• California: Last week, Salvador Plasencia, a doctor who was charged in connection to the death of "Friends" actor Matthew Perry, pleaded guilty to supplying the actor with ketamine despite knowing that he was struggling with addiction. Last year, the Department of Justice charged five people, including two doctors, in relation to Perry's death after he died of a ketamine overdose in October 2023. So far, four of the five people charged, including Plasencia, have pleaded guilty for their connection to Perry's death. According to prosecutors, Plasencia and a woman who was a major ketamine dealer face the most serious charges. Plasencia pleaded guilty to four counts of distribution of ketamine, which can carry up to 40 years in prison. "Dr. Plasencia is profoundly remorseful for the treatment decisions he made while providing ketamine to Matthew Perry," said Plasencia's attorney Debra White. "He is fully accepting responsibility by pleading guilty to drug distribution. Dr. Plasencia intends to voluntarily surrender his medical license, acknowledging his failure to protect Mr. Perry, a patient who was especially vulnerable due to addiction." (Associated Press/MedPage Today, 7/23)
• Kentucky: Humana recently announced plans to cut its prior authorization requirements for outpatient services by one third, a change that will take effect Jan. 1. In a news release, Humana said the cuts include authorization requirements for diagnostic services, such as colonoscopies, transthoracic echocardiograms, and some CT and MRI scans. Last month, several major health insurers, including Humana, pledged to reform prior authorizations to help reduce providers' administrative burden. Humana said it is aiming to provide prior authorization decisions within one business day for at least 95% of requests by next year. Currently, the insurer provides decisions within one day for over 85% of its authorization requests for outpatient services. Humana is also planning on releasing a gold card program in 2026, which will waive prior authorization requirements for certain procedures and items for eligible prescribers who have a strong track record of approval. So far, no specific criteria for the gold card program have been released. (DeSilva, Modern Healthcare, 7/22)
• Maryland: CMS announced that Medicare Part D premiums will increase next year, with the base premium increasing from $36.78 to $38.99 and the national average monthly bid amount increasing from $179.45 to $239.27. According to the Wall Street Journal, growing costs, regulatory changes, and cuts to a subsidy program are all contributing to the rise in Part D premiums. The subsidy program, which increased federal payments into Part D plans by $6.2 billion this year, is expected to have its spending cut by around 40% next year. Currently, CMS officials are negotiating with insurers about their bids for next year's Part D plans to ensure that premium increases are not too high. "Following these negotiations, CMS approved some revised bids and, for the first time, rejected standalone [Part D premium] bids that failed to address concerns regarding significant year-over-year premium increases and that were also market outliers compared to similar plans in the same region," the agency said. However, even with these efforts, Medicare officials said program costs are expected to increase by "a lot." According to Chris Klomp, who leads the Center for Medicare, these changes are "all about trying to maintain affordability against a massively increasing backdrop of expense." (Tong, Fierce Healthcare, 7/29; Mathews/Whyte, Wall Street Journal, 7/28)

Tariffs announced by President Donald Trump in recent months are expected to increase the cost of prescription drugs, medical devices, and other medical products and services, leading some health plans to increase the premiums they plan to charge enrollees next year.