Read AMA Morning Rounds®’ most popular stories in medicine and public health from the week of May 27, 2024–May 30, 2024.
Federal agencies aim to issue regulations this year making No Surprises Act arbitration more efficient
Bloomberg Law (5/30, Schilling, Subscription Publication) reports, “Federal agencies are aiming to issue final regulations this year that aim to make the arbitration process more efficient for No Surprises Act health care payment disputes, an IRS official said.” These rules “are a priority for the Treasury, Labor, and Health and Human Services departments, said IRS Office of Chief Counsel Senior Technician Reviewer Kevin Knopf during a Thursday panel at the Federal Bar Association’s Insurance Tax Seminar.” The regulations “aim to reduce certain administrative fees tied to participating in an independent dispute resolution system that arbitrates clashes between medical providers and health insurers over payments.”
You may also be interested in: Appeals court should uphold decision on No Surprises Act rule.
Ro launches tracking platform for GLP-1 drugs amid shortages
Modern Healthcare (5/29, DeSilva) reports, “Ro has launched a tracking platform showing real time availability and stock of glucagon-like peptide agonists across pharmacies, the telehealth company said Wednesday.” The platform “takes user-reported data from patients and providers who have found GLP-1s in their area, alerting local users to a drug’s availability.” Ro “designed the tracker to help patients and providers find GLP-1s during the shortage of drugs including Wegovy, Ozempic and others.” The tracker “also alerts users to which drugs or dosages are out of stock, allows them to notify the Food and Drug Administration of shortages and sign up for alerts when drugs are back in stock.”
You may also be interested in: FTC eyes how “middlemen” contribute to generic drug shortages.
Introducing peanut butter during infancy can help reduce risk of developing peanut allergy later, study finds
CNN (5/28, Howard) reports, “Reassuring new evidence suggests that feeding children smooth peanut butter during infancy and early childhood can help reduce their risk of developing a peanut allergy even years later.” When “compared with avoiding peanuts, starting peanut consumption in infancy – as early as around 4 months of age, as a soft pureed paste, for instance – and continuing regularly to around 5 years old was associated with a 71% reduced rate of peanut allergy among adolescents in the United Kingdom, according to a study published Tuesday in the journal NEJM Evidence.”
Medicare Advantage plans use prior authorization to deny care, critics claim
The New York Times (5/25, Span) reported, “Traditional Medicare rarely requires so-called prior authorization for services. But virtually all Medicare Advantage plans invoke it before agreeing to cover certain services, particularly those carrying high price tags, such as chemotherapy, hospital stays, nursing home care and home health.” In 2021, Medicare Advantage “plans received more than 35 million prior authorization requests, according to a KFF analysis, and turned down about two million, or 6%, in whole or in part.” Insurance companies “can save money by restricting coverage; they’ve also learned that few beneficiaries challenge denials, even though they are entitled to and usually win when they do.” A 2022 HHS OIG report “revealed that 13% of denied prior authorization requests met Medicare coverage rules and probably would have been approved by traditional Medicare.” The American Medical Association and other medical groups have criticized prior authorization and called for policy change.
Editor’s note: Overused prior authorization processes cause care delays, patient harm and practice hassles. Learn how the AMA is leading the charge to fix prior authorization.
Both step counts and time-based physical activity reduced risks of death, CVD
Healio (5/24, Rhoades) reported, “Both step counts and time-based physical activity reduced the risks of death and CVD among women aged 62 years and older, a study...showed.” Investigators came to this conclusion after analyzing “data on 14,399 women aged 62 years and older from the Women’s Health Study who were free of CVD and cancer at baseline.” The findings were published in JAMA Internal Medicine.
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Table of Contents
- Federal agencies aim to issue regulations this year making No Surprises Act arbitration more efficient
- Ro launches tracking platform for GLP-1 drugs amid shortages
- Introducing peanut butter during infancy can help reduce risk of developing peanut allergy later, study finds
- Medicare Advantage plans use prior authorization to deny care, critics claim
- Both step counts and time-based physical activity reduced risks of death, CVD
