AGP Executive Report
Last update: 6 hours agoMedicaid Crackdown: Ohio Gov. DeWine announced new fraud prevention steps, including a six-month provider moratorium for new home-health and hospice Medicaid enrollments and payment suspensions for high-risk providers. Medicaid Work Requirements: A new CMS interim final rule tightens “medical frailty” exemptions, raising fears that some seriously ill people could lose coverage and chemotherapy. Medicare Access Pressure: HHS Inspector General reports unusually high Medicare Advantage prior-authorization denials for rehab and long-term care, with big insurer-to-insurer swings. Medicare Finances: The Medicare trustees project the Hospital Insurance Trust Fund could run out in 2033, underscoring looming funding gaps. Pharma & Regulation: DOJ says UC Davis School of Medicine violated federal law by using race-linked “socioeconomic” proxies in admissions. Cancer Drug Move: AstraZeneca Pharma India can market Enhertu as a first-line option for HER2-positive metastatic breast cancer. Fraud & Safety: DHS says two men were convicted for a counterfeit pill scheme involving fentanyl. Research & Care: A Jersey couple pledged £1m to Southampton’s Institute for Medical Innovation, funding a Digital Collaboration Hub.
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