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Laura Joszt, Managing Editor at The American Journal of Managed Care. Welcome to This Week in Managed Care from the Managed Markets News Network

Surprise medical bills...patients receive after they’re transported by ambulance to a hospital — sometimes unconscious or in critical condition — that is out of their insurance company’s network. They’re also the bills patients receive when they land in an emergency room that contracts with their insurance company but are inadvertently treated by a doctor that doesn’t...Hospitals, physicians and insurance companies in Nevada have agreed that patients experiencing a true emergency shouldn’t have to worry about whether they’re receiving in-network care — or face bills totaling tens of thousands of dollars if they accidentally wind up out of network just because their provider and insurer don’t have a contract. Where there has historically been less agreement, though, is what to do about it...

U.S. Senator Bernie Sanders and Representative Elijah Cummings introduced legislation...aimed at lowering the cost of prescription drugs for American consumers...

- bill would peg U.S. prescription drug prices to the median price from five countries - Canada, Britain, France, Germany and Japan - where drug costs are typically far lower because of government price controls.

- also allow the U.S. Secretary for Health and Human Services to negotiate prices in Medicare Part D, a program that helps Medicare beneficiaries pay for self-administered medicines like those purchased at drugstores.

- end a ban that keeps Americans from buying medicines at lower prices from Canada and other countries.

Hours into his new job, California Governor Gavin Newsom signed an executive order...that could dramatically reshape the way prescription drugs are paid for and acquired...Newsom directed state officials to set up what he said would ultimately be the nation’s largest single-purchaser system for prescription drugs...It directed California’s massive Medicaid system to negotiate prescription drug prices for all of its 13 million recipients, changing their benefits from a managed-care or HMO approach to one that allows the state to handle all the purchases...The state would create a list of drugs to be purchased in bulk or targeted for price negotiations...The executive order also took the first steps to allow private companies and other governmental agencies to participate in the process of negotiating drug prices with pharmaceutical companies.

Nicole Grassano, PTNN, Pharmacy Week in Review, this weekly video program provides our readers with an in-depth review of the latest news, product approvals, FDA rulings and more.

A top U.S. lawmaker launched an investigation into pharmaceutical industry pricing practices on Monday, less than a week after he and fellow Democrats introduced legislation aimed at lowering medicine prices. Representative Elijah Cummings, who chairs the House Oversight Committee, sent letters to 12 drugmakers seeking information on price increases, investment in research and development, and corporate strategies to preserve market share and pricing power...Cummings’ letters focused on drugs that are the costliest to Medicare Part D, a program that helps beneficiaries of the federal health insurance program for the elderly and disabled pay for self-administered medicines like those purchased at drugstores, as well as drugs that have had the largest price increases over a five-year period.

Concern over China's territorial, military, and economic aggressiveness has been building over the past decade as the country is increasingly perceived as a threat to the United States, U.S. Asian allies, and the West. In China Rx: Exposing the Risks of America's Dependence on China for Medicine (Prometheus Books, 2018), authors Rosemary Gibson and Janardan Prasad Singh explore yet another peril: China as the largest global supplier of ingredients for many prescription drugs, over-the-counter products, and vitamins...China Rx is an important wake-up call for American citizens and government officials about the danger of our dependency on a hostile superpower and the need to safeguard our drug supply, American jobs, and industries and national security.

The Louisiana Department of Health is seeking a drug manufacturing partner for unrestricted access to curative hepatitis C treatments for Medicaid and incarcerated patients. Rather than pay the partner by prescription, the state would agree to pay a subscription fee similar to the Netflix model of paying a fixed monthly cost rather than paying per movie... The state said the plan is an attempt to help end the hep C epidemic in Louisiana. At least 39,000 people in the state's Medicaid program or in its prisons have the disease... fewer than 3% of Medicaid patients in Louisiana with hep C were treated last year. State officials blamed the lack of treatment on high drug prices.

Laura Joszt, Managing Editor at The American Journal of Managed Care. Welcome to This Week in Managed Care from the Managed Markets News Network

Nicole Grassano, PTNN, Pharmacy Week in Review, this weekly video program provides our readers with an in-depth review of the latest news, product approvals, FDA rulings and more.