Overnight Health Care — Sponsored by PCMA — Showdown in court over Medicaid overhaul | NIH shuts down controversial alcohol study | House on track to pass 50 more opioid bills next week

Sponsored by Pharmaceutical Care Management Association | View in Browser     Welcome to Overnight Health Care, sponsored by the Pharmaceutical Care Management Association.   We're so happy it's Friday (and that it’s Jazz in the Garden weather, too). On this summer afternoon, we look first at the lawsuit advocates in Kentucky have brought against the Trump administration over its approval of Medicaid work requirements and other changes to the program. The lawsuit is being argued in Washington, D.C. and Nathaniel brings us the view from the courtroom:   Attorneys for the Department of Health and Human Services, as well as for Kentucky Gov. Matt Bevin (R) argued Friday that a federal judge should rule against a group of Kentucky activists, and keep intact the state's Medicaid changes.   Kentucky was the first of four states to win approval for work requirements and other conservative changes, but the case has implications beyond Kentucky. Close to a dozen other states are looking to adopt their own work requirements. Kentucky and HHS tried a couple different arguments on Judge James Boasberg, an Obama appointee: The defendants said the activists have no legal standing to sue. The attorneys said Bevin's threat to end Medicaid expansion if the state loses means the plaintiffs can't prove they will be harmed by the work requirements. Essentially, they will lose Medicaid coverage no matter which way the court decides. They also argued that a decision against Kentucky would have a chilling effect on other states who are thinking about expanding Medicaid, but who will only do so if they can impose policies like work requirements, premiums, and coverage lockouts. Kentucky's waiver addresses dental coverage, vision coverage, and substance abuse treatment. If the work requirements are invalidated and Bevin ends the state's expansion, the state argued that coverage would also end. The plaintiffs, represented by the National Health Law Program, the Kentucky Equal Justice Center and the Southern Poverty Law Center, argued the state's waiver goes against the purpose of Medicaid. Medicaid is a health assistance program, they argued, and Kentucky's policies do not help people get coverage-- as many as 95,000 people would actually lose Medicaid if the waiver takes effect, according to the state's own estimates. Tipping his hand?  Boasberg didn't seem to favor one side or the other. He seemed to ignore the arguments about standing made by Kentucky. He got the attorneys to clarify that Bevin can't unilaterally end expansion -- he needs to submit an amendment to HHS. He also seemed skeptical of the plaintiffs request to invalidate the CMS guidance and letter to Medicaid directors that essentially gave permission for work requirements. Decision time: Kentucky's waiver is scheduled to take effect July 1. Boasberg said he will aim to have a decision by the end of the month.         SPONSORED CONTENT   Pharmaceutical Care Management Association Where PBM tools are used, a new report shows net spending – including the combined impact of drug prices, generic vs. brand drug use, and the overall number of prescriptions – declined by 2.1% last year. Spending increased in 2017 through channels not managed by PBMs. Learn how PBMs are part of the solution to reducing Rx costs at DrugBenefitSolutions.com.       The National Institutes of Health is officially shutting down a controversial study on the benefits of drinking following reports that agency officials solicited donations to fund it from the alcoholic beverage industry. "NIH has strong policies that detail the standards of conduct for NIH employees, including prohibiting the solicitation of gifts and promoting fairness in grant competitions. We take very seriously any violations of these standards," said NIH Director Francis Collins Friday. The NIH launched an investigation into the study following a New York Times story that revealed officials had vigorously campaigned for the alcohol industry to fund the study while suggesting that the results would endorse moderate drinking as healthy. Read more here.   Up next week: More opioid bills. The House is on track to pass more than 50 bills aimed at combating the opioid epidemic. So far, the House has passed 38 bills and will likely consider over a dozen more next week. The effort has largely been bipartisan (Democrats have only opposed three bills so far). But expect at least one bill next week to be contentious: It's a measure to lift limits on Medicaid paying for care at treatment facilities for opioid addiction. These limits are known as the IMD exclusion. Rep. Frank Pallone Jr. (D-N.J.), the top Democrat on the Energy and Commerce Committee, will oppose the bill next week, an aide said. Pallone objects that the bill does not do enough to encourage "the full continuum of care for people" rather than just overnight care at treatment facilities.     ICYMI THIS WEEK: Midterms: Democrats are seizing on the Trump administration's push in court to overturn ObamaCare's protections for people with pre-existing conditions. The hope: Leveraging the issue ahead of November's midterm elections. Republicans, though, are rushing to distance themselves from the Department of Justice's move. Read more here. ObamaCare premiums: Initial rate filings in some areas are showing an increase in premiums, some in the double digits. The American Academy of Actuaries said in a report released this week that increases in health-care costs and policy changes are driving the ObamaCare premium hikes. Read more here. More on opioids: Massachusetts and Kentucky both filed lawsuits related to the opioid epidemic. And the National Institutes of Health outlined its plan to spend the $500 million Congress gave it to tackle the crisis.         SPONSORED CONTENT   Pharmaceutical Care Management Association Pharmacy benefit managers (PBMs) have outlined several policy solutions to ensure patients receive opioid prescriptions when safe and medically appropriate. One important solution would be requiring e-prescribing of controlled substances in Medicare (S. 2460 / H.R. 3528, the Every Prescription Conveyed Securely Act). A study by the Opioid Safety Alliance finds this could save taxpayers $13 billion over 10 years.       What we're reading Ted Cruz thinks it's "reasonable" to argue ACA's preexisting conditions rules are now unconstitutional (Vox.com) Why the Justice Department's ObamaCare lawsuit intervention is absurd (The Federalist) Retiring CareFirst CEO Chet Burrell discusses the future of health care and insurance (The Baltimore Sun)   State by state Minnesota health insurers propose lower premiums (Star Tribune) As Medicaid costs soar, states try a new approach (Kaiser Health News) How Scott Walker's rejection of Medicaid expansion under Obamacare cost Wisconsin $1 billion (PolitiFact) Nursing supervisor in Texas pleads guilty in health care scheme that led to early deaths for hospice patients (Dallas Morning News)         Did a friend forward you this email? 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