January 12, 2025 — Last week we got another glimpse of incremental progress in coverage for obesity medicines in health insurance plans. CMS announced that Medicare drug plans (Part D or Medicare Advantage) could now cover Zepbound (tirzepatide) when doctors prescribe it to patients for obesity and sleep apnea. This is not the opening of floodgates. It is movement […]
January 9, 2025 — The docket is open for you to lend your support until January 27. The Center for Medicare and Medicaid Services (CMS) is proposing to open up access to obesity medicines in both of the programs they oversee. This is something that we – with virtually every advocate for obesity care – have been seeking for […]
December 13, 2024 — Some pharmacy benefit plans have taken a dark turn when it comes to obesity medicines. Let’s not sugarcoat it. They are exploiting people with obesity through abusive copays on drugs like Wegovy and Ozempic – two brands of semaglutide. These PBMs pretend they are covering part of the cost of the drug. But in fact, […]
December 10, 2024 — A pitched battle is underway. The fight is for equitable access to obesity medicines that can be life-changing for people living with obesity. Right now, we have a bit of a stalemate and money is the sticking point. So when Andrew Ross Sorkin put the question of greed, economics, and health to the CEO of […]
December 8, 2024 — A man was murdered this week in a manner of cold determination. As of this writing, we do not know why. But because he was the CEO of UnitedHealthcare – America’s largest health insurer – many people are interpreting this murder as an expression of rage and contempt for the health insurance industry. Some are […]
November 26, 2024 — Well, this is exciting. The news just flashed across our screen that the outgoing Biden administration is proposing to open up Medicare and Medicaid to coverage for obesity meds. Chiquita Brooks-LaSure, administrator of the Centers Medicare and Medicaid Services, said: “We don’t want to see people having to wait until they have these additional diseases […]
September 28, 2024 — Since forever, health systems have been closed to the need for obesity care. While obesity prevalence tripled, care providers, health plans, and even government policy doubled down on a simple response. “Your obesity is not our problem. It’s yours. Go away, eat less, move more, and come back when you’ve lost 25, 50, or 100 […]
June 28, 2024 — With a bipartisan a vote of 36-4 yesterday, the House Ways and Means Committee passed an amended version of TROA – the Treat and Reduce Obesity Act. Honestly, after a decade of toiling away to educate legislators about the need for this, we need a pinch to assure ourselves it’s real. This is great news […]
June 20, 2024 — It’s quite weird, actually, watching the contortions of health plans as they twist to resist the rising tide of obesity medicines. Because despite the twisting and contortions, obesity medicines are as difficult to resist as a rising tide. Those who pretend it is not happening find themselves under water. A new survey from the International […]
March 15, 2024 — Prior authorizations are a driving force in the burnout of physicians, denial of medical care, and the profitability of health insurance and pharmacy benefit plans. By one estimate, healthcare providers spend $35 billion every year on chasing down prior authorizations so that their patients can receive the care they need – whether that is a […]
