What We’re Reading: Drug Prices May Lead to ACA Premium Increases; Dealing with Problem Doctors; Autism, Obesity and Other Co-Occurring Conditions
Even After Settling Claims, These Doctors Continue to Practice
A vascular doctor is still practicing after many years of investigations by regulators and disciplinary measures by medical boards in many states. A ProPublica report has found gaps in the system that protects patients from doctors who put them at risk. ProPublica investigated vascular medicine, an area ripe for fraud and misconduct related to Medicare billing. Additionally, federal investigators have found that some doctors continue to practice after complaints of performing unnecessary procedures or misconduct claims.
ACA Marketplace Insurers Say Rates to Rise Because of Inflation, Prescription Drugs
ACA Marketplace insurers are requesting a median premium increase of 6% for 2024, according to a new KFF analysis of the preliminary rate filings. Insurers cite price increases for medical care and prescription drugs as a key driver of premium growth in 2024, according to KFF’s examination of publicly available documents from 58 insurers.
Mental Health Issues and Obesity Rise as Children with Autism Age
The prevalence of sleep disorders, mental health issues and obesity/cholesterol increase as children with autism become adults, according an article in Spectrum. Practitioners say, and a recent study has found, that those with autism have a higher prevalence of most medical conditions, including seizures, obesity and diabetes, gastrointestinal and sleep disorders, as well as mental issue issues.
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PBM-Offered Genomics Testing Could Reshape Prescribing of Medications
August 2nd 2025Two PBMs, True Rx Health Strategies and Capital Rx, are using pharmacogenomics — how a person’s DNA affects their response to medications — to reduce the trial-and-error of prescribing medications, saving employers and patients time and money.
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FDA Extends Review of Blenrep Combinations in Multiple Myeloma
August 2nd 2025Last week, an FDA advisory committee against the risk-benefit profile of Blenrep in combination with other therapies. Regulators and reviewers were concerned about the ocular side effects and dosing and tolerability. The new action date is Oct. 23, 2025.
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