News for Insurers
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5/23/2019

States that expanded Medicaid coverage had 1.6 fewer maternal deaths per 100,000 women and a more than 50% decline in infant mortality from 2010 to 2016, compared with states that didn't expand Medicaid eligibility, according to a report from the Georgetown University Center for Children and Families. The report also showed reduced racial disparities in health care, as well as a greater decline in the rate of uninsured women ages 18 to 44 in states that expanded Medicaid.

5/23/2019

Experts from the Congressional Budget Office who testified Wednesday during a House committee hearing on single-payer health care said the framework would likely increase the number of people with health insurance, but it would also increase government control over the health care system. With health care representing about one-sixth of the US economy, changes resulting from the shift to a single-payer system could be "potentially disruptive" and could have a significant impact on the economy, as well as health care access and quality, said CBO Deputy Director Mark Hadley.

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The Hill
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Congressional Budget Office
5/23/2019

CMS Administrator Seema Verma signaled openness to value-based or outcome-based reimbursement models for expensive new drugs and curative therapies, but expressed concern that the models would encourage drugmakers to set prices even higher. Verma also said she is opposed to negotiating Medicare drug prices directly with manufacturers and said pharmacy benefit managers have been effective.

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Administrator Seema Verma
5/23/2019

Eli Lilly and Co. introduced a generic version of the company's Humalog insulin lispro for $137.35 per vial or $265.20 for a package of five injection pens, or about half the price of the branded product.

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The Associated Press
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Eli Lilly and Co., Humalog, Lilly
5/23/2019

Prohibiting balance billing when patients unknowingly receive treatment from an out-of-network health care provider and requiring hospitals to notify patients of providers' network status are some ways to protect patients from unexpected medical bills, AHIP's Jeanette Thornton told a House committee Wednesday. Thornton said AHIP favors a market-based approach instead of arbitration for deciding proper payments, as the latter would raise costs and delay the resolution of claims process, while failing to address the "exorbitant bills" AHIP says are the root cause of the problem.

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HealthLeaders Media
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AHIP
5/23/2019

Hawaii, Utah and Connecticut are the healthiest states for seniors, while Mississippi, Kentucky and Louisiana are the unhealthiest for them, according to the 2019 America's Health Rankings Senior Report. Rates of depression and excessive drinking among seniors are up by 19% and 12%, respectively, while avoidance of care is up 5%, according to the report.

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depression
5/23/2019

US adults ages 45 to 64 were more likely to die from cancer than heart disease between 1999 and 2017, but cancer mortality among that group fell 19% during the study period, according to a study in the CDC's National Vital Statistics Reports. Meanwhile, the prevalence of heart disease-related deaths decreased by 22% from 1999 to 2011, then increased 4% from 2011 to 2017, with the greatest increase found among white women.

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CNN
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CDC
5/23/2019

The former owner of a dental and vision claims processing business pleaded guilty to submitting nearly $1.5 million in fraudulent claims to the Association of Pennsylvania State College and University Faculties from 2007 through 2017, according to the U.S. attorney's office.

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fraud, U.S. Attorney's office
5/23/2019

Employers whose employees use their preventive dental benefits pay less in claims for extensive treatment than those whose employees do not regularly seek preventive care, a Guardian research brief says. Employees who used their preventive dental plan benefit at least annually saved money on check-ups and cleanings, needed less major dental care and had lower out-of-pocket costs over a three-year period, while those who did not seek preventive care had claims an average of $720 higher and were more likely to reach their plan's maximum coverage.

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Guardian
5/23/2019

Claims made by marketers of charcoal toothpastes and powders are not supported by scientific evidence, and although the products might whiten teeth, they also might damage dental enamel, according to a study in the British Dental Journal. Moreover, charcoal and bentonite clay, which was found in one-third of the products tested in a separate study, are recognized carcinogens, and dentists say toothpastes that contain fluoride are proven to prevent tooth decay and cavities.

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Reuters