Weekend Update

David Ermer–Congress, Medical / Rx research, Rx coverage, U.S. Healthcare–

From Washington, DC,

  • Both Houses of Congress will be taking their August recess until September 9.
  • Per Senate press releases,
    • “Sen. Bernie Sanders (I-Vt.), Chairman of the Senate Committee on Health, Education, Labor, and Pensions (HELP), today introduced legislation to address the long COVID crisis that is affecting more than 22 million adults and 1 million children across the United States – and millions more around the globe. The Long COVID Research Moonshot Act of 2024 provides $1 billion in mandatory funding per year for 10 years to the National Institutes of Health (NIH) to support long COVID research, the urgent pursuit of treatments, and the expansion of care for patients across the country.”
    • “Read the bill text, here. 
    • “Read the summary, here. 
    • “Read the section-by-section, here.”
  • and
    • “U.S. Senator Angus King (I Maine) is introducing legislation to ensure Maine people have access to affordable and preventative mental health and behavioral healthcare services. The Primary and Behavioral Healthcare Access Act would require private insurance plans to cover three annual primary care visits, and three annual outpatient mental health or outpatient substance use disorder treatment visits, without charging a copayment, coinsurance, or deductible-related fee. This commonsense legislation would cover private insurance under Affordable Care Act (ACA) and employer-sponsored plans.
    • “Congresswoman Lauren Underwood (D-IL) has introduced a companion bill in the House of Representatives.”
  • Per an HHS press release,
    • “On August 1, 2024, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR) announced a civil monetary penalty of $115,200 collected against American Medical Response (AMR), a provider of emergency medical services across the United States. The civil monetary penalty was the result of an investigation based on a complaint that AMR had failed to provide a patient with timely access to their medical records. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule’s right of access provisions require that individuals or their personal representatives have timely access to their health information (within 30 days, with the possibility of one 30-day extension) and for a reasonable, cost-based fee.” * * *
    • “View the Notice of Proposed Determination and Notice of Final Determination – PDF.
    • “Read about OCR’s guidance on the HIPAA right of access.”

From the public health and medical research front,

  • NPR Shots lets us know,
    • “A key protein that helps assemble the brain early in life also appears to protect the organ from Alzheimer’s and other diseases of aging.
    • “A trio of studies published in the past year all suggest that the protein Reelin helps maintain thinking and memory in ailing brains, though precisely how it does this remains uncertain. The studies also show that when Reelin levels fall, neurons become more vulnerable.
    • “There’s growing evidence that Reelin acts as a “protective factor” in the brain, says Li-Huei Tsai, a professor at MIT and director of the Picower Institute for Learning and Memory.
    • “I think we’re on to something important for Alzheimer’s,” Tsai says.”
  • The Washington Post informs us,
    • “People living with chronic pain are more likely than their peers without pain to need mental health treatment, yet less likely to get it, a new analysis suggests.
    • “The study, published in the journal PAIN, relied on data from the 2019 National Health Interview Survey, which tracked population-wide health in the United States by surveying a nationally representative sample of about 32,000 adults.”
  • The American Medical Association tells us about what doctors wish their patient knew about “summer finger bumps.”

From the U.S. healthcare business front,

  • The Washington Post reports,
    • “Urgent care or ER? With ‘one-stop shop,’ hospitals offer both under same roof.
    • “Hospitals are partnering with a private-equity-backed company to offer emergency and urgent care in one building. Patients may not realize prices vary between the services.”
      • “UF Health is one of about a dozen health systems in 10 states partnering with Intuitive Health to set up and run hybrid ER-urgent care facilities. More are in the works; VHC Health, a large hospital in Arlington, Va., plans to start building one this year.
      • “Intuitive Health was established in 2008 by three emergency physicians. For several years, the company ran independent combination ER-urgent care centers in Texas.
      • “Then, Altamont Capital Partners, a multibillion-dollar private equity firm based in Palo Alto, Calif., bought a majority stake in Intuitive in 2014.
      • “Soon after, the company began partnering with hospitals to open facilities in states including Arizona, Delaware, Indiana and Kentucky. Under their agreements, the hospitals handle medical staff and billing while Intuitive manages administrative functions — including initial efforts to collect payment, checking insurance and taking co-pays — and nonclinical staff, said Thom Herrmann, CEO of Intuitive Health.”
  • Forbes tells us,
    • “CVS Health is rolling out a new store format in several U.S. markets that includes Oak Street Health’s senior-focused health centers “side-by-side” a pharmacy, the healthcare company said.
    • “What began as a pilot project in Houston last year is now beginning a national expansion, starting with three Chicago locations that are among about 25 Oak Street Health centers that will be alongside a CVS pharmacy in reformatted former drugstores by the end of 2024. The new format is being deployed this year in several other markets including New York City, Dallas-Fort Worth and Columbus, Ohio. Another 11 of the new formats with Oak Street health centers alongside a pharmacy will open in 2025.”
  • Per Fierce Pharma,
    • “As growth in Vertex’s cystic fibrosis portfolio buoys the company amid the launch of gene therapy Casgevy, the company is feeling confident enough to boost its revenue outlook for the year.
    • “After collecting $2.65 billion in second-quarter revenues, representing a 6% uptick from last year’s second quarter, Vertex lifted its full-year sales guidance to a range of $10.65 billion to $10.85 billion. The new forecast adds $100 million on either end of the company’s prior guidance.
    • “The new numbers reflect expectations for continued cystic fibrosis growth and Casgevy’s uptake in its approved indications and markets, the company said in a release.
  • Per HR Dive,
    • “U.S. employers are planning for 3.5% raises in 2025, according to Payscale’s most recent salary budget survey. 
    • “The anticipated salary increase rates vary by industry, Payscale found. On the upper end, government, and engineering and science workers will see raises above 4.5% and 4.2%, respectively. Meanwhile, retail, customer service and education workers can expect raises of just 3.1%, Payscale said.
    • “Given the stabilization of inflation and the easing of labor market conditions, we’re seeing a slight reduction in planned salary increases for 2025, though figures are still above the 3% pre-pandemic baseline that employees have come to expect,” said Ruth Thomas, chief of research and insights at Payscale, in a statement.”