More Employers Cover Transgender Surgery As Politics Shift

http://www.forbes.com/sites/brucejapsen/2016/05/17/as-transgender-politics-shift-more-employers-cover-gender-surgery/#41a97d433216

http://www.healthcaredive.com/news/transgender-surgery-increasingly-covered-by-us-employers/419361/

The nation’s employers are increasingly becoming more open to covering gender reassignment surgery for their workers as attitudes and public policies shift on transgender rights. Nearly one-third of large companies include gender confirmation surgery as part of employee health benefit packages.  Though it does vary by employer size and by region of the country, the trend is rapidly moving toward providing coverage, benefits consultants say.

US uninsured rate hits all-time low in 2015

http://www.healthcaredive.com/news/us-uninsured-rate-hits-all-time-low-in-2015/419381/

Of course, the uninsured rate only tells part of the story. Debate continues over whether coverage under the ACA has sufficiently equated to accessibility and affordability of care, and just how much premiums are likely to balloon in 2017.

Feuding HIEs Pit Cerner vs. Epic Loyalists in Missouri

http://www.healthleadersmedia.com/technology/feuding-hies-pit-cerner-vs-epic-loyalists-missouri?spMailingID=8939007&spUserID=MTMyMzQyMDQxMTkyS0&spJobID=921781487&spReportId=OTIxNzgxNDg3S0&page=0%2C1

Health Insurance Exchanges

Don’t panic about House v. Burwell.

Don’t panic about House v. Burwell.

US Court of Federal Claims

The Affordable Care Act obligates the federal government to reimburse health plans for cutting their low-income customers a break on their out-of-pocket payments. Whether or not there’s an appropriation for the cost-sharing reductions, that statutory obligation is enforceable in court—specifically, in the Court of Federal Claims.

Health plans that get stiffed can therefore sue the federal government for the cost-sharing reductions. Winning those cases should be easy: the plans will just have to show that they’re owed money under the ACA. And here’s the kicker: Congress has permanently appropriated the money to pay court judgments, even if it hasn’t appropriated money for the cost-sharing reductions.

The right question isn’t whether health plans will get paid. It’s when.

HOW FACTORY FARMS PLAY CHICKEN WITH ANTIBIOTICS

How Factory Farms Play Chicken With Antibiotics

And the inside story of one company confronting its role in creating dangerous superbugs.

This health-care trend could make your hospital stay $2,000 more expensive

https://www.washingtonpost.com/news/business/wp/2016/05/13/this-health-care-trend-could-make-your-hospital-stay-2000-more-expensive/?utm_campaign=CHL%3A+Daily+Edition&utm_source=hs_email&utm_medium=email&utm_content=29610264&_hsenc=p2ANqtz-975AWgcmTkkC2d1jCNh05FbqpW8RJ8NybR11FkpIp8h6PTB7PNX77koXW7JFLnHO7C4pDPSvipWVgB0i0OHkFpoibl0g&_hsmi=29610264

Federal Trade Commission chairwoman Edith Ramirez is concerned that consolidation in health care is driving up prices for consumers.

Are High Out-Of-Pocket Costs Forcing Patients To Settle For Substandard Care?

http://www.forbes.com/sites/peterubel/2016/05/13/are-high-out-of-pocket-costs-forcing-patients-to-settle-for-substandard-care/#1fe3b594713a

Rosemary Myers and her husband came to the oncology clinic with no major treatment decisions to make. Her breast cancer had metastasized to her brain many months ago, but after the metastasis was removed surgically, it had not shown signs of recurrence in any follow-up tests. So today’s visit wasn’t going to involve talking about chemotherapy or radiation; it wasn’t going to center upon end-of-life decision-making. Myers (a pseudonym) was here to see if her doctor could improve her quality of life. Eventually, that quality-of-life discussion would focus on the cost of Myers’ care.

Is High Prescription Drug Spending Becoming Our New Normal?

http://healthaffairs.org/blog/2016/05/17/is-high-prescription-drug-spending-becoming-our-new-normal/

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6 things to know about non-embedded deductibles

http://www.beckershospitalreview.com/payer-issues/6-things-to-know-about-non-embedded-deductibles.html

Embedded-Deductible_1

Non-embedded deductibles are not economical for some families. For some families, such as married couples without children, non-embedded deductible plans can cause families to spend thousands of dollars in extra out-of-pocket expenses that otherwise would have been covered had they purchased individual plans with lower deductibles or embedded family plans.

A government defeat in House v. Burwell

A government defeat in House v. Burwell

House vs Burwell

Having previously held that the House of Representatives has standing to sue, the district court in House v. Burwell has now held that the Obama administration is violating the Appropriations Clause in making cost-sharing payments under the ACA in the absence of the requisite congressional appropriation. The court has stayed its decision pending appeal, meaning that it won’t take immediate effect. Indeed, I suspect it will never take effect.