News for Insurers
Top stories summarized by our editors
9/18/2019

Health insurance providers are expanding their offerings, and they are committed to ensuring access to affordable coverage, AHIP said in response to a report from the American Medical Association on competition in commercial health insurance markets. AHIP highlighted a recent study from the Health Care Cost Institute that found almost three-quarters of US hospital markets are highly concentrated, arguing "large, consolidated hospital systems have stronger market power to drive up prices, giving them the ability to negotiate prices that are significantly higher than what Medicare pays for the same exact services."

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FierceHealthcare
9/18/2019

The American Academy of Pediatrics and four other health organizations issued guidance recommending breast milk or infant formula for babies up to 6 months old; breast milk or infant formula plus some water among those ages 6 months to 12 months that are eating solid food; whole milk and water for children ages 12 months to 2 years; and low-fat or skim milk and water among those ages 2 years to 5 years. Children younger than 12 months shouldn't drink 100% fruit juice, while those ages 12 months to 5 years should not consume more than 4 ounces of juice daily, according to the recommendations.

9/18/2019

US District Judge Rosemary Collyer overturned the CMS' site-neutral payment rule that reduced Medicare payments for some care at off-campus hospital sites, arguing the Trump administration exceeded its authority with the policy. Collyer asked hospitals and the CMS for a status report so she can determine whether she needs more information before deciding on a remedy.

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Judge Rosemary Collyer
9/18/2019

Tennessee officials announced a plan to transform its Medicaid program by converting it to the nation's first block grant program. Under the proposal, which would require CMS approval, the state would receive almost $7.9 billion from the federal government, based on estimated Medicaid costs, and the amount could increase in the future if enrollment rises as well as with adjustments for inflation.

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The Hill
9/18/2019

A study published in Frontiers in Endocrinology revealed that postmenopausal women in Finland who had higher leisure time physical activity levels had an improved blood lipid profile, as shown by lower fasting blood glucose, LDL cholesterol, total cholesterol and triglyceride levels, and higher HDL-C levels. Researchers surveyed 193 women, ages 47 to 55, and found that although physical activity was associated with a healthier blood lipid profile, it "does not entirely offset the unfavorable lipid profile changes associated with the menopausal transition," said Sira Karvinen, the study's first author.

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Medical News Today
9/18/2019

Researchers found that adults with overweight or obesity, but without diabetes, who followed a low-fat vegan diet had an increase in the number of bacteroidetes in the gut, especially Faecalibacterium prausnitzii that was associated with a +4.8% treatment effect, compared with those who had no dietary changes. The findings, presented at the European Association for the Study of Diabetes annual meeting and based on 148 individuals, also showed that an increase in F. prausnitzii correlated with an increase in insulin sensitivity and weight loss.

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Obesity, Faecalibacterium
9/18/2019

Children in California had a five percentage points lower likelihood of late hepatitis B vaccination and 1.4 percentage points reduced odds of late Haemophilus influenzae B and diphtheria, tetanus and pertussis immunizations after the state implemented a paid family leave policy, according to a report in the IZA Institute of Labor Economics Discussion Papers. The report also showed that families living below poverty level had the most significantly reduced odds of late vaccination after paid family leave implementation.

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diphtheria, pertussis, tetanus
9/18/2019

A study in the American Journal of Preventive Medicine showed only about one in three American adults have received intraoral exam for cancer during a dental clinic visit, and 70.6% of them were non-Hispanic whites. Researchers examined data from the National Health and Nutrition Examination Survey collected from 2011 to 2016 and found lower screening rates among racial and ethnic minorities and those with lower education and income levels.

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Reuters
9/18/2019

The Texas Veterans Commission Fund for Veterans' Assistance has awarded a $500,000 grant to Baylor Scott & White Health's Warriors Research Institute in Waco, Texas. The funds will help the institute expand a pilot mental telehealth treatment for veterans and their families from Central Texas to the entire state.

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mHealth Intelligence
9/18/2019

Everardo Villarreal, former owner of the now-closed DME Medical Supply Depot in Elsa, Texas, was sentenced to three years and four months in prison plus three years of supervised release and was ordered to pay almost $870,000 in restitution after admitting his involvement in a Medicaid fraud scheme. Authorities said Villarreal and his ex-secretary, Delilah Robles, who received a time-served sentence and six months of home confinement plus three years of supervised release, submitted fraudulent claims to Medicaid for over $850,000 worth of durable medical equipment supplies that were never delivered to Medicaid recipients from about April 2010 to September 2014.