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Bill aims to fix glitch that penalizes rural ACOs even if they generate savings

New bipartisan legislation aims to address a "rural glitch" that can cause some rural ACOs to be penalized even if they generate savings. ....

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UnitedHealthcare delays controversial ER policy following backlash

Published June 10, 2021
Dive Brief:
UnitedHealthcare, the biggest private payer in the U.S., is delaying a controversial policy that could retroactively deny emergency room bills it deems non-emergent potentially saddling patients with costly medical bills following intense backlash from patient advocates and hospital groups.
Based on feedback from our provider partners and discussions with medical societies, we have decided to delay the implementation of our emergency department policy until at least the end of the national public health emergency period, UnitedHealthcare tweeted on Thursday.
UnitedHealthcare said it planned to use the time to educate consumers, customers and providers on the new policy and help ensure that people visit an appropriate site of service for non-emergency care needs. The payer has estimated the policy could lead to as many as one in every 10 claims being rejected. ....

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Novo keeps price in line with FDA approval of second obesity shot

Dive Brief:
The Food and Drug Administration on Friday approved Novo Nordisk s newest treatment for obesity, a weekly injection called Wegovy. The Danish company followed up Monday with an announcement that it will set the list price at $1,297 a month, equivalent to its daily obesity drug Saxenda.
Saxenda has been the most successful obesity drug launched in the past decade, earning sales of 5.6 billion Danish kroner, or about $918 million, in 2020. Wegovy is a similar drug to Saxenda, coming from class of drugs called glucagon-like peptide 1, or GLP-1, agonists, which are mainly used to control diabetes.
In diabetes, Novo s GLP-1s are likely to face new pressure soon from rival Eli Lilly, which has developed a weekly combination shot called tirzepatide that has outperformed Novo s weekly drug. Novo is developing a similar drug, but it hasn t completed early stage trials. ....

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