UnitedHealth, the biggest health insurer in the country, ran an algorithm that flagged patients for “too much” therapy. If they had more than 30 sessions in 8 months or twice a week, they denied coverage to save money. Regulators in California, New York, and Massachusetts called it illegal under federal mental health parity laws because they don’t do this to physical health claims. They settled, paid fines, and kept right on doing it in Medicaid plans across dozens of states. Insurance companies deciding your care, not your doctor. That’s the policy failure. Read it.

An experimental weight-loss drug, unapproved anywhere in the world, is being smuggled in and sold to teenagers online. FDA already has the authority to stop it at the border, and patients deserve more than warning letters. washingtonexaminer.com/op-ed… via @dcexaminer

What happens when a program designed to support care for low-income patients creates a financial incentive to treat patients with better insurance? That contradiction was at the center of Dr. Anthony DiGiorgio’s remarks at the State of the Patient Summit, where he broke down how 340B eligibility and 340B revenue can reward two very different things: “One of the ironies of 340B is that once you meet that DSH threshold, you aren't rewarded for treating more safety-net patients in your hospital," Dr. DiGiorgio said. You're actually incentivized to treat fewer safety-net patients and treat more privately insured commercial patients.”

There's a federal program that lets many of the country's largest nonprofit hospitals buy outpatient drugs at deep discounts — 25%, 50%, sometimes 70% off. Last year it moved more than $81 billion. So where did the money go? The program is called 340B, and the entire justification for it is that the savings reach vulnerable and underserved patients. But hospitals aren't required to show where those savings land, and no patient is ever told the discount touched their prescription. There's no box on your receipt that says "I'm a 340B patient." A medication can save your hospital $5,000 and you'll pay the same copay and walk out knowing nothing. So Patients Rising stopped arguing about surveys and went to the one place the relationship between a hospital and a struggling patient becomes a public record: bankruptcy court. Listen to this episode: hubs.ly/Q04x5WVr0

Thomas L. Johnson has spent more than 30 years working across healthcare, from leading Medicaid health plans and the DC Hospital Association to serving as Chair of the Sickle Cell Disease Association of America. Today, he leads the Alliance to Save America’s 340B Program, putting him directly inside one of the most consequential debates over the program’s future. And there is plenty to debate. As Congress considers major changes to 340B, questions about transparency, accountability and how the program serves patients are taking on new urgency. On September 24, Thomas will join us at the State of the Patient Summit for The Invisible Patient: Transparency and Accountability in 340B, examining what reform could mean for the patients the program is intended to serve. Join us on Capitol Hill to hear his perspective and be part of the 340B conversation shaping what comes next. Register here: hubs.ly/Q04wFZ650

Dutch Rojas is a healthcare entrepreneur and investor who has spent two decades building and financing companies across the delivery system. He has founded and sold four healthcare companies, among them an ambulatory surgery center development company and a direct-contracting company, co-founded two others, including a medical malpractice insurance carrier, and invested in more than twenty healthcare companies. He is Managing Partner of the PhyCap venture fund, founder of the physician advisory firm MedMerge and founder of The Rojas Report, whose POH Intelligence is the most comprehensive public record of physician-owned hospitals in the country. He also serves on the board of Physician-Led Healthcare for America. At the State of the Patient Summit, Dutch will join the panel The Invisible Patient: Transparency and Accountability in 340B, examining where 340B dollars go, what patients and the public can actually see and whether the program’s benefits are reaching the people and communities it was designed to serve. Join us on Capitol Hill to hear Dutch Rojas and our panelists take on the future of 340B. Register here: hubs.ly/Q04w_db80

I took my kids to see Coyote vs. Acme and came home thinking about drug development. No, there aren’t shelves full of secret cures. But medicine does have shelves—promising therapies, new uses for old drugs, and unanswered questions nobody has enough incentive to pursue. The science didn’t always fail. Sometimes the math did. My latest State of the Patient: Who owns the next step? Link: terrilox.com/p/the-coyote-wa…

The CMS comment window closed yesterday at 5pm. Here's what we told them — three questions that should decide the whole rule: hubs.ly/Q04tdhMP0

Blog and Comment Letter: patientsrising.org/advocacy-…