Payer Roundup—CMS reviews Alabama work requirements; Drug prices are still climbing

Medicaid on paper and a stethoscope
CMS will review Alabama's Medicaid work requirement waiver. (Getty/designer491)

CMS to review Medicaid work requirements

The Trump administration will review an application from Alabama to implement work requirements in the Medicaid program.

The state's proposal would require residents with Medicaid coverage to work, attend job training or do community service 35 hours a week, while parents of children younger than six would be required to work 20 hours, according to The Hill. The state argues that working parents will improve the health of young children.

The plan includes certain exemptions for pregnant women and residents over 60 years of age. Department of Health and Human Services Secretary Alex Azar has said his agency is “undeterred” by a recent ruling striking down the approval of Kentucky’s work requirements. (The Hill)

Free Daily Newsletter

Like this story? Subscribe to FierceHealthcare!

The healthcare sector remains in flux as policy, regulation, technology and trends shape the market. FierceHealthcare subscribers rely on our suite of newsletters as their must-read source for the latest news, analysis and data impacting their world. Sign up today to get healthcare news and updates delivered to your inbox and read on the go.

UnitedHealth warns hospitals it could drop Envision

UnitedHealth sent a notice to 300 hospitals, warning them that the insurer plans to drop the emergency staffing firm Envision from its network beginning next year, according to Axios.

In April, court filings indicated that UnitedHealth planned to cut ties with the staffing company next year, and negotiations have gone nowhere since then. Investment firm KKR bought Envision for $10 billion in June.

Dan Rosenthal, president of UnitedHealthcare's provider networks, warned hospitals that they could “experience a decrease in patient satisfaction driven from higher out-of-pocket costs and patient confusion.” (Axios)

Humana survey: One-third of seniors aren’t socially engaged

Nearly one-third of seniors 65 and older don’t feel they are socially engaged despite recognizing the importance of friendships and companionship, a new survey from Humana shows.

One place that could solve that issue: the gym. Nearly one-quarter of respondents said they go to the gym on a regular basis, and 54% of single seniors expressed interest in meeting someone there. (Survey)

Brand name drug prices are still going up

Trump may have promised that drug manufacturers would voluntarily reduce prices, but it’s not happening, according to the Associated Press.

An AP investigation of drug prices for the first seven months of the year found 96 price hikes for every price cut. Although there were fewer price increases than in previous years, all told there were just 46 price cuts.

HHS Secretary Alex Azar said admitted the administration’s drug pricing policy would take some time.

“I am not counting on the altruism of pharma companies lowering their prices,” he told the AP. (AP article)

Surprise billing could be a campaign issue

Although concerns around surprise billing are generating more media attention and prompting some legislators to draft legislation, the topic hasn’t emerged as a campaign issue.

But polling shows that the issue could generate a lot of public traction, writes Kaiser Family Foundation President and CEO Drew Altman in Axios. But it’s also an issue that’s difficult to pin blame for on either party, which makes it a weak attack issue.

“People talk about their unexpected bills a lot, and with a sense of outrage. It’s the candidates who aren’t talking about it on the campaign trail, and that’s almost certainly a missed opportunity,” Altman writes. (Axios)

Suggested Articles

Blue Cross and Blue Shield of North Carolina and Cambia Health Solutions have jointly decided to end their talks to enter a "strategic affiliation."

The Trump administration's new rules to overhaul the Stark Law have some areas that could create major regulatory headaches.

Medicare Part D beneficiaries could see their out-of-pocket costs go up next year before they reach catastrophic coverage, a new analysis shows.