Trump, Biden trade shots over struggling finances of Social Security and Medicare

By Austin Denean - Both presidential candidates accused each other of running Social Security and Medicare into the ground at their debate in Atlanta Thursday night as both popular entitlement programs are facing serious budget shortfalls in the next decade that could result in stiff benefits cuts without congressional intervention. Read Full Article…

HVBA Article Summary

1. Long-Term Financial Challenges of Social Security and Medicare: Over the next decade, the long-term finances of Social Security and Medicare are a significant concern for Washington. Without Congressional intervention, these programs are headed towards automatic benefit cuts, making them a focal point in ongoing budget battles on Capitol Hill. Both programs face insolvency within the next 15 years, with Medicare's hospital insurance trust fund projected to deplete by 2036 and Social Security reserves by 2035.

2. Impact on Seniors and Retirees: Ensuring access to Social Security and Medicare is crucial for millions of seniors and retirees, making it a vital issue in political debates. During a recent debate, Trump and Biden accused each other of threatening these programs. Biden emphasized raising taxes on the wealthy to make the programs solvent, while Trump criticized Biden for allegedly expanding benefits to undocumented immigrants. Both candidates have promised to protect these benefits, but clear and effective plans are lacking.

3. Political Stalemate and Unpopular Remedies: Despite the known fiscal crisis, Congress has struggled to formulate a solution due to partisan politics and the unpopularity of potential remedies, such as raising the retirement age, cutting benefits, or increasing taxes. Seniors, who are highly likely to vote, rely heavily on these benefits, complicating lawmakers' efforts to enact necessary changes. An analysis by the Committee for a Responsible Federal Budget highlights that inaction could lead to substantial benefit cuts, worsening the financial stability of newly retired Americans.

Pressed on addiction, Trump and Biden talk border security but don’t mention treatment

By Lev Facher - President Biden and former President Trump were each given the chance on Thursday to speak to a kitchen-table issue plaguing the nation: the addiction and drug overdose epidemic claiming over 110,000 American lives each year. Read Full Article…

HVBA Article Summary

1. Avoidance of Treatment Discussion: During the first debate of the 2024 presidential campaign, both President Biden and former President Trump avoided directly addressing the issue of addiction treatment, instead focusing on border security measures such as drug sniffing dogs and fentanyl-detection machines.

2. Misleading Statements and Blame Shifting: Trump attributed the rise in drug deaths during his tenure to the Covid-19 pandemic, despite data from the CDC indicating that overdose deaths were already increasing before the pandemic. He emphasized border security improvements made during his administration, while Biden blamed Trump for blocking legislation that would fund fentanyl-detection equipment.

3. Biden's Unmentioned Policy Achievements: While Biden highlighted the need for fentanyl-detection machines, he did not mention his administration's significant efforts in harm reduction and expanding access to addiction treatment medications. These efforts include eliminating the “X-waiver” for buprenorphine prescribers and introducing more flexible regulations for methadone clinics.

Walgreens Plans Major U.S. Store Closures; Shares Tumble

By Anna Wilde Mathews and Joseph Walker - Walgreens Boots Alliance Chief Executive Tim Wentworth is taking the struggling chain in a new direction, planning to close a substantial number of poorly performing stores and pulling back on the company’s plunge into the primary-care business. Read Full Article…

HVBA Article Summary

1. Stock Decline and Strategic Changes: Walgreens' stock plummeted by 22.16% to $12.19, marking its largest percentage decline on record, following disappointing quarterly earnings and lowered full-year guidance. CEO Tim Wentworth announced plans to close a significant number of the company's 8,600 U.S. stores, focusing on those that are unprofitable or located close to one another, as part of a broader strategy to streamline operations and address financial challenges in the core pharmacy business.

2. Divestment and Focus on Core Business: Walgreens will reduce its stake in the primary-care provider VillageMD, moving away from being a majority owner. This shift marks a departure from previous strategies under former CEOs Rosalind Brewer and Stefano Pessina, who had aimed to expand Walgreens' role in healthcare services. Wentworth emphasized that while Walgreens will retain some units like Boots and Shields Health Solutions, the company will not pursue majority investments in primary and specialty care providers, focusing instead on retail pharmacy and customer experience.

3. Operational Adjustments and Future Outlook: In response to ongoing financial pressures, including reduced revenue growth from prescription drugs and increased reimbursement pressures from pharmacy-benefit managers, Walgreens plans to reassess its store footprint and improve operational efficiency. The company is also dealing with losses from high-price drugs and competition from telehealth and online pharmacies. Despite these challenges, Walgreens aims to reassign staff from closed stores and enhance its focus on women's health and loyalty programs.

Will the real Ozempic please stand up? Lilly, Novo face uphill counterfeit battle

By Amy Baxter - In the booming weight loss drug market, counterfeits and compound copycats have infiltrated the U.S. medical supply chain — and drugmakers aren’t happy about it. Read Full Article…

HVBA Article Summary

1. Counterfeit and Compounded Medication Concerns: Novo Nordisk and Eli Lilly have issued warnings about counterfeit versions of their weight loss drugs, semaglutide and tirzepatide, respectively. The FDA also alerted about fake Ozempic, urging checks for specific lot numbers. Both companies face challenges with compounded versions of their drugs being sold at lower prices, raising safety and effectiveness concerns.

2. Extent and Impact of Counterfeit Medications: The problem of counterfeit medications is substantial and hard to quantify, with sales estimated between $200 billion and $431 billion annually. With the weight loss drug market potentially reaching $200 billion by 2030, counterfeit and compounded versions pose significant risks. Legal actions and increased production efforts by Novo Nordisk and Eli Lilly aim to address these issues and protect consumers.

3. Legal Actions and Market Responses: Eli Lilly and Novo Nordisk have initiated lawsuits against sellers of counterfeit and compounded medications, focusing on false advertising and trademark infringement. Lilly's lawsuits serve as a deterrent to others making false claims, while Novo Nordisk has succeeded in barring deceptive marketing practices in several cases. Both companies are investing heavily in ramping up production to meet demand and safeguard patients from the risks of counterfeit drugs.

House panel passes bills to expand Medicare obesity drug coverage, cancer screening

By Rachel Cohrs Zhang, John Wilkerson, and Lizzy Lawrence - A House committee overwhelmingly passed four bills on Thursday that would expand Medicare coverage of obesity drugs and cancer screening blood tests and place guardrails around Medicare’s discretion in covering drugs and devices approved by the Food and Drug Administration. Read Full Article…

HVBA Article Summary

1. Obesity Drug Coverage Legislation for Seniors: The House Ways & Means Committee passed legislation to offer limited Medicare coverage for weight loss drugs like Wegovy and Zepbound to adults 65 and older. This plan is more restrictive than previous proposals, primarily ensuring that seniors already on these medications do not lose coverage upon entering Medicare. Without this bill, seniors would face high out-of-pocket costs, potentially leading to higher future healthcare expenses for taxpayers. The bill passed with a strong bipartisan vote of 36-4, though key Democrats raised concerns about inequities in coverage.

2. Expansion of Medicare Cancer Screening Coverage: The committee also approved a bill to expand Medicare coverage for cancer screening tests, including Grail’s Galleri, which screens for multiple types of cancer. Although the bill received unanimous support, its high projected costs delayed the start date to 2028, with phased coverage based on age. Currently, these tests are not FDA-approved, and patients pay out-of-pocket. The bill aims to reduce future Medicare costs by implementing gradual coverage and setting a Medicare payment rate for these tests.

3. Medicare Coverage for Breakthrough Medical Devices: A new bill was passed to address the coverage gap for breakthrough medical devices, offering temporary Medicare coverage for devices approved by the FDA. The bill, passed with a 36-5 vote, grants CMS the authority to selectively provide coverage based on clinical trial data and allocates $10 million annually for this program. This measure seeks to expedite patient access to innovative treatments while maintaining safety standards, addressing concerns about the current limited scope of coverage for breakthrough devices.

Who's conducting layoffs in healthcare?

By Paige Haeffele - Grappling with rising practice costs, inflation and staffing shortages has created an increasingly competitive market for health systems, practices and ASCs. Dealing with these financial headwinds has forced some care sites to lay off staff. Read Full Article…

HVBA Article Summary

1. Significant Workforce Reductions Across Multiple Healthcare Entities: Several health systems, hospitals, and healthcare entities have announced substantial layoffs over the past two months, impacting thousands of employees. Key examples include Oregon Health & Science University laying off at least 500 employees and Cleveland-based University Hospitals reducing its leadership structure by more than 10% as part of over 300 layoffs.

2. Financial and Regulatory Challenges Driving Layoffs: The layoffs are primarily driven by financial challenges, regulatory compliance issues, and strategic restructuring efforts. For instance, Stanislaus Surgical Hospital in California laid off dozens of CRNAs due to non-compliance with Medicare conditions, and Union Springs, Ala.-based Bullock County Hospital plans to end psychiatric services and lay off 95 staff members as it transitions to a rural emergency hospital.

3. Diverse Impact Across Various Healthcare Sectors: The layoffs span various sectors within the healthcare industry, from hospitals and health systems to biotech companies and virtual care services. Notable cases include Biotech company Cue Health shutting down entirely and laying off all its employees, Walmart Health Virtual Care laying off 74 employees at its corporate headquarters, and Burlington, Mass.-based Tufts Medicine laying off 174 employees due to industry challenges.

SCOTUS to hear retired firefighter’s ADA claims

By Ryan Golden - The ADA defines “qualified individual” to mean a person who, with or without reasonable accommodation, can perform a job’s essential functions. Per the writ of certiorari, the 2nd and 3rd Circuits have taken the stance that former employees do not lose their ability to sue an employer for discriminatory practices that harm them when they no longer hold or seek their former position. Read Full Article…

HVBA Article Summary

1. Supreme Court Review: The U.S. Supreme Court has agreed to review the case of Stanley v. City of Sanford, where a retired firefighter argues that the Americans with Disabilities Act (ADA) allows former employees to sue for discrimination related to post-employment benefits earned while they were employed. This case could potentially resolve the split in circuit court decisions regarding the ADA's coverage of former employees.

2. Circuit Court Split: The 11th U.S. Circuit Court of Appeals ruled that the plaintiff lacked standing under the ADA, aligning with the 6th, 7th, and 9th Circuits. These circuits hold that former employees cannot sue under the ADA for discrimination regarding benefits earned during employment. This ruling contrasts with the 2nd and 3rd Circuits, which have held different interpretations, creating a significant legal conflict for the Supreme Court to address.

3. Arguments and Implications: The plaintiff argues that the ADA’s definition of a "qualified individual" should not restrict who can sue for discrimination regarding benefits. The City of Sanford contends that the plaintiff was not discriminated against based on her disability since non-disabled retirees with similar service received no benefits. The outcome of this case could have broad implications for how post-employment benefits and ADA protections are interpreted and applied nationwide.

Psychedelic-assisted therapy: ‘the beginning’ of a health benefits trend?

By Dawn Kawamoto - With employee mental health among employers’ top workforce concerns, some HR leaders are starting to seek solutions that are outside the box. Among the more nontraditional strategies employers are considering? Ketamine treatments and psychedelic-assisted therapy, which involves the supervised use of small doses of mushrooms, ecstasy or LSD. Read Full Article…

HVBA Article Summary

1. Increasing Employer Interest in Psychedelic-Assisted Therapy: Driven by the interest of their employees, a growing number of employers are incorporating coverage for psychedelic-assisted therapies into their health plans. This shift is aimed at addressing mental health conditions that have not improved with traditional treatments. According to a survey by benefits consultant NFP, 17% of U.S. employers had invested in such therapies for their employees last year.

2. Impact and Expansion of Ketamine Therapy: Enthea, a start-up providing mental health benefits, has become the first licensed provider offering ketamine-assisted therapy treatments to employers. Although ketamine is not classified as a psychedelic, it has shown potential in treating conditions like treatment-resistant depression, PTSD, and addiction. Over the past two years, Enthea’s customer base has expanded significantly, and they plan to include coverage for other psychedelic-assisted therapies in states where it is legal.

3. Challenges and Future Outlook: Despite growing interest, several challenges hinder the widespread adoption of psychedelic-assisted therapy by employers. These include societal perceptions shaped by past anti-drug campaigns and safety concerns following high-profile incidents. The future of this trend may hinge on upcoming FDA decisions, such as the potential approval of MDMA for PTSD treatment, which could significantly influence employer coverage decisions.

Arkansas files opioid epidemic lawsuit against PBMs Optum, Express Scripts

By Noah Tong - Arkansas Attorney General Tim Griffin revealed the state is filing a lawsuit against pharmacy benefit managers (PBMs) Optum and Express Scripts for their role in the state's ongoing opioid epidemic. Read Full Article…

HVBA Article Summary

1. Arkansas Attorney General Sues PBMs for Opioid Crisis Role: Arkansas Attorney General Tim Griffin announced a lawsuit against pharmacy benefit managers (PBMs) Optum and Express Scripts, accusing them of exacerbating the state's opioid epidemic. Griffin emphasized the PBMs' significant role in facilitating the crisis, alleging that they enabled the misuse, abuse, and over-prescription of opioids by placing them on lower tiers of their formularies and operating online retail pharmacies that contributed to widespread opioid distribution.

2. Allegations of Collusion and Profiteering: The lawsuit asserts that Optum and Express Scripts colluded with opioid manufacturers, such as Purdue Pharma, to remove utilization management measures, thereby increasing opioid availability. It claims that these PBMs prioritized profits over safety, using the revenue from opioid sales to expand into powerful, vertically-integrated entities. Optum, owned by UnitedHealth Group, and Express Scripts, owned by Cigna, reportedly made over $100 billion in annual revenue in recent years from such practices.

3. Broader Context and Impact of Opioid Lawsuits: This lawsuit is part of a larger national reckoning with the opioid crisis, which has seen numerous healthcare and pharmaceutical companies facing litigation and settlements. The Centers for Disease Control and Prevention reported that prescription opioid misuse cost the U.S. healthcare system almost $1.5 trillion in 2020. In Arkansas alone, opioid overdose deaths surged by 350% from 2000 to 2020. The lawsuit underscores the ongoing struggle to hold accountable those who contributed to the opioid epidemic and highlights the significant financial and human toll it has taken.

Medicare cutting price of 64 drugs that outpaced inflation

By Justin Sink - Some of America's seniors will see their out of pocket costs fall for more than five dozen drugs — including treatments for osteoporosis and cancer — as part of the White House's crackdown on rising pharmaceutical prices. Read Full Article…

HVBA Article Summary

1. Impact on Seniors and People with Disabilities: From July to September, seniors and those with disabilities who have met their annual deductible will benefit from lower coinsurance rates on 64 selected drugs, whose prices had increased beyond the rate of inflation. This initiative is part of an ongoing effort to curb rising drug prices using provisions from the Inflation Reduction Act.

2. Program Implementation and Savings Example: The White House announced that the savings program, aimed at addressing the rapid increase in drug prices, could save Medicare beneficiaries significant amounts annually. For instance, a person prescribed the cancer drug Padcev might save nearly $1,200 over a year. The announcement, highlighting the practical impact of these measures, will be made by Neera Tanden at an event hosted by the Center for American Progress.

3. Limitations and Future Goals: While the Inflation Reduction Act's price bargaining tools are projected to save taxpayers $237 billion over the next decade, their impact is limited to Medicare, covering about 20% of the population, and only certain drugs are eligible for bargaining. Despite these limitations, expanding the government's price negotiating powers remains a central part of President Biden's platform as he campaigns for reelection.