News Briefs

Donna White

Donna White

By Donna White, Principal Consultant and Owner of Legacy Consulting Services and Legacy Billing Solutions in Montgomery, Alabama.

The beginning of February has seen multiple news stories come across the wire. We did a round up of the top stories over the last week.

Senate Health Committee reviews proposal for provider dispensed generic drugs

This week Dr. Josh Umbehr, co-founder of Atlas MD, proposed before the Senate this week that by cutting out the middle man and allowing providers to not only prescribe, but dispense generic drugs would be cheaper, for the patient and for the provider.

This direct purchase model is already legal in 44 states. According to Umbehr, most doctors don’t know that they can do it. He told Modern Healthcare, “We’re looking for ways to lower health care costs, and 17% of healthcare costs are prescription drugs. The manufacturers say their list prices haven’t gone up much in the last two or three years. But prices to the consumer have.”

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Lower rates for mental health care can reduce patient access

Because many commercial and Medicare Advantage plans use a different type of fee schedule, mental health service reimbursement rates are lower. According to a study from the Health Care Cost Institute, average in-network rates were 13% – 14% less than traditional Medicare fee-for-service rates. This, in turn, can reduce patient’s access to mental health care treatment.

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Hepatitis C Cases on the rise, tied to reformulated OxyContin

From 2010 to 2015, Hepatitis C cases have been on the rise after declining in the 90’s. The number of cases has nearly tripled. According to a new study, this may be due to a response to the national opioid epidemic. OxyContin was reformulated in 2010 to be more abuse-deterrent, in other words, unable to crush or dissolve, to prevent inhaling or injection of the drug.

With OxyContin abuse reduced, it has left those addicted to the prescribed painkiller to turn to other opiates, namely heroin. With the increased injections of heroin, we see a rise in shared needles – leading to a large increase in Hepatitis C cases since 2010.

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