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Will Courts and States Prevent the Trump Administration from Playing Humpty-Dumpty with the ACA: Responses to the Association Health Plan Final Rule
Source Fellow April 29, 2019
By: Erin Sclar, Student Fellow In late March, U.S. District Judge John Bates rejected the Trump Administration’s policy promoting Association Health Plans (AHPs), holding its interpretation of the Employee Retirement Income Security Act (ERISA) violated the Administrative Procedure Act (APA) and undermined the Affordable Care Act (ACA). This post analyzes implications of the Trump Administration’s Final Rule on AHPs, looks at the U.S. District Court’s response to litigation challenging the rule, and considers state options for regulating AHPs. The AHP Final Rule: Implications for Consumers, Providers, and States As The …
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States Are Taking the Helm on Antitrust Enforcement Efforts in Healthcare
Amy Y. Gu, Managing Editor April 15, 2019
State enforcement is the theme of the month in healthcare antitrust. A panel of antitrust experts at a recent Antitrust Symposium hosted by UC Hastings College of the Law discussed how exclusionary contracts and anticompetitive conduct by players in both the provider and pharmaceutical markets hinder competition and drive up healthcare prices. This edition of Litigation and Enforcement Highlights takes a look at current anticompetitive practices of providers and PBMs and the ensuing state regulatory efforts to address them. A Tale of Two Coasts in Provider Market Enforcement As …
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Affordable Care Act Hanging by a Thread in the Legal Tug of War
Source Fellow April 11, 2019
By: Katie Beyer, Student Fellow In 2018, the Trump Administration issued a number of new regulations that gutted the Affordable Care Act (ACA) by effectively eliminating the ACA’s safeguards and benefits. A multitude of lawsuits brought by cities, states and health plans challenging these administrative initiatives quickly followed suit. This post provides a litigation update on the prominent cases that highlight these challenges. There are three primary categories of lawsuits at issue: (1) state challenges on the constitutionality of the ACA’s Individual Mandate; (2) city challenges on the Trump Administration’s regulatory …
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Who’s Driving Healthcare Prices: A Look at Anticompetitive Conduct of Various Players in the Healthcare Market
Source Fellow and Amy Y. Gu, Managing Editor April 9, 2019
By: Megan O’Leary, Student Fellow and Amy Y. Gu, Managing Editor On Thursday, April 4, The Source attended the “Antitrust in the New Millennium Symposium” hosted by UC Hastings College of the Law. This blog focuses on the session “New Antitrust and Healthcare”, moderated by The Source Board member and UC Hastings Professor Thomas Greaney, and featuring the panel of, notably all women, UC Hastings Professor Robin Feldman, California Senior Assistant Attorney General Kathleen Foote, and American Antitrust Institute (AAI) President Diana L. Moss. What drives rising healthcare prices? Perhaps it stems …
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The Source Roundup: April 2019 Edition
Source Fellow April 1, 2019
By: Erin Sclar, Student Fellow Spring is finally here! With it, we review articles and reports about 1) single payer health plans and universal health care, 2) the causes, effects, and possible solutions to rising prescription drug pricing, and 3) health care costs and price transparency. Single Payer Health Plans and Universal Health Care The terms “single payer health plans” and “universal health care” are becoming increasingly familiar as the 2020 elections approach. But the meanings of these terms, and the specific policies and proposals associated with them, are often …
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AB 744 and Other 2019 Bills Seek to Increase and Improve Telehealth Delivery in California
Sammy Chang, Health Policy Researcher March 31, 2019
Avoid driving, get help instantly. That’s the premise of telehealth. Telehealth, under California law, is defined as “the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patient’s health care.”[1] One study has shown that the use of telehealth, in California, has been found to save a patient 278 miles in driving, 4 hours in time, and $156 in direct travel costs per consultation.[2] As such, telehealth has been used as an …
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Upcoming Event: The Source to Give Talk on State Laws Addressing Pharmacy Prices
Amy Y. Gu, Managing Editor March 18, 2019
In an increasingly complicated and blurry landscape, stakeholders across the health care industry are searching for ways to control health care costs, improve quality, enhance access to care, and maintain fair market power. We’re excited to share that The Source’s Senior Health Policy Researcher Katie Gudiksen will be participating in a webinar series hosted by Catalyst for Payment Reform (CPR), featuring leading experts in policy and health care innovation. The free four-part spring series will kick off on April 2, highlighting complex areas of health care strategy that may need …
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Litigation and Enforcement Highlights – March 2019
Amy Y. Gu, Managing Editor March 15, 2019
It’s been an eventful month in healthcare litigation and enforcement, as we saw the final conclusions to the legal challenges to Maryland’s drug pricing law and the sale of nonprofit hospitals in California. In addition to reflecting on the Supreme Court’s latest action, or lack thereof, we also bring updates on increased action in pending state antitrust enforcement in Pennsylvania and Washington. Landmark Maryland Drug Pricing Law Officially Dead The breaking litigation development in pharma last month was none other than Supreme Court’s denial to review the constitutionality of …
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Innovations in State Medicaid Programs to Control Prescription Drug Costs
Katie Gudiksen, Senior Health Policy Researcher March 7, 2019
Medicaid serves nearly one in five Americans, including many with chronic conditions, and purchases about 10% of total prescription medications dispensed in the U.S.[1] From 2013 to 2016, Medicaid’s nationwide drug spending increased almost 50%, from $22.4 billion to $33.4 billion.[2] Medicaid programs consume an increasing percentage of state budgets and threaten to overtake funding for other programs like education and infrastructure.[3] In 2018, the National Association of State Budget Officers (NASBO) estimated that Medicaid accounted for nearly 30% of total state spending and is the fastest growing component of …
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The Source Roundup: March 2019 Edition
Source Fellow March 1, 2019
By: Leah S. Gray, Student Fellow Happy March! This month we take a look at articles that examine 1) state health system reform efforts, 2) protections against surprise medical bills, 3) effects of market concentration on cost and quality, and 4) ways to control rising costs for health care and pharmaceuticals. States are taking the lead in health system reform While the federal health policy debate has remained rather stagnant, states have stepped up protect their citizens from rising health care costs. North Carolina is poised to make rapid, unprecedented …
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