Removal of prior authorization for certain mental health services signed into law
Gov. JB Pritzker signed off Tuesday on a plan that will remove prior authorization for outpatient and partial hospitalization for mental health services deemed medically necessary.
Legislative session focused on PBM reform, behavioral health coverage
Lawmakers approved sweeping changes to pharmacy benefit managers and removed prior authorization for some behavioral health services during the recently concluded spring session. Below is a roundup of some of the proposals that […]
Senate approves removal of prior authorization for certain behavioral health services
The Senate signed off Thursday evening on a plan to remove prior authorization for outpatient and partial hospitalization for behavioral health services deemed medically necessary.
Q&A: Talking Prior Authorization With Rep. Suzan DelBene
Although the Centers for Medicare & Medicaid Services (CMS) issued a final rule on prior authorization, there is more that can be done to ease clinician burdens in this area, according to Rep. Suzan DelBene (D-Wash.). DelBene sponsored the Improving Seniors’ Timely Access to Care Act, which would, among other provisions, require affected plans to […]
Asthma Attacks Decreased Among Black Patients During the Pandemic
Despite Black patients having the highest prevalence of asthma prior to the COVID-19 pandemic, decreasing trends in asthma attacks were observed for this population during the pandemic relative to white patients, according to findings from a national survey study. Asthma attack rates decreased from 29.3% in 2019 to 22.1% in 2022 among Black adults, with […]
FDA Relents, Approves Novel Antidepressant After Many Rejections
After multiple prior rejections, gepirone hydrochloride extended-release (ER; Exxua) gained FDA approval for the treatment of major depressive disorder (MDD) in adults, drugmaker Fabre-Kramer Pharmaceuticals announced. Gepirone ER is the first approved antidepressant that selectively targets the serotonin 1A receptor, which regulates mood and emotion. The drug was approved based on data from two 8-week […]
FDA Reviewers Have Concerns About Artificial Womb Trials in Humans
FDA staff raised concerns that need to be addressed prior to potential human tests of artificial womb technology (AWT), a device that simulates a womb for extremely premature infants, as detailed in briefing documents released ahead of a Pediatric Advisory Committee meeting next week. AWT devices are intended to treat extremely premature infants, who have […]
EphrinB2 Expression in Urothelial Cancer Tied to Checkpoint Inhibitor Activity
A prior analysis of data from The Cancer Genome Atlas (TCGA) demonstrated that high EphrinB2 gene expression was associated with poor survival in patients with muscle-invasive bladder cancer. At the American Society of Clinical Oncology (ASCO) annual meeting, researchers reported new findings showing that EphrinB2 expression in patients with metastatic urothelial carcinoma was linked with […]
One Paid Medical Malpractice Claim May Signal More to Come
Physicians who had a prior paid medical malpractice claim were three to four times more likely to have future claims, according to a retrospective case-control study, challenging the commonly held notion among physicians that medical malpractice claims are simply bad luck or random events. Among every physician licensed to practice in the U.S. at the […]
Medicare Advantage Plans Fielded 35 Million Prior Auth Requests in 2021
Over 35 million prior authorization requests were submitted to Medicare Advantage insurers in 2021, according to a new report from the Kaiser Family Foundation (KFF). Two million of these requests, or 6%, were fully or partly denied, according to Jeannie Fuglesten Biniek, PhD, associate director of the Program on Medicare Policy, and Nolan Sroczynski, MSPH, […]