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Public Health and Policy

Opioids, drug competition named by FDA as top 2018 policy goals

Washington, D.C. — On Jan. 11, the U.S. Food and Drug Administration (FDA) released its list of top policy priorities for 2018.  On that list are plans to focus on reducing opioid misuse and promoting drug competition. 


The agency also said it wants to strengthen its scientific workforce and use nutrition to reduce the burden of disease in 2018.



Kentucky nodded as first Medicaid work-requirement state

Lexington, KY — In mid-January, Kentucky became the first U.S. state to get federal approval to impose work requirements as a condition for getting coverage by Medicaid, the federal healthcare program for the poor.


In the coming weeks, adult beneficiaries in Kentucky ages 19 to 64 will be required to complete 80 hours per month of community engagement activities, such as employment, education, job skills training, and community service to maintain their Medicaid eligibility.


In a Jan. 12 letter sent to Kentucky Gov. Matt Bevin, Medicaid director Brian Neale of the U.S. Centers for Medicare and Medicaid Services (CMS) wrote that “Your substantial work will help inform future state demonstrations seeking to draw on Kentucky’s novel approaches to Medicaid reform.”


Bevin originally submitted the waiver request to the CMS in August 2016.  Nine other states—Arizona, Arkansas, Indiana, Kansas, Maine, New Hampshire, North Carolina, Utah and Wisconsin—have also applied for the Section 1115 waivers.


However, a Health Affairs analysis found that 11 million Medicaid enrollees would be at risk of losing coverage if the work requirement spreads nationwide.



Feds Propose Expanding Small Business Health Plans

Washington, D.C. — On January 4th, the U.S. Dept. of Labor (DOL) released a proposed rule that would ease requirements for the formation of Small Business Health Plans, also known as Association Health Plans (AHPs).


The proposed rule would modify the definitions of “employer” and “employee” under the Employee Retirement Income Security Act (ERISA) to make it easier for multiple employers to form a single AHP and purchase coverage in the large group market.


The proposed rule includes protections against discrimination based on health status, medical condition, medical history, and disability—but would allow AHPs to vary premiums based on “non-health factors,” including age and principal location of business.



CDC drops the bomb to focus on flu

Atlanta, GA — A planning mid-January briefing at CDC headquarters on public-health response to a nuclear attack was and quietly replaced with a briefing on the ongoing robust flu season.


In an earlier announcement for the nuclear briefing, the CDC said nuclear detonation is unlikely but that if an event were to occur, professionals must understand how response efforts are unique.


But on Jan. 12, the CDC changed the event’s topic to severe influenza due to the spike in flu cases around the country.  (Hospital emergency rooms and doctor offices across the country have been swamped with cases of the flu—so get your flu shot!  It’s not too late.)  The session offered the latest information on how to reduce the spread of seasonal flu and how to adjust to spot shortages of antiviral drugs.



Biotech CEOs unfazed by Brexit

San Francisco, CA — Despite the uncertainty brought by the U.K.’s exit from the European Union, which include a relocation of the European Medicines Agency (EMA) from London to Amsterdam, biotech and pharma companies are mostly shrugging off the looming Brexit.


Leaders speaking at the J.P. Morgan Healthcare Conference, an industry roundtable held mid-January in San Francisco, all essentially chalked up the change to cost of doing business, and said that they’d be continuing doing business as usual.


The EMA’s headquarters relocation will displace nearly 900 regular staff at the agency.



A.M. Best: health insurance industry “stable”

Washington, D.C. — Ratings agency A.M. Best has revised its outlook for the health insurance industry from “negative” to “stable” for 2018.


The agency said the reason for the change is that health insurers have adapted to the pressures of the Affordable Care Act (ACA) and improved earnings and risk-adjusted capitalization levels, according to its new report, Market Segment Outlook: U.S. Health.


A.M. Best said multiple payer product lines remain profitable, including the employer-based market, Medicaid and Medicare Advantage.