RealClearHealth Morning Scan -- 04/19/2016

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UnitedHealth Exit Would Hurt Some States
Zachary Tracer, Bloomberg
Although UnitedHealth Group Inc. hasn’t been a major seller of Affordable Care Act insurance plans, a further retreat from President Barack Obama’s health insurance reform program could pose problems for Obamacare users in some states.

Theranos Is Subject of Criminal Probe by U.S.
Weaver & Carreyrou, WSJ
Federal prosecutors have launched a criminal investigation into whether Theranos Inc. misled investors about the state of its technology and operations, according to people familiar with the matter. Walgreens Boots Alliance Inc. and the New York State Department of Health have received subpoenas in recent weeks seeking documents and testimony about representations made to them by the Palo Alto, Calif., blood-testing company, some of the people said.

Holmes to Unveil Theranos Data in August
Meghana Keshavan, MedCity
Right on the heels of today’s “Today” show interview — in which Theranos CEO Elizabeth Holmes said she’s “devastated” by the failures of her company — we have some bold news: Holmes plans on finally pulling back the veil on the company’s “nanotainers,” its Edison device and other proprietary research in August at the American Association for Clinical Chemistry‘s annual scientific meeting.

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Blue Cross and Blue Shield (BCBS) companies are committed to addressing the nation’s growing opioid crisis community by community, nationwide. Learn more about the BCBS commitment.

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CMS Drops Two-Midnight Rule's Payment Cuts
Virgil Dickson, Mod. HC
The CMS will not continue to impose an inpatient payment cut to hospitals under the two-midnight rule following ongoing industry criticism and a legal challenge. It will provide a onetime bump to hospitals to offset the cuts. The agency imposed the cut because it estimated the two midnight policy would increase Medicare spending by approximately $220 million due to an expected increase in inpatient admissions.

Customers Dumped From Covered California
Emily Bazar, California HL
Lynn Kersey has some advice for pregnant women who bought health insurance policies from Covered California and want to keep them: Don’t report your pregnancy to the agency. “It’s not a requirement … and it’s actually worse to do so,” said Kersey, executive director of Maternal and Child Health Access, an advocacy group based in Los Angeles County. Why? Two of Kersey’s clients with Covered California health plans recently were thrown into Medi-Cal — the state’s health program for low-income residents — without their consent or prior notice after they reported their pregnancies to the state’s health insurance exchange.

Medicaid Expansion Encourages Poor to Seek Care
Phil Galewitz, KHN
In states that expanded Medicaid under the Affordable Care Act, low-income adults were more likely to see a doctor, stay overnight in a hospital and receive their first diagnoses of diabetes and high cholesterol, according to a study published Monday. Yet researchers found no improvement in adults’ own assessments of their health, a conclusion echoed by similar studies, the authors wrote in the Annals of Internal Medicine.

Biosimilars More Costly for Some on Medicare
Ed Silverman, Pharmalot
The reason is that the law requires drug makers to provide 50 percent discounts for brand-name biologics when beneficiaries reach the so-called donut hole, or coverage gap in which there is a temporary limit on what Medicare Part D will pay for drugs. However, the law does not require companies to provide discounts for biosimilars, which are lower-cost and nearly identical versions.

States Seek to Regulate Air Ambulance Costs
Amy Beth Hanson, AP
The first time Jason Ebert needed an air ambulance, it saved his life. The second time, it nearly broke the bank. Both times, Montana doctors ordered Ebert flown 150 miles from Bozeman to Billings for treatment. But while insurance covered the first flight, the hospital called a for-profit service the second time, and Ebert got stuck with a more than $27,000 bill.

Rethinking How Doctors Treat Pain
Booker & De Melker, PBS NewsHour
Pain is the most common reason that people go to the doctor. Yet physicians and medical students have limited training in pain management and prescribing opioids. As the nation suffers from an opioid epidemic, people within the medical field are reexamining what doctors are taught about pain.

OxyContin Helped Spark an Epidemic
Richard Gunderman, Conversation
The sources of the opioid epidemic are complex, but one powerful motivator has been the pursuit of profit. Purdue Pharma, which calls itself a “pioneer in developing medications for reducing pain, a principal cause of human suffering,” is the producer of OxyContin, a timed-release formulation of oxycodone, an opioid pain reliever.

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Blue Cross and Blue Shield (BCBS) companies around the country are undertaking initiatives to help patients, families, health professionals and communities address the opioid epidemic. These programs are reducing the misuse of opioids while ensuring those who need access to pain medication can get it, when they need it. Learn more about the BCBS commitment to fight substance use disorder and help prevent opioid addiction.

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