News for Insurers
Top stories summarized by our editors
12/15/2017

HealthCare.gov enrollments were 17% higher this year compared with the same time period last year, according to data shared by HHS this week, and many of those signing up are new enrollees. Although the shortened enrollment window ending today means the total will likely come in well under last year's enrollment, observers have been surprised by this year's pace given reduced advertising and navigator support.

12/15/2017

AHIP and other stakeholders wrote a letter to state insurance commissioners arguing that an executive order signed in October that sought to relax Affordable Care Act rules and expand access to leaner health plans could further destabilize markets and raise premiums, particularly for those with pre-existing conditions. The groups encouraged states to reinstate duration limits on short-term plans if federal regulations ultimately allow longer coverage periods, and the letter called on regulators to protect consumers from other consequences of a change in standards.

More Summaries:
insurance commissioners, AHIP
12/15/2017

Republican leaders' effort to pass a $1.5 trillion compromise tax bill has been complicated by a declaration from Sen. Marco Rubio, R-Fla., that he will oppose the legislation unless the child tax credit for low-income families is expanded, while a number of other Republican senators said they are still undecided and two others have missed votes this week because of health issues. Rubio's possible defection threatens Republicans' slim majority on the tax plan, which targets the Affordable Care Act mandate that most Americans buy health insurance or face penalty.

12/15/2017

Employers making Utah Business' "Best Companies to Work For" list offer comprehensive health care benefits along with a wide range of wellness-related perks, such as catered meals, break rooms and massage chairs. These companies also focus on strong leadership, creating a good corporate culture, and offering opportunities for employee growth.

Full Story:
Utah Business
12/15/2017

The Biologics Price Competition and Innovation Act does not compel biosimilar-drug makers to provide a copy of marketing applications and related manufacturing information to reference product makers after the FDA accepts the application for review, according to a federal appeals court.

More Summaries:
FDA
12/15/2017

The House and Senate are unlikely to take swift action to reduce drug prices, comments by Reps. Greg Walden, R-Ore., and Michael Burgess, R-Texas, suggest.

More Summaries:
Greg Walden, Michael Burgess, Senate
12/15/2017

As lawmakers debate ways to bring down drug prices, the drug industry lobby brushed aside the notion that pay-for-delay, patent evergreening and other industry practices to protect profits contribute to the problem. "I don't think it's in the top 100 problems plaguing the health care system," said Pharmaceutical Research and Manufacturers of America CEO Stephen Ubl, later adding: "The system is fundamentally sound and is leading to greater competition."

12/15/2017

Pfizer will not immediately market Ixifi, a newly approved biosimilar version of Johnson & Johnson's Remicade, in the US, preferring instead to focus on its existing biosimilar, Inflectra, Pfizer spokesperson Thomas Biegi said.

Full Story:
Regulatory Focus
More Summaries:
Pfizer, Johnson & Johnson, Ixifi
12/15/2017

Mississippi-based Region 8 Mental Health Services, a community health center covering several counties in the state, reached a settlement deal worth over $6.93 million with the federal government resolving accusations that it violated the False Claims Act by submitting fraudulent claims from 2004 to 2010 for day treatment services that were not provided or were rendered by unqualified employees. The settlement is thought to be the biggest health care False Claims Act settlement in the state's history, according to the US attorney's office.

12/15/2017

DaVita Rx, a pharmacy chain based in Coppell, Texas, agreed to a nearly $64 million settlement deal to resolve allegations that it improperly billed federal health care programs for unprovided prescription drugs. Prosecutors said the payment also settles accusations that the company paid illegal kickbacks or offered unwarranted discounts to program beneficiaries.

More Summaries:
DaVita Rx