and Prevention, highlight continuing discrepancies in adult obesity rates across geographic areas, race, and education levels.

Lack of surgical care in U.S. prisons may cost lives
Linda Carroll, Reuters Health

Poor healthcare in America’s prisons may be leading to avoidable deaths, a new study suggests. Researchers who examined autopsy reports for inmates who died while incarcerated in Florida’s Miami Dade County found that two-thirds of those who needed surgery for a non-liver-related medical condition never got it, according to the report published in JAMA Surgery.

Stocks Rise as Asia Rebounds; Euro Dips Before ECB: Markets Wrap
Eddie van der Walt, Bloomberg

U.S. equity futures climbed with European stocks and Asian shares ended the longest losing streak in 16 years on the prospect of fresh trade negotiations between the world’s two biggest economies. The euro edged lower and the pound was steady ahead of key policy meetings.

Payers

Trump administration makes it easier to avoid Obamacare tax penalty
Carmin Chappell, CNBC

The Centers for Medicare & Medicaid Services announced on Wednesday a new opportunity for those who failed to comply with the individual mandate in 2018 to avoid the corresponding tax penalty. The new policy allows hardship exemptions to be claimed without “the documentary evidence or written explanation generally required.”

A Setback For Massachusetts In States’ Drive To Contain Medicaid Drug Spending
Martha Bebinger, NPR News

Massachusetts wanted to negotiate prices for about 1 percent of the highest-priced drugs and stop covering some of them. CMS rejected the proposal without much explanation beyond saying Massachusetts couldn’t do what it wanted and continue to receive the deep discounts drugmakers are required by law to give state Medicaid programs.

More Medicare Advantage upcoding could follow court ruling
Shelby Livingston, Modern Healthcare

A federal judge’s recent decision to vacate a 2014 CMS rule that UnitedHealthcare said resulted in underpayment for Medicare Advantage insurers leaves the federal government with fewer tools to combat upcoding practices that cost the taxpayer-funded Medicare program billions of dollars. U.S. District Judge Rosemary Collyer last week vacated the 2014 overpayment rule, which required Medicare Advantage plans to return overpayments to the government within 60 days of identifying them or they would be considered in violation of the False Claims Act and potentially subject to civil lawsuits, damages and penalties.

Providers

As Hurricane Florence approaches, these hospitals are in the storm’s path
Bertha Coombs, CNBC

Disruption from Hurricane Florence could hurt hospital system earnings in the third quarter, analysts said. Lifepoint Health has the largest potential exposure, with nearly 30 percent of its hospital beds in North and South Carolina within the forecasted path of the storm.

Health systems’ scale not linked to higher revenue
Alex Kacik, Modern Healthcare

New data from Navigant Consulting challenge the common perception that scale will improve healthcare providers’ operations, researchers said. The report, which covered 104 highly rated health systems comprising about half of nation’s hospitals, showed that there was no correlation between higher revenues and better operating margins from 2015 to 2017

Pharma, Biotech and Devices

Trump Eyeing ‘Disruptive’ Changes to Drug Pricing, Health Secretary Says
Cynthia Koons and Anna Edney, Bloomberg

The Trump administration is looking to make “disruptive” changes to U.S. drug pricing to bring down costs for patients, Health and Human Services Secretary Alex Azar said. “Every player in the system has their share of blame,” Azar said in an interview at Bloomberg headquarters in New York on Wednesday, adding that he’s working on overhauling the system.

Beleaguered price-hiking drug CEO says he wasn’t defending Shkreli, he was condemning FDA
Meg Tirrell, CNBC

A 400 percent price hike on a decades-old medicine is a risky move in a post-Martin Shkreli world. But Nirmal Mulye, founder of Nostrum Pharmaceuticals, said he had to take the price increase — or continue losing money manufacturing generic drugs.

With CRISPR, Scientists Engineered Nearly 4,000 Mutations of a Breast-Cancer Gene
Sarah Zhang, The Atlantic

BRCA1 is one of the best-studied cancer genes in the world. Still, on occasion, doctors will test a patient and find a BRCA1 mutation no one has ever seen before. This creates a dilemma. The newly discovered “variant of unknown significance,” or VUS, could be harmful, making a woman’s risk of developing breast cancer as high as 72 percent.

Biotech unicorn Moderna prepares for sector’s biggest-ever IPO
Damian Garde, Stat News

Moderna Therapeutics, a biotech unicorn valued at more than $7.5 billion, is preparing for an initial public offering that could come as early as this winter, according to people familiar with the process. The Cambridge, Mass.-based company, which has doggedly stayed private amid a boom of biotech IPOs, has recruited Goldman Sachs, J.P. Morgan, and Morgan Stanley to manage its Wall Street debut, the people said.

Many Americans continue to misuse prescription drugs, but patterns of abuse are ‘changing’
Ed Silverman, Stat News

Although more than half of Americans misuse prescription drugs, the percentage that did so has held steady for four consecutive years, according to a new analysis. Meanwhile, though, there has also been a surge in the use of illicit drugs and medicines obtained without a prescription among patients being treated for substance use disorders.

FDA Approves New Drug For Hepatitis A And Measles Exposure
Robin Seaton Jefferson, Forbes

The US Food and Drug Administration (FDA) has approved a new drug for people who have been exposed to measles and hepatitis A viruses. This could be especially good news for older adults who are more likely to suffer from weakened immune systems and thus have more difficulty fighting off infections.

Health IT

The new Apple Watch has a heart monitor and the FDA approves
Maggie Fox, NBC News

The new Apple Watch unveiled Wednesday has a new, real-life medical app: a heart monitor. The watch has two electrocardiogram, or EKG, apps that are approved by the Food and Drug Administration and supported by the American Heart Association.

Cigna Launches $250M Fund To Invest In Start-Ups
Bruce Japsen, Forbes

Health insurance giant Cigna is escalating its interest in startup and innovative ventures, launching a $250 million fund to develop “promising startups and growth-stage companies.” Cigna Ventures will focus on three areas: insights and analytics; digital health and retail; care delivery/management, the health insurer said Wednesday.

Instagram Will Show A “Get Support” Pop-Up When Users Search Opioid-Related Hashtags
Nicole Nguyen, Buzzfeed News

The company said that while some people on Instagram use hashtags, like #opioids, to promote the sale of illegal drugs, which is banned on Instagram, the hashtags are also used for people who are struggling with substance misuse to find support within the community. According to CDC data, nearly two-thirds of drug overdose–related deaths (over 41,000) in the US involved a prescription or illicit opioid in 2016.

A Message from PhRMA: 

Congress can protect the most vulnerable seniors in Medicare Part D by fixing the Cliff and restoring balance to payment responsibility in the donut hole. Together these two policy fixes reduce out-of-pocket costs for seniors with high drug costs more than the BBA changes alone, leaving them better off and, in 2020, saving them up to 7% on their out-of-pocket costs. Learn more.

Opinions, Editorials and Perspectives

Simplifying Provider Credentialing in Oregon: A Cautionary Tale for All States
Julian Roberts, Morning Consult

As states work to simplify the health care delivery system for consumers, a recent decision in the state of Oregon could soon have national implications. The state suspended a legislatively mandated provider credentialing program before it could be launched — after five years of startup activities.

New census data show gains to low- and middle-income families but stalled progress on health coverage
Jared Bernstein, The Washington Post

New data out Wednesday show that poverty fell and middle-class incomes rose in the U.S. last year, though not as quickly as in prior years (and a more accurate poverty gauge did not decline at all). Gains in health insurance coverage stalled in 2017, likely due, in part, to efforts by the Trump administration to suppress health insurance enrollment through the Affordable Care Act.

Research Reports

A Policy Option to Enhance Access and Affordability for Medicare’s Low-Income Beneficiaries
Cathy Schoen et al., The Commonwealth Fund

With the goal of enhancing access and affordability for people vulnerable due to low incomes and poor health, this issue brief proposes a policy that would reduce Medicare’s cost-sharing and premiums for beneficiaries with incomes below 150 percent of the federal poverty level.