Latest news with #BCBS
Yahoo
16-04-2025
- Health
- Yahoo
Blue Cross Blue Shield now requires Oklahomans receive prior approval for severe asthma drugs
Starting today, Blue Cross Blue Shield will mandate that severe asthma patients self-administer their drugs at home, unless their provider gets prior approval from the insurance company. (Photo courtesy of Dr. Priya Bansal) Patients in five states who have severe asthma and are covered by Blue Cross Blue Shield are facing a new obstacle to getting treatment. On Tuesday, BCBS began mandating that severe asthma patients self-administer their drugs at home, unless their provider gets prior approval from the insurance company. The patients affected are those covered in Illinois, Texas, Oklahoma, New Mexico, and Montana, but not those with Medicare or Medicaid, the insurance giant says. Given as injections, the treatments in question are Fasenra (benralizumab), Tezspire (tezepelumab), Nucala (mepolizumab) and Xolair (omalizumab). All belong to a class of drugs known as biologics. The decision is expected to affect thousands of patients. It's estimated that between 5% and 10% of asthma patients have severe asthma, characterized by more flare-ups and hospitalizations. In Illinois, for example, about 860,000 patients have asthma, according to the federal Centers for Disease Control and Prevention. That means between 43,000 and 86,000 of them have severe asthma. Clinics already have loads of prior authorizations to process that often delay care, said Dr. Priya Bansal, a pediatrician and asthma and allergy physician in Illinois. Her practice sees many rural patients and those with chronic disease. 'On any given day, we'll have anywhere from 30, to my highest was 130,' she said. The change interferes with a provider and patient decision on whether in-office or at-home treatment is best for the patient, Bansal said. 'That decision that's supposed to go on between the physician and the patient is getting taken away,' she said. 'If I have a pediatric food allergy patient and they want to get the medication in the clinic, I want to be able to have the flexibility to do that.' The sickest asthma patients are often on biologics, explained Dr. Bridgette Jones, past chair of the American Academy of Pediatrics' drug committee and the American Academy of Allergy Asthma and Immunology's asthma cough diagnosis and treatment panel. 'These are the patients that have failed at other therapies,' said Jones, a pediatric allergy and immunology physician at Children's Mercy Hospital in Missouri. 'Once you're getting to a biologic, it means that your asthma is not under control, having frequent flare-ups.' Black and Indigenous adults and children, as well as Puerto Rican people have higher rates of illness and less access to care. For people who suffer from severe asthma, the typical inhaler is often not enough. The affected drugs can help manage severe, uncontrolled asthma by reducing airway inflammation, While the drugs are approved by the U.S. Food and Drug Administration for self-injecting at home, they also come with risks for the uncommon but life-threatening anaphylaxis. That's why providers typically start patients on these drugs in-office for monitoring. But for at least one of the drugs, Xolair, the reaction can also happen up to a year into treatment. Many families are not comfortable administering biologics to their kids with severe asthma, Jones said. Clinics serving higher-need or underserved populations may often lack the resources to deal with more prior approvals, she added. A recent study by Massachusetts General Hospital and funded by Amgen, which developed Tezspire with AstraZeneca, suggested that in some states, the percentage of asthma patients with severe asthma is higher than 10%. In Texas, for example, about 23% of severe persistent asthma had severe uncontrolled disease. Stateline reporter Nada Hassanein can be reached at nhassanein@ SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
15-04-2025
- Health
- Yahoo
Blue Cross Blue Shield now requires prior approval for severe asthma drugs in some states
Starting today, Blue Cross Blue Shield will mandate that severe asthma patients self-administer their drugs at home, unless their provider gets prior approval from the insurance company. (Courtesy of Dr. Priya Bansal) Patients in five states who have severe asthma and are covered by Blue Cross Blue Shield are facing a new obstacle to getting treatment. On Tuesday, BCBS began mandating that severe asthma patients self-administer their drugs at home, unless their provider gets prior approval from the insurance company. The patients affected are those covered in Illinois, Texas, Oklahoma, New Mexico, and Montana, but not those with Medicare or Medicaid, the insurance giant says. Given as injections, the treatments in question are Fasenra (benralizumab), Tezspire (tezepelumab), Nucala (mepolizumab) and Xolair (omalizumab). All belong to a class of drugs known as biologics. The decision is expected to affect thousands of patients. It's estimated that between 5% and 10% of asthma patients have severe asthma, characterized by more flare-ups and hospitalizations. In Illinois, for example, about 860,000 patients have asthma, according to the federal Centers for Disease Control and Prevention. That means between 43,000 and 86,000 of them have severe asthma. Clinics already have loads of prior authorizations to process that often delay care, said Dr. Priya Bansal, a pediatrician and asthma and allergy physician in Illinois. Her practice sees many rural patients and those with chronic disease. 'On any given day, we'll have anywhere from 30, to my highest was 130,' she said. The change interferes with a provider and patient decision on whether in-office or at-home treatment is best for the patient, Bansal said. 'That decision that's supposed to go on between the physician and the patient is getting taken away,' she said. 'If I have a pediatric food allergy patient and they want to get the medication in the clinic, I want to be able to have the flexibility to do that.' States try to rein in health insurers' claim denials, with mixed results The sickest asthma patients are often on biologics, explained Dr. Bridgette Jones, past chair of the American Academy of Pediatrics' drug committee and the American Academy of Allergy Asthma and Immunology's asthma cough diagnosis and treatment panel. 'These are the patients that have failed at other therapies,' said Jones, a pediatric allergy and immunology physician at Children's Mercy Hospital in Missouri. 'Once you're getting to a biologic, it means that your asthma is not under control, having frequent flare-ups.' Black and Indigenous adults and children, as well as Puerto Rican people have higher rates of illness and less access to care. For people who suffer from severe asthma, the typical inhaler is often not enough. The affected drugs can help manage severe, uncontrolled asthma by reducing airway inflammation, While the drugs are approved by the U.S. Food and Drug Administration for self-injecting at home, they also come with risks for the uncommon but life-threatening anaphylaxis. That's why providers typically start patients on these drugs in-office for monitoring. But for at least one of the drugs, Xolair, the reaction can also happen up to a year into treatment. Many families are not comfortable administering biologics to their kids with severe asthma, Jones said. Clinics serving higher-need or underserved populations may often lack the resources to deal with more prior approvals, she added. A recent study by Massachusetts General Hospital and funded by Amgen, which developed Tezspire with AstraZeneca, suggested that in some states, the percentage of asthma patients with severe asthma is higher than 10%. In Texas, for example, about 23% of severe persistent asthma had severe uncontrolled disease. Stateline reporter Nada Hassanein can be reached at nhassanein@ SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
28-03-2025
- Business
- Yahoo
Banks' Spot Crypto Holdings Continue to Collapse as Firms Move to ETPs
Banks across the globe held a total of 341.5 billion euros ($368.3 billion) in crypto assets under custody in the second quarter of 2024 but spot crypto assets now make up less than 3% of banks' holdings — down significantly from a few years ago, data by standard setter Basel Committee on Banking Supervision (BCBS) showed on Wednesday. BCBS, which focuses on setting measures to ensure the stability of banks, gathered voluntary and confidential submissions from 176 banks — of which 115 are internationally active — in June 2024. The data showed that just 29 banks contributed to the 341.5 billion euro figure, and the vast majority hold exchange-traded products tracking crypto over cryptocurrencies. Global watchdogs have been keeping a close eye on how interlinked the financial sector is with crypto following the collapse of crypto-friendly banks like Signature Bank and Silicon Valley Banks in 2023. The BCBS also recommended that banks' spot crypto exposure should not exceed 2% in December 2022. Banks appear to be following through on this; their exposure to spot crypto holdings fell 44% between 2021 to 2022. As of the June 2024 survey, banks held almost no spot crypto, at 2.46%, instead preferring exchange-traded products. About 92.5% of banks' holdings are now in these more regulated products tracking crypto prices, rather than crypto assets themselves, the BCBS survey showed. Read more: Blackrock to List Bitcoin ETP in First Crypto Foray Outside of U.S. Sign in to access your portfolio
Yahoo
07-02-2025
- Business
- Yahoo
Blue Cross Blue Shield settlement checks will be disbursed soon
Blue Cross Blue Shield payments to about six million people are set to go out, more than two years after the health insurer reached a $2.67 million settlement with subscribers. Notices of payments to claimants are being emailed on a rolling basis, according to an update on the BCBS settlement website. The settlement stems from a class action lawsuit alleging that more than 35 BCBS health insurance plans violated antitrust laws by agreeing not to compete with one another, thereby limiting competition in the health insurance market. The defendants deny allegations of wrongdoing. "Instead, Plaintiffs and Settling Defendants have agreed to a Settlement to avoid the risk and cost of further litigation," the update on the settlement site reads. Who gets a check? Participants must have filed claims by Nov. 5 2021 to be eligible to receive a payment from the $2.67 billion settlement fund. Subscribers who were covered by certain Blue Cross Blue Shield health insurance or administrative services plans between February 2008 and October 2020 are potential class members. The site does not indicate when notices of payments will be sent. How are individual payments determined? Individual payment amounts are determined based on the number of valid claims that are filed, the premiums paid to one or more of the defendants during one of two class periods, and whether one's insurance was fully insured or self-funded. "The Settlement Class Period for Individuals and Insured Groups is from Feb.7, 2008, through Oct. 16, 2020," according to the settlement website. "The Settlement Class Period for Self-Funded Accounts is from Sept. 1, 2015 through Oct. 16, 2020." If the total payment for any claimant is equal to or less than $5.00, the claimant won't receive a check. After deducting attorney's fees and administrative costs, the net settlement fund is worth approximately $1.9 billion, which will be distributed across roughly 6 million claimants. On average, claimants can expect checks of $333. Arab-Americans who voted for Trump react to Gaza takeover plan Search for plane that went missing off Alaska with 10 people on board Netanyahu's response on U.S. soldiers in Gaza for Trump's plan
