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In a first, Colorado gets CMS approval to make gender-affirming care an essential health benefit

All individual and small group health plans in Colorado’s Affordable Care Act marketplace must cover a wide range of gender-affirming services, including breast/chest construction and reductions and laser hair removal, starting Jan. 1, 2023.

Mount Sinai, Empire BlueCross BlueShield to extend access to home-based care models

Empire members will gain access to three Mount Sinai Health System care models, which enable patients to opt for in-home care when medically appropriate. The agreement also includes a plan to improve bi-directional data exchange between the provider and payer.

NHS fast tracks access to Amgen’s just-approved KRAS cancer drug

Amgen’s first-in-class KRAS inhibitor Lumykras has been approved in Great Britain and arrives already armed with an agreement to allow early access while its cost-effectiveness is appraised by NICE. The MHRA has approved Lumykras (sotorasib) for patients with previously treated locally advanced or metastatic non-small cell lung cancer (NSCLC) with the KRAS G12C mutation, and …

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Should hospitals pay for housing for ED frequent flyers?

That is one approach being explored in Philadelphia according to an article in Kaiser Health News. Using funding from Temple University, two Pennsylvania Medicaid health plans, and some grant funding, the Template University Health System: …launched a two-year program last year to help 25 homeless Medicaid patients who frequently use its emergency room and other …

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Study: Poor care access, higher costs more likely with private than public insurance

People with private insurance report poorer access to care, higher costs and lower satisfaction as compared to those with public insurance plans, a new study shows. As the debate over health insurance reform continues, policymakers should consider efforts that expand Medicare and increase protections for those with private insurance.

Healthcare bills to pay? Let hi.health pick up the tab

Just over a year ago, hi.health launched an app that takes the legwork out of submitting reimbursement claims to private health insurers. Now, the startup has taken another leap forward, settling users bills immediately.  Fredrik Debong The addition to the hi.health app acts as a digital health expense account, according to the company’s co-founder and …

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Beyond Reference Management: How Literature Management is a Win for the Life Science Organization

Scientific literature is a critical component to virtually all aspects of a life science enterprise, including Medical Affairs, Pharmacovigilance and R&D. However, the process of curating and sharing literature can lead to significant challenges in organizing content, facilitating collaboration and enforcing copyright compliance. In many cases, reference management tools (e.g. EndNote, Zotero) are used to …

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Getting the 340B program back on track in 2021

As our nation continues to fight a global pandemic, the need for access to affordable and quality health care feels even more pressing. This is especially true for vulnerable patients who have been disproportionately impacted by COVID-19. That’s why it has never been more important for policymakers to ensure federal programs, like the 340B program, …

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Why hospitals want CMS, FTC to examine two UnitedHealthcare policies

Two UnitedHealthcare policies have raised several concerns among providers, including that they may display anti-competitive behavior and could block patient access to certain healthcare services. The American Hospital Association is asking the FTC and CMS to review and potentially block these policies.

Patients report unmet care needs despite rising telehealth use

Roughly a third of adults had a telehealth visit in the first 6 months of the pandemic, according to a new survey conducted by the Urban Institute. But not everyone who wanted a telehealth visit was able to access it, leaving some adults with unmet care needs.

After NICE okay, Scots denied access to Vifor’s Veltassa

The Scottish Medicines Consortium (SMC) has ruled that there’s not enough evidence to support NHS funding of Vifor Pharma’s Veltassa for excess potassium in the blood (hyperkalaemia), even though patients in England can access the drug. It’s the second time that the SMC has rejected Veltassa (patiromer), having previously turned it down for hyperkalaemia in …

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Alvotech and Cipla Collaborate to Ensure Access to Biosimilars in South Africa

Shots: Alvotech and Cipla entered an exclusive partnership to provide patients with better access to high quality and cost-effective biosimilar medicines in South Africa Alvotech will be responsible for the development and supply of the products and Cipla will be responsible for the registration and commercialization The biosimilar portfolio will include five biosimilars- two for …

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Growth in innovative, value-based contracts holds promise for the health system and for patients

The extraordinary financial pressure COVID-19 is creating for the U.S. economy underscores the need for a renewed push toward a more value-driven health care system that prioritizes patient access and affordability. Now more than ever, we need to make sure we’re spending our health resources wisely. That’s why it’s heartening to see the number of …

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Anger at US deal for Moderna’s ‘taxpayer-funded’ COVID-19 vaccine

The US government has signed another big coronavirus vaccine supply deal, snapping up 100 million doses of Moderna’s mRNA jab for a little over $1.5 billion –around $15 per dose or $30 per course. That’s a steep discount on the $32 to $37 price per dose in its earlier smaller deals, revealing that purchasing power …

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UK places order for 60m doses of Sanofi/GSK’s COVID-19 vaccine

The UK government has signed its fourth coronavirus vaccine deal, snapping up 60 million doses of an experimental shot being developed by Sanofi and GlaxoSmithKline. The order has come in even before the vaccine has started clinical development, with a phase 1/2 trial not due to get underway until September. Sanofi is providing the vaccine …

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US places $1.95 billion order for Pfizer/BioNTech’s COVID-19 vaccine

The US government has agreed to pay Pfizer and BioNTech $1.95 billion to secure access to 100 million doses of their coronavirus vaccine on approval, just days after promising results in a clinical trial. The deal – part of the Trump administration’s Operation Warp Speed that aims to deliver 300 million coronavirus vaccines in early …

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