Drug Pricing Policy

Health Affairs Blog, August 14, 2018
by Rachel E. Sachs (Academic Fellow Alumna)

From the post:  Last Tuesday, the Centers for Medicare and Medicaid Services (CMS) took its latest action in the area of drug pricing. CMS gave Medicare Advantage (MA) plans the ability… Read More

The Trump admin has another pretty good, pretty modest plan to lower drug costs

Vox, August 13, 2018
by Dylan Scott, quoting Rachel E. Sachs (Academic Fellow Alumna)

From the article: “My concern is that once again, the administration’s rhetoric is out of step with its actual policy moves,” Sachs said. “The administration is promoting this move… Read More

States Question Costs Of Middlemen That Manage Medicaid Drug Benefits

NPR, August 8, 2018
by Alison Kodjak

Several states are questioning the cost of using pharmacy middlemen to manage their prescription drug programs in a movement that could shake up the complex system that manages how pharmaceuticals are… Read More

CMS’ plan to lower drug spending in Medicare Advantage

Politico Pulse, August 8, 2018
by Brianna Ehley, quoting Rachel E. Sachs (Academic Fellow Alumna)

From the article: Some viewed the step as a bit of a letdown, since HHS Secretary Alex Azar has been touting more sweeping changes to drug prices in Medicare Part B, like letting the private sector insurance… Read More

Here’s what’s behind the ads accusing Bob Hugin of ‘killing off cancer patients’

northjersey.com, August 7, 2018
by Herb Jackson, quoting Rachel E. Sachs (Academic Fellow Alumna)

From the article: "They're resorting to tactics the FDA criticized. Under the guise of patient safety, this is really about preserving a monopoly position," said law professor Rachel Sachs, who teaches at… Read More

Administering Health Innovation

Cardozo Law Review, Volume 39, Issue 6 (July 2018)
by Rachel E. Sachs (Academic Fellow Alumna)

From the article: Scholars and policymakers have recently begun to focus on the role federal agencies charged with health-related missions can play in the development of innovative health technologies… Read More

​CMS Proposes Plan To Pay Doctors The Same For Seeing Patients With A Cold Or Stage 4 Cancer

Kaiser Health News, July 23, 2018

KHN Morning Briefing: Summaries of health policy coverage from major news organizations CMS Administrator Seema Verma says the goal is to cut down on paperwork and free up physicians' time. But… Read More

HHS forced to choose migrants over medicines

Politico, July 18, 2018
by By Dan Diamond, quoting Rachel Sachs (Academic Fellow Alumna)

From the article: Echoing the pharma industry, Verma stressed that the state's request violated current law — the first time she's publicly cited a legal defense. “f you want to go… Read More

The Health 202: ‘ACA’ removed from swaths of Medicaid.gov website, watchdog reports

Washington Post, July 12, 2018
by By Colby Itkowitz, quoting Rachel Sachs (Academic Fellow Alumna)

From the article: As The Post’s Damian Paletta also noted, the announcement was an example of Trump’s successful use of the presidential bully pulpit. “This is not an industry… Read More

As Arkansas ushers in new Trump-era Medicaid rules, thousands fear losing benefits

Reuters, July 10, 2018
by By Yasmeen Abutaleb, quoting Allison K. Hoffman (Academic Fellow Alumna)

From the article: Days after the ruling, Kentucky Governor Matt Bevin cut dental and vision benefits for some 460,000 state Medicaid recipients, saying the benefits were dependent on implementation of… Read More

Health-Care Coverage Is Increasingly Determined by Where You Live

Wall Street Journal, July 18, 2018
by Stephanie Armour

This story is behind a paywall. Harvard affiliates can access the full story online via Hollis. [...] Across the country, the details vary but the story is the same. The Trump administration has been rolling… Read More

Investigation: Patients’ Drug Options Under Medicaid Heavily Influenced By Drugmakers

NPR, with the Center for Public Integrity, July 18, 2018
by Liz Essley White, Joe Yerardi, and Alison Kodjak

[...] Medicaid, which uses state and federal tax dollars to pay for health care for 76 million poor or disabled Americans, tries to ensure that patients get drugs that work the best and yet are also… Read More

7,000 people fail to meet Arkansas Medicaid work requirement

AP, July 13, 2018
by Andrew DeMillo

LITTLE ROCK, Ark. (AP) — More than 7,000 people on Arkansas’ Medicaid expansion didn’t meet a requirement that they report at least 80 hours of work in June and face the threat of losing… Read More

Insurers Fall Short In Catching And Reporting Medicaid Fraud, Inspectors Find

Kaiser Health News, July 12, 2018
by Chad Terhune

Despite receiving billions of dollars in taxpayer money, Medicaid insurers are lax in ferreting out fraud and neglect to tell states about unscrupulous medical providers, according to a federal report… Read More

GOP State Senators Sue To Stop Nebraska Voters From Deciding Medicaid Expansion

Forbes, July 10, 2018
by Bruce Japsen

Two Nebraska Republican legislators have filed a lawsuit in an attempt to stop voters in the state from putting a Medicaid expansion initiative on the November general election ballot, questioning… Read More

‘It’s Almost Like a Ghost Town.’ Most Nursing Homes Overstated Staffing for Years

New York Times, July 7, 2018
by Jordan Rau

ITHACA, N.Y. — Most nursing homes had fewer nurses and caretaking staff than they had reported to the government for years, according to new federal data, bolstering the long-held suspicions of many… Read More

When Health Insurance Prices Rose Last Year, Around a Million Americans Dropped Coverage

New York Times, July 3, 2018
by Margot Sanger-Katz

Last year, as insurance prices rose by an average of just over 20 percent around the country, people who qualified for Obamacare subsidies hung onto their insurance. But the increases appear to have been… Read More

Judge blocks Kentucky’s Medicaid work requirement

Politico, June 29, 2018
by Rachana Pradhan

A federal judge has blocked Kentucky from instituting the first-ever Medicaid work requirements, potentially dealing a major blow to the Trump administration's efforts to scale back the health care… Read More

Fearing Deportation, Immigrant Parents Are Opting Out Of Health Benefits For Kids

Kaiser Health News, June 25, 2018
by Ashley Lopez, KUT

The fear of family separation is nothing new for many immigrants already living in the U.S. In fact, that fear, heightened in recent weeks, has been forcing a tough decision for a while. Advocates say… Read More

‘Holy Cow’ Moment Changes How Montana’s State Health Plan Does Business

Kaiser Health News, June 20, 2018
by Julie Appleby

[...] Instead of starting with the hospital’s list price and negotiating down for discounts, the state began telling these facilities how much it was willing to pay — a “reference price”… Read More

As Medicaid Costs Soar, States Try A New Approach

Kaiser Health News, June 15, 2018
by Phil Galewitz

[...] state officials say Medicaid is busting Minnesota’s budget, particularly with patients like Dowland and its system of paying hospitals for each admission, ER visit and outpatient test.… Read More

Health Insurance’s Secondary Cost Problem

Harvard Law & Policy Review, Forthcoming
by Matthew J.B. Lawrence (Academic Fellow Alumnus)

From the abstract: This Article identifies a fundamental problem with health insurance and, so, contemporary American health care. While competition pushes health insurers to minimize the primary costs… Read More

Trump Wants Medicaid to Push for Lower Drug Prices – But Will Patients Be Hurt?

PEW, May 30, 2018
by Michael Ollove, quoting Rachel Sachs (Academic Fellow Alumna)

From the article: While 74 percent of closed formularies result in lower prices, 21 percent result in price increases, a 2016 report in the American Journal of Managed Care found. And 29… Read More

Judge Tells Maine It Must Implement Voter-Approved Medicaid Expansion…

Kaiser Health News, June 5, 2018

Judge Tells Maine It Must Implement Voter-Approved Medicaid Expansion That Governor Has Been Stonewalling HN Morning Briefing: Summaries of health policy coverage from major news organizations Maine… Read More

Another Cause Of Doctor Burnout

Kaiser Health News, May 31, 2018
by Jake Harper, WFYI

[...] There are an estimated 6,500 undocumented immigrants in the U.S. with end-stage kidney disease. Many of them can’t afford private insurance and are barred from Medicare or Medicaid. Treatment… Read More

After Years of Trying, Virginia Finally Will Expand Medicaid

New York Times, May 30, 2018
by Abby Goodnough

WASHINGTON — Virginia’s Republican-controlled Senate voted on Wednesday to open Medicaid to an additional 400,000 low-income adults next year, making it all but certain that the state will… Read More

Under Trump Proposal, Lawful Immigrants Might Be Inclined To Shun Health Benefits

Kaiser Health News, May 2018
by Christina Jewett and Melissa Bailey and Paula Andalo

The Trump administration is considering a policy change that might discourage immigrants who are seeking permanent residency from using government-supported health care, a scenario that is alarming some… Read More

The Ethics of Medicaid’s Work Requirements and Other Personal Responsibility Policies

JAMA, May 7, 2018
by Harald Schmidt and Allison K. Hoffman (Academic Fellow Alumna)

From the paper:  Breaking controversial new ground, the Centers for Medicare & Medicaid Services (CMS) recently invited states to consider establishing work requirements as a condition of receiving… Read More

Work Requirements Give Republicans Cover to Expand Medicaid

U.S. News, April 23, 2018
by Gabrielle Levy, quoting Allison K. Hoffman (Academic Fellow Alumna)

From the article: While the Medicaid law sets certain mandatory minimums of eligibility and coverage, the waiver program allows states wide latitude to run their programs as they see fit. For state Republican… Read More

House Democrat wants to know why a pharma insider is overseeing Trump’s drug pricing reform

Vox, April 9, 2018
by Dylan Scott, quoting Rachel Sachs (Academic Fellow Alumna)

From the article: House Democrats want to know why the Trump administration is letting a former pharmaceutical industry insider oversee its plans to fulfill President Donald Trump’s promises to bring… Read More

Politico Pulse April 6, 2018

Politico, April 6, 2018
by Dan Diamond, quoting Rachel Sachs (Academic Fellow Alumna)

From the article: In Health Affairs, Nick Bagley and Rachel Sachs ask why Massachusetts' proposal to ostensibly lower drug prices is getting a cold shoulder from the Trump administration. Read the… Read More

ICER Weekly View April 6, 2018

Institute For Clinical And Economic Review, April 6, 2018
by Mitchell Stein, quoting Rachel Sachs(Academic Fellow Alumna)

From the article: To the shock of patient advocates, MA wanted to institute a drug formulary for Medicaid. Reports this week indicate that CMS is poised to deny the waiver request. Law Professors Nicholas… Read More

Massachusetts Wants To Drive Down Medicaid Drug Costs: Why Is The Administration So Nervous?

Health Affairs, April 5, 2018
by Nicholas Bagley, and Rachel Sachs (Academic Fellow Alumna)

From the article: Although drug formularies are ubiquitous in Medicare and the private insurance market, they’re absent in Medicaid. By law, state Medicaid programs that offer prescription drug… Read More

Utah’s quixotic Medicaid expansion plan, explained

Vox, April 2, 2018
by Dylan Scott, quoting Rachel E. Sachs (Academic Fellow Alumna)

From the article: Utah wants to expand Medicaid under the Affordable Care Act. Kind of. The state legislature has passed and Gov. Gary Herbert has signed a bill that would partially expand… Read More

Communications Associate
Association for Community Affiliated Plans (ACAP)

Deadline: Open until filled.

POSITION SUMMARY                             The Association… Read More

Medicaid’s Best-Price Rule May Not Be Such a Big Problem

Physician's Weekly, October 23, 2017
by Physician's Weekly, quoting Rachel E. Sachs (Academic Fellow Alumna)

From the article: Rachel Sachs, J.D., M.P.H., from Washington University in St. Louis, and colleagues discussed Medicaid’s “best-price rule” and the extent to which it might frustrate… Read More

Axios Vitals post from October 4

Axios, October 4, 2017
by By Sam Baker, featuring work by Rachel E. Sachs (Academic Fellow Alumna)

From the post: Medicaid and value-based drug deals: New research casts some doubt on the pharmaceutical industry's claim that Medicaid's "best-price" rule inhibits its ability to create contracts… Read More

Academic Fellow Alum Matthew J. B. Lawrence Joins Faculty at Dickinson Law (Penn State)

Dickinson Law, Penn State University, August 1, 2017

Matthew J.B. Lawrence has joined the faculty of Penn State’s Dickinson Law as assistant professor of law. An expert in the fields of health law and administrative law, Lawrence will teach Health… Read More

From the Technical to the Personal: Teaching and Learning Health Insurance Regulation and Reform

Saint Louis University Law Journal, Vol. 61, no. 411
by Allison K. Hoffman (Academic Fellow Alumna), Whitney A. Brown, and Lindsay Cutler

From the article: In the Fall of 2016, I taught Health Law and Policy for the fourth consecutive semester. In this repeat loop, one thing has become increasingly clear: the aspect of this survey course… Read More

Analyst in Health Policy
Library of Congress

Deadline: June 15, 2017

General DescriptionThe Congressional Research Service (CRS) seeks two Analysts in Health Policy to join its Domestic Social Policy Division (DSP). Applicants should have experience conducting analysis… Read More

Louisiana proposes tapping a century-old patent law to cut hepatitis C drug prices

Kaiser Health News, May 2, 2017
by Sarah Jane Tribble, quoting Rachel E. Sachs (Academic Fellow Alumna)

From the article: Rachel Sachs, an associate professor of law at Washington University in St. Louis who attended the recent Johns Hopkins meeting, said she believes “the case is strong” in… Read More

Harnessing the U.S. Taxpayer to Fight Cancer and Make Profits

New York Times, December 19, 2016
by Matt Richtel and Andrew Pollack, quoting Rachel E. Sachs (Academic Fellow alumna)

From the article: Rachel Sachs, an associate law professor at Washington University in St. Louis and expert in innovation policy, said the government had every right to seek price concessions. She noted… Read More

Senate committee calls for ban on surgeons conducting simultaneous operations

Boston Globe, December 6, 2016
by Jonathan Salzman and Jenn Abelson

From the article: A powerful Senate committee wants all hospitals to explicitly ban surgeons from overseeing two simultaneous operations, weighing in on a controversy that has roiled Massachusetts General… Read More

Proposition 61 Gives California Mandate To Lower Drug Prices, Not Tools

KPBS Midday Edition, October 31, 2016
by Ben Bradford, quoting Rachel E. Sachs (Academic Fellow Alumna)

From the article: Proposition 61 would require Medi-Cal to get VA prices for about 3 million of its patients (it excludes other Medi-Cal patients, who are on managed care plans). Rachel Sachs, a law professor… Read More

Student Fellow Alumna Lauren Taylor on the American Health Care Paradox

Center for Bioethics, Harvard Medical School, October 27, 2016

Lauren A. Taylor, MPH, MDiv will discuss her book,  The American Health Care Paradox: Why Spending More is Getting Us Less. Commentator: John E. McDonough, DrPH, MPA, Professor… Read More

Contrived Threats v. Uncontrived Warnings

83 University of Chicago Law Review 503, 2016
by Einer Elhauge (Founding Faculty Director)

Abstract: Contractual duress, unconstitutional conditions, and blackmail have long been puzzling. The puzzle is why these doctrines sometimes condemn threatening lawful action to induce agreements… Read More

Prizing Insurance: Prescription Drug Insurance as Innovation Incentive,

Harvard Journal of Law and Technology, Vol. 30, No. 1 (forthcoming)
by Rachel E. Sachs

Abstract:  A problem perennially facing scholars of both intellectual property and health law is the need to incentivize appropriately the development of new pharmaceuticals. Although physicians have… Read More

Innovations in Health Law and Policy: Regulatory Challenges and Strategies for Change Conference

UNH School of Law, October 26, 2015
by W. Nicholson Price II (Academic Fellow Alumnus)

Innovations in Health Law and Policy: Regulatory Challenges and Strategies for Change When: Monday, October 26, 2015 Where: UNH School of Law 2 White Street Concord, New Hampshire Presented by the Health… Read More

How Prescription Drugs Get So Wildly Expensive

WIRED, September 23, 2015
by Nick Stockton, quoting Rachel E. Sachs (Academic Fellow)

From the article: [...] With all that in mind, here’s the important question: Is Shkreli an industry outlier, or was he just unlucky enough to be found out? “There’s one aspect… Read More

Practice Associate
Medicaid Accountable Care Organization Demonstration Project, Camden Coalition of Healthcare Providers

Deadline: December 01, 2014

OverviewThe Camden Coalition of Healthcare Providers is a 501c3 that is engaged in a three year Medicaid Accountable Care Organization Demonstration Project. Through the ACO, the Coalition is working to… Read More

Was the Medicaid Expansion Coercive?

Routledge, 2014
by I. Glenn Cohen (Petrie-Flom Faculty Co-Director)

In The Affordable Care Act Decision: Philosophical and Legal Implications, Fritz Allhoff and Mark Hall, eds. In this book chapter on the ACA decision, NFIB v. Sebelius, I focus on the Court's… Read More