These states may add weightloss drugs to their Medicaid program
Plus: Walgreens to close 8,000+ stores on Thanksgiving
Good morning and happy Friday. Welcome to this week’s edition of the Friday Pulse Check from Fulcrum Strategies.
In the news:
Priority Health flouts Michigan law requiring it to cover cancer drugs
In a ProPublica investigation published this week, it was revealed that Grand Rapids-based Priority Health refused to cover a cancer treatment for a particular patient. Because of its refusal that patient died this year. How much would it have cost if Priority Health passed it on to its members? Calculations show it could have raised premiums by 9 cents per member. It is a heartbreaking story and one that will likely be told again and again. Read more in ProPublica.
Five states considering adding weight loss drugs to Medicaid coverage
A new Kaiser Family Foundation survey of Medicaid state directors found that Illinois, Massachusetts, New Mexico, Utah, and Vermont are considering adding weight loss drugs to their respective Medicaid programs. It is not immediately clear if that means they will cover newer GLP1 drugs such as Wegovy and Zepbound. Currently, sixteen states cover weight loss drugs such as the older (and less expensive) Orlistat. Will Medicare cover it? Not anytime soon; federal law prohibits Medicare from covering weight loss drugs. Read more from the Kaiser Family Foundation.
LIVE drug manufacturer stock prices:
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Walgreens to close many stores on Thanksgiving
Pharmacy retail giant Walgreens announced that they will close more than 8,000 locations for Thanksgiving day for the first time in the company’s history. This follows a walkout by disgruntled pharmacists on October 31st and November 1st at Walgreens, CVS, and RiteAid (though less than 2% of pharmacists from these companies participated). Walgreens will not be closing nearly 700 of its 24-hour locations so patients can still fill prescriptions there if need be.
LIVE pharmacy retail stock prices:
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CVS - CVS 0.00%↑
Other articles of interest:
LIVE UHC stock price: UNH 0.00%↑
Pharmacists say Biden’s PBM law is backfiring on independent pharmacies - CBS News
President Biden and President Xi agree to curb fentanyl production - Axios
California Watch: Patient who refused to be discharged for weeks being sued by hospital under “commercial blockade” law - The Los Angeles Times
HIPAA Violation of the Week: HHS settles first HIPAA violation involving ransomware - The National Law Review
The FLATLINING Podcast from Fulcrum Strategies
Ron and I have shared our skepticism of corporate medicine; that is the practice of large entities (such as hospitals or insurance companies) owning physician groups and medical practices.
It is so blatantly obvious that when your insurance company owns your doctor, there is a conflict of interest. Now, both sides can claim all they want that the doctor has the ability to independently practice medicine, but when his or her paycheck is dependent on the person who gets to decide if they are going to pay for the patient’s care, is it really possible to say that?
The American Medical Association debated this issue this week and that was the topic of our discussion on the FLATLINING Podcast. I encourage you to check it out and share it with a friend.
Subscribe to the FLATLINING Podcast on Apple Podcasts, Spotify, the iHeartRadio app, Amazon Music, Google Podcasts, Stitcher, Pandora, TuneIn, and Audible.
Have a good weekend and a happy Thanksgiving,
Matthew