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Trending: Senate Republicans Add Lapse Penalty to ACA Repeal, Statewide Prescription Monitoring Cuts Abuse, and More

Senate Republicans Add Coverage Lapse Penalty to ACA Repeal Bill

Senate Republicans announced some provisions to the newly released draft of the Better Care Reconciliation Act (BCRA), including a penalty for those who have a lapse in coverage.

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Illinois Medicaid Negotiations Fall Through, State Could be Forced to Pay Billions

Illinois currently owes $3.1 billion in unpaid Medicaid bills to managed care organizations. 

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Statewide Prescription Monitoring Cuts Opioid Abuse

A recent paper examined how programs that monitor physician prescribing and pharmacist dispensing are impacting the fight against opioid misuse.

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NJ Bill to Regulate Horizon’s Profits Could Force Government Shutdown

A bill proposed by New Jersey Governor Chris Christie, which would give the state control of Horizon Blue Cross Blue Shield’s profits, advanced out of committee this week.

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Behind the Bill

Behind the Bill
The Senate’s $3 Trillion Deal. Tax Relief Now, Medicaid Coverage Loss Later?
07/02/2025
Katie Hayes, MJ
The Senate has done it. After weeks of behind-the-scenes wrangling and last-minute amendments, lawmakers have passed a sprawling tax-and-spending megabill that makes good on a long-standing Republican goal: making the 2017 Trump tax cuts...
The Senate has done it. After weeks of behind-the-scenes wrangling and last-minute amendments, lawmakers have passed a sprawling tax-and-spending megabill that makes good on a long-standing Republican goal: making the 2017 Trump tax cuts...
The Senate has done it. After...
07/02/2025
First Report Managed Care
Behind the Bill
When a Cap Isn’t Just a Cap: How a Provider Tax Proposal Could Reshape Medicaid Financing
06/25/2025
Katie Hayes, MJ
In Washington, the most consequential policies are often buried in the fine print. One such detail in the Senate Finance Committee’s latest tax and spending proposal would gradually cap provider taxes—a core funding tool states use to pull in...
In Washington, the most consequential policies are often buried in the fine print. One such detail in the Senate Finance Committee’s latest tax and spending proposal would gradually cap provider taxes—a core funding tool states use to pull in...
In Washington, the most...
06/25/2025
First Report Managed Care
Behind the Bill
Rewriting the Safety Net? Inside the Senate’s Changes to Medicaid and the ACA
06/18/2025
Katie Hayes, MJ
Over the past few weeks, I’ve been following the progress of the One Big Beautiful Bill Act (OBBBA), which started in the House with sweeping tax reforms and some eye-catching health care proposals. Now, the Senate has released its (highly...
Over the past few weeks, I’ve been following the progress of the One Big Beautiful Bill Act (OBBBA), which started in the House with sweeping tax reforms and some eye-catching health care proposals. Now, the Senate has released its (highly...
Over the past few weeks, I’ve...
06/18/2025
First Report Managed Care
Behind the Bill
How States Might Respond to the One Big Beautiful Bill Act
06/11/2025
Katie Hayes, MJ
With the One Big Beautiful Bill Act (OBBBA) still in the hands of the Senate, much of the national conversation has centered on what this legislation would do to federal coverage programs. But regardless of how the federal process unfolds,...
With the One Big Beautiful Bill Act (OBBBA) still in the hands of the Senate, much of the national conversation has centered on what this legislation would do to federal coverage programs. But regardless of how the federal process unfolds,...
With the One Big Beautiful Bill...
06/11/2025
First Report Managed Care
Behind the Bill
Is the Affordable Care Act on the Chopping Block? What the One Big Beautiful Bill Act Tells Us.
06/04/2025
Katie Hayes, MJ
It’s been weeks of headline-grabbing debate over Medicaid work requirements, and the “One Big Beautiful Bill Act” remains in the Senate as they deliberate over several health care provisions. While the Medicaid provisions sparked most of the...
It’s been weeks of headline-grabbing debate over Medicaid work requirements, and the “One Big Beautiful Bill Act” remains in the Senate as they deliberate over several health care provisions. While the Medicaid provisions sparked most of the...
It’s been weeks of...
06/04/2025
First Report Managed Care
Behind the Bill
From House to Senate: The Journey of Cutting Medicaid
05/28/2025
Katie Hayes, MJ
Last week, the House of Representatives narrowly passed the One Big Beautiful Bill Act (HR 1, 119th Congress) by a single vote, sending the sweeping tax and spending reconciliation package, backed by President Trump, to the Senate. With its...
Last week, the House of Representatives narrowly passed the One Big Beautiful Bill Act (HR 1, 119th Congress) by a single vote, sending the sweeping tax and spending reconciliation package, backed by President Trump, to the Senate. With its...
Last week, the House of...
05/28/2025
First Report Managed Care
Behind the Bill
Eligibility, Paperwork, and Penalties: The Not-So-Hidden Costs of Medicaid ‘Reform’
05/21/2025
Katie Hayes, MJ
It’s been another eventful week in health policy—a phrase that’s quickly becoming routine. This time, House Republicans advanced a sweeping budget reconciliation bill, designed to implement elements of the March budget resolution, with a...
It’s been another eventful week in health policy—a phrase that’s quickly becoming routine. This time, House Republicans advanced a sweeping budget reconciliation bill, designed to implement elements of the March budget resolution, with a...
It’s been another eventful week...
05/21/2025
First Report Managed Care
Behind the Bill
A Busy Week in Drug Pricing Policy: Aligning US Drug Prices With Global Standards?
05/14/2025
Katie Hayes, MJ
It’s been a busy few days for drug pricing policy. While I’d love to dig into the details of both President Trump’s latest executive order and the newest Republican bill that would cut Medicaid spending, we don’t have the time—and this isn’t...
It’s been a busy few days for drug pricing policy. While I’d love to dig into the details of both President Trump’s latest executive order and the newest Republican bill that would cut Medicaid spending, we don’t have the time—and this isn’t...
It’s been a busy few days for...
05/14/2025
First Report Managed Care
BEHIND THE BILL
When Agencies Lose Power: How 3 Seismic Shifts are Transforming Pharmaceutical Regulation
05/07/2025
Katie Hayes, MJ
In the span of just 9 months, the landscape of administrative law has undergone a transformation so profound that pharmaceutical executives, health care providers, and patients alike are struggling to navigate the new terrain. The Supreme...
In the span of just 9 months, the landscape of administrative law has undergone a transformation so profound that pharmaceutical executives, health care providers, and patients alike are struggling to navigate the new terrain. The Supreme...
In the span of just 9 months,...
05/07/2025
First Report Managed Care
Behind the Bill
The Medicare Paradox, Part 3: Strategic Trade Doesn’t Have to be a Zero-Sum Game
05/07/2025
Katie Hayes, MJ
Over the past 2 weeks, I’ve examined the growing friction between the Section 232 pharmaceutical tariff investigations and the Medicare drug pricing reforms authorized by the Inflation Reduction Act (IRA). These 2 policy agendas—industrial...
Over the past 2 weeks, I’ve examined the growing friction between the Section 232 pharmaceutical tariff investigations and the Medicare drug pricing reforms authorized by the Inflation Reduction Act (IRA). These 2 policy agendas—industrial...
Over the past 2 weeks, I’ve...
05/07/2025
First Report Managed Care

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Trending Articles

News
Comparing the Effectiveness and Cost of DMTs vs Ozanimod for MS Patients
10/05/2023
Danielle Sposato
Findings showed that ozanimod had lower annual drug costs per person than many other DMTs, making it more cost-effective in terms of drug costs per relapse avoided.
Findings showed that ozanimod had lower annual drug costs per person than many other DMTs, making it more cost-effective in terms of drug costs per relapse avoided.
Findings showed that ozanimod...
10/05/2023
First Report Managed Care
News
Analyzing FDA Data on Just-in-Time Interventions, Digital Therapeutics
10/24/2023
Danielle Sposato
The systematic review suggests that the available information in FDA databases regarding the performance and effectiveness of digital medical devices used in JITIs is quite diverse and often lacks comprehensive details, such as product...
The systematic review suggests that the available information in FDA databases regarding the performance and effectiveness of digital medical devices used in JITIs is quite diverse and often lacks comprehensive details, such as product...
The systematic review suggests...
10/24/2023
First Report Managed Care
News
HexSDF and HexRK are Required for Clostridioides difficile Synthesis, Which Impacts Resistance to Daptomycin and Bacitracin
11/15/2023
Lisa Kuhns, PhD, MD
“C difficile is a major cause of hospital-acquired diarrhea and represents an urgent concern due to the prevalence of antibiotic resistance and the rate of recurrent infections,” wrote Anthony Pannullo, Department of Microbiology and...
“C difficile is a major cause of hospital-acquired diarrhea and represents an urgent concern due to the prevalence of antibiotic resistance and the rate of recurrent infections,” wrote Anthony Pannullo, Department of Microbiology and...
“C difficile is a major cause of...
11/15/2023
First Report Managed Care
David Zawrotny Headshot
Commentary
The Overlooked Responsibility: The Administrative Side of Family Caregiving
12/19/2023
David Zawrotny
David Zawrotny, Chief Service Officer at RetireeFirst, the premier Retiree Benefits Management provider, offers insights into enhancing the experience and outcomes for group plan sponsors and their retirees via industry-leading strategy,...
David Zawrotny, Chief Service Officer at RetireeFirst, the premier Retiree Benefits Management provider, offers insights into enhancing the experience and outcomes for group plan sponsors and their retirees via industry-leading strategy,...
David Zawrotny, Chief Service...
12/19/2023
First Report Managed Care
News
Impact of Brolucizumab on Choroidal Morphology in Neovascular AMD: Insights From a Comparative Study
02/07/2024
Lisa Kuhns, PhD, MD
Brolucizumab significantly impacts choroidal morphology in eyes affected by type 1 neovascular AMD, according to a study published in Scientific Reports.
Brolucizumab significantly impacts choroidal morphology in eyes affected by type 1 neovascular AMD, according to a study published in Scientific Reports.
Brolucizumab significantly...
02/07/2024
First Report Managed Care

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