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April 2016 - FRMC

Multiple Myeloma: Factors for Payers to Consider
04/13/2016
Multiple Myleoma (MM) is a malignant cancer caused by the abnormal accumulation of the plasma cells derived from B cells in the bone marrow, leading to eventual marrow failure and skeletal destruction through bone metastases.1 The American...
Multiple Myleoma (MM) is a malignant cancer caused by the abnormal accumulation of the plasma cells derived from B cells in the bone marrow, leading to eventual marrow failure and skeletal destruction through bone metastases.1 The American...
Multiple Myleoma (MM) is a...
04/13/2016
First Report Managed Care
Health Transformation Alliance Seeks Dramatic Changes
04/13/2016
Dean Celia
Industry titans want to exert their heft to alter employer-sponsored health care. Do they have what it takes, and how is managed care responding?
Industry titans want to exert their heft to alter employer-sponsored health care. Do they have what it takes, and how is managed care responding?
Industry titans want to exert...
04/13/2016
First Report Managed Care
News Connection
Three New Agents for Multiple Myeloma Expand Armamentarium
04/13/2016
Primary clinical reviewers from the FDA discuss the changing treatment models for individuals living with the disease.
Primary clinical reviewers from the FDA discuss the changing treatment models for individuals living with the disease.
Primary clinical reviewers from...
04/13/2016
First Report Managed Care
Managing Mental Health: The Demands of Dementia
04/13/2016
Paul Nicolaus
As dementia saps the health and resources of an aging population and their family members, university programs are fighting back with innovative solutions.
As dementia saps the health and resources of an aging population and their family members, university programs are fighting back with innovative solutions.
As dementia saps the health and...
04/13/2016
First Report Managed Care
Department
FDA Approves Biosimilar of Johnson and Johnson’s Blockbuster Drug Remicade
04/12/2016
The FDA has approved Inflectra (infliximab-dyyb, Celltrion Inc) for the treatment of multiple conditions, including rheumatoid arthritis and inflammatory bowel disease. This is the second biosimilar to be approved in the US.
The FDA has approved Inflectra (infliximab-dyyb, Celltrion Inc) for the treatment of multiple conditions, including rheumatoid arthritis and inflammatory bowel disease. This is the second biosimilar to be approved in the US.
The FDA has approved...
04/12/2016
First Report Managed Care
News Connection
Diabetes Prevention Program First Under ACA to Gain Medicare Coverage
04/12/2016
In an expansion of the YMCA’s diabetes prevention program, Medicare will pay for services for individuals at high risk of developing the disease. 
In an expansion of the YMCA’s diabetes prevention program, Medicare will pay for services for individuals at high risk of developing the disease. 
In an expansion of the YMCA’s...
04/12/2016
First Report Managed Care
News Connection
Coordinated Care May Help Reduce Harmful Transitions for Patients With Dementia
04/12/2016
Coordinated care and a long-term care plan may help reduce unnecessary transitions for patients with dementia according to a study published in the Journal of the American Geriatrics Society.
Coordinated care and a long-term care plan may help reduce unnecessary transitions for patients with dementia according to a study published in the Journal of the American Geriatrics Society.
Coordinated care and a long-term...
04/12/2016
First Report Managed Care
News Connection
Long-Term Care Payment Initiative To Lower Medicare, Medicaid Spending
04/12/2016
CMS will test a new payment model for nursing facilities and practitioners in long-term care settings that is designed to lower Medicare and Medicaid spending by reducing avoidable inpatient hospitalizations.
CMS will test a new payment model for nursing facilities and practitioners in long-term care settings that is designed to lower Medicare and Medicaid spending by reducing avoidable inpatient hospitalizations.
CMS will test a new payment...
04/12/2016
First Report Managed Care
Department
Valeant Doubles Price of Physician-Assisted Suicide Drug
04/12/2016
In response to California’s passage of the “aid in-dying” law, Valeant Pharmaceuticals has doubled the price of Seconal Sodium (secobarbital) to more than $3000.
In response to California’s passage of the “aid in-dying” law, Valeant Pharmaceuticals has doubled the price of Seconal Sodium (secobarbital) to more than $3000.
In response to California’s...
04/12/2016
First Report Managed Care
News Connection
Newer Antidepressants Not Associated With CV Risk
04/11/2016
A study investigated the link between the use of selective serotonin reuptake inhibitors and individual risk of arrhythmia, stroke, and myocardial infarction.
A study investigated the link between the use of selective serotonin reuptake inhibitors and individual risk of arrhythmia, stroke, and myocardial infarction.
A study investigated the link...
04/11/2016
First Report Managed Care
High Cost, High Risk: How Managed Care Can Overcome the Challenges of End-of-Life Care
04/10/2016
Jill Sederstorm
The opportunity to improve quality for end-of-life care is large, but few managed care organizations have found the most effective way to do this. 
The opportunity to improve quality for end-of-life care is large, but few managed care organizations have found the most effective way to do this. 
The opportunity to improve...
04/10/2016
First Report Managed Care
Experts Weigh In on Health Transformation Alliance Plan to Break Costly, Wasteful Marketplace Practices
04/10/2016
Dean Celia
Industry titans want to exert their heft to alter employer-sponsored health care. Do they have what it takes, and how is managed care responding?
Industry titans want to exert their heft to alter employer-sponsored health care. Do they have what it takes, and how is managed care responding?
Industry titans want to exert...
04/10/2016
First Report Managed Care
News
21st Century Cures Act: Is Faster Always Better?
04/10/2016
As the US Senate considers aspects of the 21st Century Cures Act, some experts voice concerns over finding the right balance between getting products on the market faster without lowering standards.
As the US Senate considers aspects of the 21st Century Cures Act, some experts voice concerns over finding the right balance between getting products on the market faster without lowering standards.
As the US Senate considers...
04/10/2016
First Report Managed Care
Prior Authorization Programs for Specialty Drugs
04/10/2016
Dean Celia
With arguably more at stake in these high-risk therapeutic areas, it’s crucial that payers and providers get it right.
With arguably more at stake in these high-risk therapeutic areas, it’s crucial that payers and providers get it right.
With arguably more at stake in...
04/10/2016
First Report Managed Care
Majority of ACOs Lacking Infrastructure, Protocols to Optimize Medication Use
04/10/2016
Researchers gauged ACO readiness for optimizing medication use in the real world via a survey.
Researchers gauged ACO readiness for optimizing medication use in the real world via a survey.
Researchers gauged ACO readiness...
04/10/2016
First Report Managed Care

Behind the Bill

Behind the Bill
The Senate’s $3 Trillion Deal. Tax Relief Now, Medicaid Coverage Loss Later?
07/02/2025
Katie Hayes, MJ
The Senate has done it. After weeks of behind-the-scenes wrangling and last-minute amendments, lawmakers have passed a sprawling tax-and-spending megabill that makes good on a long-standing Republican goal: making the 2017 Trump tax cuts...
The Senate has done it. After weeks of behind-the-scenes wrangling and last-minute amendments, lawmakers have passed a sprawling tax-and-spending megabill that makes good on a long-standing Republican goal: making the 2017 Trump tax cuts...
The Senate has done it. After...
07/02/2025
First Report Managed Care
Behind the Bill
When a Cap Isn’t Just a Cap: How a Provider Tax Proposal Could Reshape Medicaid Financing
06/25/2025
Katie Hayes, MJ
In Washington, the most consequential policies are often buried in the fine print. One such detail in the Senate Finance Committee’s latest tax and spending proposal would gradually cap provider taxes—a core funding tool states use to pull in...
In Washington, the most consequential policies are often buried in the fine print. One such detail in the Senate Finance Committee’s latest tax and spending proposal would gradually cap provider taxes—a core funding tool states use to pull in...
In Washington, the most...
06/25/2025
First Report Managed Care
Behind the Bill
Rewriting the Safety Net? Inside the Senate’s Changes to Medicaid and the ACA
06/18/2025
Katie Hayes, MJ
Over the past few weeks, I’ve been following the progress of the One Big Beautiful Bill Act (OBBBA), which started in the House with sweeping tax reforms and some eye-catching health care proposals. Now, the Senate has released its (highly...
Over the past few weeks, I’ve been following the progress of the One Big Beautiful Bill Act (OBBBA), which started in the House with sweeping tax reforms and some eye-catching health care proposals. Now, the Senate has released its (highly...
Over the past few weeks, I’ve...
06/18/2025
First Report Managed Care
Behind the Bill
How States Might Respond to the One Big Beautiful Bill Act
06/11/2025
Katie Hayes, MJ
With the One Big Beautiful Bill Act (OBBBA) still in the hands of the Senate, much of the national conversation has centered on what this legislation would do to federal coverage programs. But regardless of how the federal process unfolds,...
With the One Big Beautiful Bill Act (OBBBA) still in the hands of the Senate, much of the national conversation has centered on what this legislation would do to federal coverage programs. But regardless of how the federal process unfolds,...
With the One Big Beautiful Bill...
06/11/2025
First Report Managed Care
Behind the Bill
Is the Affordable Care Act on the Chopping Block? What the One Big Beautiful Bill Act Tells Us.
06/04/2025
Katie Hayes, MJ
It’s been weeks of headline-grabbing debate over Medicaid work requirements, and the “One Big Beautiful Bill Act” remains in the Senate as they deliberate over several health care provisions. While the Medicaid provisions sparked most of the...
It’s been weeks of headline-grabbing debate over Medicaid work requirements, and the “One Big Beautiful Bill Act” remains in the Senate as they deliberate over several health care provisions. While the Medicaid provisions sparked most of the...
It’s been weeks of...
06/04/2025
First Report Managed Care
Behind the Bill
From House to Senate: The Journey of Cutting Medicaid
05/28/2025
Katie Hayes, MJ
Last week, the House of Representatives narrowly passed the One Big Beautiful Bill Act (HR 1, 119th Congress) by a single vote, sending the sweeping tax and spending reconciliation package, backed by President Trump, to the Senate. With its...
Last week, the House of Representatives narrowly passed the One Big Beautiful Bill Act (HR 1, 119th Congress) by a single vote, sending the sweeping tax and spending reconciliation package, backed by President Trump, to the Senate. With its...
Last week, the House of...
05/28/2025
First Report Managed Care
Behind the Bill
Eligibility, Paperwork, and Penalties: The Not-So-Hidden Costs of Medicaid ‘Reform’
05/21/2025
Katie Hayes, MJ
It’s been another eventful week in health policy—a phrase that’s quickly becoming routine. This time, House Republicans advanced a sweeping budget reconciliation bill, designed to implement elements of the March budget resolution, with a...
It’s been another eventful week in health policy—a phrase that’s quickly becoming routine. This time, House Republicans advanced a sweeping budget reconciliation bill, designed to implement elements of the March budget resolution, with a...
It’s been another eventful week...
05/21/2025
First Report Managed Care
Behind the Bill
A Busy Week in Drug Pricing Policy: Aligning US Drug Prices With Global Standards?
05/14/2025
Katie Hayes, MJ
It’s been a busy few days for drug pricing policy. While I’d love to dig into the details of both President Trump’s latest executive order and the newest Republican bill that would cut Medicaid spending, we don’t have the time—and this isn’t...
It’s been a busy few days for drug pricing policy. While I’d love to dig into the details of both President Trump’s latest executive order and the newest Republican bill that would cut Medicaid spending, we don’t have the time—and this isn’t...
It’s been a busy few days for...
05/14/2025
First Report Managed Care
BEHIND THE BILL
When Agencies Lose Power: How 3 Seismic Shifts are Transforming Pharmaceutical Regulation
05/07/2025
Katie Hayes, MJ
In the span of just 9 months, the landscape of administrative law has undergone a transformation so profound that pharmaceutical executives, health care providers, and patients alike are struggling to navigate the new terrain. The Supreme...
In the span of just 9 months, the landscape of administrative law has undergone a transformation so profound that pharmaceutical executives, health care providers, and patients alike are struggling to navigate the new terrain. The Supreme...
In the span of just 9 months,...
05/07/2025
First Report Managed Care
Behind the Bill
The Medicare Paradox, Part 3: Strategic Trade Doesn’t Have to be a Zero-Sum Game
05/07/2025
Katie Hayes, MJ
Over the past 2 weeks, I’ve examined the growing friction between the Section 232 pharmaceutical tariff investigations and the Medicare drug pricing reforms authorized by the Inflation Reduction Act (IRA). These 2 policy agendas—industrial...
Over the past 2 weeks, I’ve examined the growing friction between the Section 232 pharmaceutical tariff investigations and the Medicare drug pricing reforms authorized by the Inflation Reduction Act (IRA). These 2 policy agendas—industrial...
Over the past 2 weeks, I’ve...
05/07/2025
First Report Managed Care

Trending Articles

News
FTC and HHS Launch Joint Inquiry into Generic Drug Shortages: Seeking Public Input on GPOs and Wholesalers
02/16/2024
Danielle Sposato
In a news release published on February 14, 2024, the US Department of Health and Human Services (HHS) issued a "Request for Information" in collaboration with the Federal Trade Commission (FTC). This request aims to gain insight into how...
In a news release published on February 14, 2024, the US Department of Health and Human Services (HHS) issued a "Request for Information" in collaboration with the Federal Trade Commission (FTC). This request aims to gain insight into how...
In a news release published on...
02/16/2024
First Report Managed Care
Julie Schulz headshot
Commentary
How Lab Values Can Close the Gap Between Patients With Undiagnosed and Under-Staged Chronic Kidney Disease
03/27/2024

By Julie Schulz, MD, MPH

By Julie Schulz, MD, MPH
Chronic kidney disease (CKD) is an insidious condition with devastating consequences when detected and treated too late. While primary care physicians usually make the initial diagnosis, regular screening is not routine for the general...
Chronic kidney disease (CKD) is an insidious condition with devastating consequences when detected and treated too late. While primary care physicians usually make the initial diagnosis, regular screening is not routine for the general...
Chronic kidney disease (CKD) is...
03/27/2024
First Report Managed Care
News
Neurologist Recognized for Pioneering MS Research and Treatment Strategies
04/24/2024
Hannah Musick
Dr Rhonda Voskuhl received the 2024 John Dystel prize for her groundbreaking research on sex differences in multiple sclerosis (MS), advancing women's health.
Dr Rhonda Voskuhl received the 2024 John Dystel prize for her groundbreaking research on sex differences in multiple sclerosis (MS), advancing women's health.
Dr Rhonda Voskuhl received the...
04/24/2024
First Report Managed Care
Melissa Andel, Principal, CommonHealth Solutions, LLC
Videos
Navigating the Impact of the Inflation Reduction Act: Implications for Payers, Patients, and Manufacturers
05/24/2024
Learn about the impacts of the Inflation Reduction Act on payers and patients, highlighting the changes in Medicare benefits and drug coverage coming in 2025 and 2026.
Learn about the impacts of the Inflation Reduction Act on payers and patients, highlighting the changes in Medicare benefits and drug coverage coming in 2025 and 2026.
Learn about the impacts of the...
05/24/2024
First Report Managed Care
News
Challenges and Progress in Understanding and Combating Respiratory Syncytial Virus Infection
07/02/2024
Hannah Musick
While challenges such as vaccine safety, immunogenicity, and durability remain, ongoing research and clinical trials show promise for the development of effective RSV vaccines in the near future according to research compiled in the Official...
While challenges such as vaccine safety, immunogenicity, and durability remain, ongoing research and clinical trials show promise for the development of effective RSV vaccines in the near future according to research compiled in the Official...
While challenges such as vaccine...
07/02/2024
First Report Managed Care

April 2016 Volume 13 Issue 4

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