Content about Healthcare reform in the United States

As states grapple with tight budgets, rising Medicaid costs and the anticipated expansion of Medicaid following the Supreme Court’s decision to uphold the Patient Protection and Affordable Care Act, policy-makers should consider how community pharmacists can help reduce expenses. In addition, new evidence offers a fresh reminder of the perils of managed care in Medicaid and the need for proper oversight of managed care entities.

WASHINGTON — The Department of Health and Human Services on Wednesday announced partnerships with several pharmacies to help customers learn about new Medicare benefits available to them under the Patient Protection and Affordable Care Act.

These partnerships — with CVS Caremark, Sam's Club, Thrifty White, Walgreens and Walmart — will provide Medicare beneficiaries with a range of educational materials on newly available preventive services, as well as savings on prescription drug spending in the "doughnut hole" coverage gap.

NEW YORK — Beginning this month, South Carolina is allowing retail-based health clinics to enroll as providers in Medicaid, a move that will enable Medicaid patients to use clinics for wellness visits, preventive services and to treat acute ailments, according to a local news report.

According to The Post and Courier, South Carolina Medicaid director Tony Keck said the move is designed to expand access to care and keep those patients with basic health issues from using high-cost emergency departments.

WASHINGTON — As many as 47 million women will be gaining greater control over their health care and access to eight new prevention-related healthcare services without paying more out of their own pocket beginning Aug. 1, Health and Human Services secretary Kathleen Sebelius announced Tuesday.

“This law puts women and their doctors, not insurance companies or the government, in charge of healthcare decisions," Sebelius stated, citing regulations going into effect under the Patient Protection and Affordable Care Act.

ALEXANDRIA, Va. — The Centers for Medicare and Medicaid Services on Monday hosted a public meeting to entertain a controversial payment adjustment — called "inherent reasonableness" — in reimbursing for non-mail-order diabetes supplies.

WHAT IT MEANS AND WHY IT'S IMPORTANT — Pharmacy retailers have a relationship with the healthcare-reform law more complicated than most individuals and businesses.

(THE NEWS: "NRF praises House's decision to repeal ACA." For the full story click here)

WASHINGTON — The House of Representatives' vote to repeal the Patient Protection and Affordable Care Act has drawn praise from the National Retail Federation.

WHAT IT MEANS AND WHY IT'S IMPORTANT — The Supreme Court's decision last week to maintain the Patient Protection and Affordable Care Act doesn't mean much. Not really. Because without regard of who's paying for what services, more people will need more health care in 2014 than people need health care today.

WASHINGTON — While the Supreme Court on Thursday morning left the Patient Protection and Affordable Care Act mostly intact, the court did rule that Congress cannot withhold federal Medicaid spending from a state that does not expand its eligibility requirements under the act.

Under the Affordable Care Act, Medicaid was to be transformed into a program to meet the healthcare needs of the entire nonelderly population with income below 133% of the poverty level.

MENLO PARK, Calif. — Americans still are forgoing or delaying health care on account of the economy, according to the Kaiser Family Foundation, which recently released its May Health Tracking Poll.

One in four Americans reported they have had problems paying medical bills in the past year, and as many as 60% said they have cut corners to avoid healthcare costs.

WHAT IT MEANS AND WHY IT'S IMPORTANT — If it's good for the goose, then it's good for the gander. That's what was in a recent letter from the Ohio Department of Job and Family Services to the National Association of Community Pharmacists. In place of mandatory mail order and competitive bidding in covering diabetic test strips, Ohio Medicaid is opting to employ a manufacturer rebate model, where manufacturers exchange discounted pricing for a listing on Ohio's preferred drug list. Sound familiar?