Modern Healthcare - - LATE NEWS -

A pair of in­flu­en­tial sen­a­tors are seek­ing an­swers about the steep cost of the hepati­tis C drug So­valdi.

Sens. Ron Wy­den (D-Ore.), chair­man of the Fi­nance Com­mit­tee, and Chuck Grass­ley (R-Iowa), the rank­ing mi­nor­ity mem­ber of the Ju­di­ciary Com­mit­tee, sent a let­ter last week to the chair­man and CEO of So­valdi man­u­fac­turer Gilead Sci­ences with ques­tions about how the drug’s price was de­ter­mined. The sen­a­tors also are seek­ing de­tailed in­for­ma­tion about the com­pany’s Novem­ber 2011 pur­chase of Phar­mas­set, the orig­i­nal de­vel­oper of So­valdi.

By com­bin­ing forces, solo and small-group med­i­cal prac­tices helped gen­er­ate $237 mil­lion in sav­ings over three years in CareFirst’s Pa­tient-Cen­tered Med­i­cal Home Pro­gram,

the in­surer re­vealed last week. CareFirst, a Blue Cross and Blue Shield af­fil­i­ate cov­er­ing the District of Columbia, Mary­land and por­tions of north­ern Vir­ginia, re­leased find­ings demon­strat­ing how 4,000 providers par­tic­i­pat­ing in its med­i­cal home ini­tia­tive saved $130 mil­lion in 2013—the third year of the pro­gram—when health­care spend­ing came in 3.2% lower than pro­jected for the 1.1 mil­lion Blues plan mem­bers who re­ceive care at CareFirst pri­mary-care prac­tices op­er­at­ing as med­i­cal homes.

The CMS is quizzing a few states about whether tech­ni­cal woes are de­lay­ing Med­i­caid ac­cess for their res­i­dents, and if so, when and how states plan to fix the glitches.

The states in­volved have un­til Mon­day to re­spond to the query sent to them June 27. Most of the tar­geted states—Alaska, Kansas, Michi­gan, Mis­souri and Ten­nessee—are not op­er­at­ing health in­sur­ance ex­changes, or have a part­ner­ship agree­ment through which they rely on the federal Health­ mar­ket­place to screen ap­pli­cants for Med­i­caid el­i­gi­bil­ity and to trans­mit clear­ance for those it deems qual­i­fied for the pro­gram.

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