Not without cause, Katie Keith in the Health Affairs blog provides her thoughts on how Biden’s election will impact the Affordable Care Act “in what otherwise appears to be a status quo election.” Compare your thoughts with hers. Remember that the ACA puts a lot authority in the hands of the Secretary of Health and Human Services often together with the Labor and Treasury Secretaries.
On the COVID-19 front, Healthcare Dive reminds us, not surprisingly, that
Patients overwhelmingly turned to telehealth visits early in the COVID-19 pandemic but skipped out on diagnostic procedures and other preventive and elective care that can only be done in-person, according to a study published Thursday [today] in JAMA Network Open. The number of mammograms and colonoscopies performed in March and April dropped more than 65% compared to the year prior, according to the analysis of more than 5 million commercially insured patients. Overall, healthcare utilization dropped 23% in March and 52% in April. * * *
Researchers looked at insurance claims data from 2018 to 2020 from about 200 employers. Beyond major declines for mammograms and colonoscopies, they found other procedures like musculoskeletal surgery, cataract surgery and MRIs all dropped by 45% or more.
In-person visits to manage chronic conditions dropped too, including blood sugar tests for patients with diabetes, which fell more than 50% in March and April. Chemotherapy treatments dropped 4%. And among children under 2 years old, vaccinations dropped 22%.
Utilization did increase in the third quarter. Fierce Healthcare reports that
Major insurer Cigna reported a rebound in healthcare utilization in the third quarter from massive declines in the second quarter due to COVID-19. Cigna, which posted a $1.39 billion profit in the third quarter, said that healthcare use remains slightly below average when not taking into account costs for COVID-19. The insurer’s performance in the quarter was bolstered by its newly rebranded Evernorth subsidiary. Cigna executives said that utilization was 95% below normal levels without factoring COVID-19 costs.
Nevertheless, given the current upswing in COVID-19 cases, it’s unlikely that a lot of catch up preventive care will happen this year. It is incumbent on health plans to help members catch up, in the FEHBlog’s opinion.
In sobering news, the Robert Wood Johnson Foundation helps us look at the impact of COVID-19 on households across our country.
Finally, FedWeek offers upcoming Open Season advice to federal employees and annuitants
Thanks to Aaron Burden for sharing their work on Unsplash.
Happy Election Day!
The FEHBlog enjoyed reading this American Medical Association article about the five things that doctors should tell their patients about the COVID-19 vaccines currently under development. This could be good information for health plans to share with their members.
Nearly half the nation’s hospitals, many of which are still wrestling with the financial fallout of the unexpected coronavirus, will get lower payments for all Medicare patients because of their history of readmitting patients, federal records show.
The penalties are the ninth annual round of the Hospital Readmissions Reduction Program created as part of the Affordable Care Act’s broader effort to improve quality and lower costs. The latest penalties are calculated using each hospital case history between July 2016 and June 2019, so the flood of coronavirus patients who have swamped hospitals this year were not included.
The number and severity of penalties were comparable to those of recent years, although the number of hospitals receiving the maximum penalty of 3% dropped from 56 to 39.
Beckers Hospital Review provides a list of those 39 hospitals here.
Humana bested Wall Street expectations as it gained more members during the third quarter, generated higher revenue and beat earnings estimates, according to its quarterly results released Tuesday morning.
The payer’s medical utilization continued to trend slightly below pre-COVID levels during the third quarter, though still well above the severe dip in March and April. The lower levels of utilization were partially offset by higher COVID-19 testing and treatment costs as cases began to tick back up.
Executives warned during Tuesday’s call with investors that they expect a loss in the fourth quarter due to a number of issues, including COVID-19 testing and treatment and rebounding utilization.
It’s the last bullet that caught the FEHBlog’s attention.
Finally, Kaiser Health News offers a nice story about seniors forming friendship pods to ward off the loneliness of the great hunkering down.
In view of the impending national election on Tuesday, Congress is out of session for the next two weeks except for one Committee hearing on November 10.
On the COVID-19 front –
The Wall Street Journal reports about research and medical efforts to address the health problems of so-called COVID-19 long haulers.
Nearly a year into the global coronavirus pandemic, scientists, doctors and patients are beginning to unlock a puzzling phenomenon: For many patients, including young ones who never required hospitalization, Covid-19 has a devastating second act.
Many are dealing with symptoms weeks or months after they were expected to recover, often with puzzling new complications that can affect the entire body—severe fatigue, cognitive issues and memory lapses, digestive problems, erratic heart rates, headaches, dizziness, fluctuating blood pressure, even hair loss.
What is surprising to doctors is that many such cases involve people whose original cases weren’t the most serious, undermining the assumption that patients with mild Covid-19 recover within two weeks. Doctors call the condition “post-acute Covid” or “chronic Covid,” and sufferers often refer to themselves as “long haulers” or “long-Covid” patients.
According to the article, the estimated numbers of long haulers varies “widely.” Nevertheless, [w]ith more than 46 million cases world-wide, even the lower estimates would translate into millions living with long-term, sometimes disabling conditions, increasing the urgency to study this patient population, researchers said. What they find could have implications for how clinicians define recovery and what therapies they prescribe, doctors said.” What’s more, “[o]ther viral outbreaks, including the original SARS, MERS, Ebola, H1N1 and the Spanish flu, have been associated with long-term symptoms.”
Last Friday, ” the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Defense (DOD) jointly announced a $12.7 million contract with InBios International Inc., of Seattle, to expand domestic production capacity for two rapid point-of-care tests for SARS-CoV-2, the virus that causes COVID-19. The first, called the SCoV-2 Ag Detect Kit, detects current infections by identifying antigens – genetic material – of the virus in a nose swab sample. The second test, called the SCoV-2 Detect IgM/IgG Kit, detects antibodies for the virus in a finger prick of blood, indicating whether the person had a previous COVID-19 infection. The contract enables InBios to ramp up production of either or both tests to 400,000 units per week – 20 times the facility’s current output – by May 2021, significantly expanding the nation’s testing capacity.
According to UnitedHealth Group’s fifth annual UnitedHealthcare Consumer Sentiment Survey, which examines Americans’ opinions about multiple areas of healthcare, a survey-record 56% said it is likely they would use virtual care for medical services. More than a quarter of respondents (26%) said they would prefer a virtual relationship with a primary care physician, the survey found. And when comparison shopping for care, 55% of respondents said they had used the internet or mobile apps to comparison shop for healthcare during the past year, with 1 in 4 patients saying that online or mobile resources were their first option for evaluating health issues.
Follow up on a couple of stories that the FEHBlog has been following:
Health Payer Intelligence discusses various angles on the payer transparency rule that the ACA regulators issued last week. That rule is applicable to the FEHBP.
A friend of the FEHBlog related that the federal government has noticed an appeal to the D.C. Circuit of District Judge James Boasberg’s September 2, 2020, decision preliminarily enjoining certain provisions of the Trump Administration’s revised ACA Section 1557 rule that adversely affected transgendered people. The government’s 60 day period to notice such an interlocutory appeal would have expired tomorrow.
Today’s big news is that the ACA regulators (the Departments of Health and Human Services (“HHS”), Labor, and Treasury) finalized a lengthy pricing transparency rule for payers, including ERISA and FEHBP group health plans (see footnote 233). The related fact sheet explains
This final rule includes two approaches to make health care price information accessible to consumers and other stakeholders, allowing for easy comparison-shopping.
First, most non-grandfathered group health plans and health insurance issuers offering non-grandfathered health insurance coverage in the individual and group markets will be required to make available to participants, beneficiaries and enrollees (or their authorized representative) personalized out-of-pocket cost information, and the underlying negotiated rates, for all covered health care items and services, including prescription drugs, through an internet-based self-service tool and in paper form upon request. For the first time, most consumers will be able to get real-time and accurate estimates of their cost-sharing liability for health care items and services from different providers in real time, allowing them to both understand how costs for covered health care items and services are determined by their plan, and also shop and compare health care costs before receiving care. An initial list of 500 shoppable services as determined by the Departments will be required to be available via the internet based self-service tool for plan years that begin on or after January 1, 2023. The remainder of all items and services will be required for these self-service tools for plan years that begin on or after January 1, 2024.
Second, most non-grandfathered group health plans or health insurance issuers offering non-grandfathered health insurance coverage in the individual and group markets will be required to make available to the public, including stakeholders such as consumers, researchers, employers, and third-party developers, three separate machine-readable files that include detailed pricing information. The first file will show negotiated rates for all covered items and services between the plan or issuer and in-network providers. The second file will show both the historical payments to, and billed charges from, out-of-network providers. Historical payments must have a minimum of twenty entries in order to protect consumer privacy. And finally, the third file will detail the in-network negotiated rates and historical net prices for all covered prescription drugs by plan or issuer at the pharmacy location level. Plans and issuers will display these data files in a standardized format and will provide monthly updates. This data will provide opportunities for detailed research studies, data analysis, and offer third party developers and innovators the ability to create private sector solutions to help drive additional price comparison and consumerism in the health care market. These files are required to be made public for plan years that begin on or after January 1, 2022.
The final rule also provides some medical loss ratio relief to compliant health insurance issuers as explained in the fact sheet. Here is AHIP’s reaction to the final rule.
Also today HHS issued an interim final rule with a comment period that “extends the compliance dates and timeframes necessary to meet certain requirements related to information blocking and Conditions and Maintenance of Certification (CoC/MoC) requirements. Released to the public on March 9, 2020, ONC’s Cures Act Final Rule established exceptions to the 21st Century Cures Act’s information blocking provision and adopted new health information technology (health IT) certification requirements to enhance patients’ smartphone access to their health information at no cost through the use of application programming interfaces (APIs).” The rule had been scheduled to take effect beginning next week.
Fierce Healthcare reports that “Regeneron’s anti-SARS-CoV-2 antibody cocktail has significantly reduced medical visits in ambulatory COVID-19 patients. The phase 2/3 clinical trial linked REGN-COV2 to a 57% decline in medical visits associated with COVID-19 in the 29 days after treatment.”
HealthPartners, a Minneapolis health insurer that participates in the FEHBP, offers a helpful, complete explanation of the benefits of wearing masks to prevent COVID-19. “At its core, wearing a mask is an act of kindness and neighborliness. It’s one of the simplest good deeds you can do these days, and a great way to be a force of positivity for the people in your life.”
The financial crisis for hospitals and physician practices caused by the COVID pandemic is a “clarion call” for the healthcare industry to move from a fee-for-service payment model to value, said Kevin Mahoney, chief executive officer of the University of Pennsylvania Health System (Penn Medicine).
“The hospital sector has taken a giant hit. We keep hearing about ‘the new normal.’ The lesson that we learned is that there is nothing new or normal about a pandemic, there’s just been an acceleration of trends,” Mahoney said during a recent virtual event hosted by the University of Pennsylvania. “It has laid bare how dependent hospitals are on commercially-insured, elective procedures, and without them, we don’t make money.”
The FEHBlog’s youngest son is a research coordinator for Penn Medicine. The FEHBlog seconds his boss’s sentiments.
Call to Action to Control Hypertension (Call to Action) seeks to avert the negative health effects of hypertension by identifying evidence-based interventions that can be implemented, adapted, and expanded in diverse settings across the United States.
The Call to Action outlines three goals to improve hypertension control across the United States, and each goal is supported by strategies to achieve success:
Goal 1. Make hypertension control a national priority. Goal 2. Ensure that the places where people live, learn, work, and play support hypertension control. Goal 3. Optimize patient care for hypertension.
Following up on yesterday’s post about mandatory of coverage of COVID-19 vaccines with no member cost sharing once available, the FEHBlog wants to add that the same rule applies to Medicare. CMS “estimates the overall cost of providing the vaccine to every senior on Medicare would be around $2.6 billion, which would be covered by the federal government. CMS will also cover the vaccine for any uninsured individuals by using money from a $175 billion provider relief fund passed as part of the CARES Act.” It appears however that the vaccine would be administered through the Part D program. That would not be much help to FEHB plans as most FEHB members with primary Medicare coverage does not carry Medicare Part D.
The Health and Human Services Department, the Cybersecurity and Infrastructure Security Agency and the FBI warn hospitals face an imminent threat from cybercriminals that encrypt and hold their data hostage—and some health care facilities are already dealing with the fallout.
The agencies collectively issued an advisory Wednesday detailing the tactics, techniques and procedures reportedly used against at least five hospitals already this week. The advisory includes recommendations for mitigating what observers are referring to as the most serious cyber threat the U.S. has seen to date, being perpetrated by an especially ruthless group of criminals.
“CISA, FBI, and HHS have credible information of an increased and imminent cybercrime threat to U.S. hospitals and healthcare providers,” reads the advisory.
The Affordable Care Act regulators (the Departments of Health and Human Services, Labor and Treasury) issued an interim final rule with an opportunity to comment (“IFC”) on coverage of COVID-19 preventive services. This rule focuses on coverage of COVID-19 vaccinations. The fact sheet explains with respect to private plans, including FEHB plans, that
the Departments [have] amend[ed] existing regulations to implement the unique requirements related to rapid coverage of qualifying coronavirus preventive services. This coverage is required to be provided within 15 business days after the date on which the United States Preventive Services Task Force or the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) makes an applicable recommendation relating to a qualifying coronavirus preventive service.
Specifically, plans and issuers must cover COVID-19 immunizations that have in effect a recommendation of ACIP with respect to the individual involved, even if not listed for routine use on the Immunization Schedules of the CDC. This IFC also provides that during the public health emergency for COVID-19, plans and issuers must cover without cost sharing qualifying coronavirus preventive services, regardless of whether an in-network or out-of-network provider delivers such services. The IFC also affirms that plans and issuers subject to section 2713 of the Public Health Service Act must cover without cost sharing items and services that are integral to the furnishing of recommended preventive services, including the administration of COVID-19 immunizations.
When the coronavirus vaccine arrives on the market, demand will far exceed supply. During those first few months, state and county public health officials will face tough questions about who should be first in line to get one of the limited vaccine doses. The Vaccine Allocation Planner for Covid-19, a new tool released Wednesday, aims to help make those decisions with data.
Jointly developed by Ariadne Labs, a project run out of Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health, and the Surgo Foundation, a nonprofit at the intersection of behavioral and data science, the tool allows policymakers to look at region-specific data. They can estimate the size of high-risk populations, consider factors like particular community’s vulnerabilities, and run scenarios based on an estimated number of vaccine doses available.
The New York Times maintains a COVID-19 vaccine tracker here
Anthem beat Wall Street’s third-quarter expectations on earnings and reported revenue of $31.2 billion, up 16.8% from the year prior, in results released Wednesday morning. Expenses, however, were up more than 22% year over year, leaving profit to plummet roughly 80%. Total medical membership jumped 4%, attributed to increases in Medicare and Medicaid rolls. Anthem CEO Gail Boudreaux said on the earnings call the overall membership trends are outpacing internal expectations. The payer also reported a $594 million payment in Q3 toward a federal antitrust settlement reached with Blue Cross Blue Shield plans that is still awaiting approval by a judge. Other terms include nixing the “best efforts” rule that required member plans to generate at least two-thirds of their annual revenue from Blues brands and allowing employers to request a second bid from a non-local Blues plan, Boudreaux said, adding “we don’t see this changing our strategy.”
There is a clear overlap between specialties that are using telemedicine the most, and those specialties that manage chronic illnesses, such as endocrinology and rheumatology. Treating long-term chronic conditions like diabetes and arthritis require frequent patient visits, but they don’t always need to be in-person. For patients that require long-term care, telemedicine tools can reduce taxing trips to hospitals or clinics.
Doximity is a professional network for physicians.
Medpage Today lets us know that
Screening for colorectal cancer (CRC) should begin at age 45 for all average-risk adults in the United States, the U.S. Preventive Services Task Force (USPSTF) recommends in a guideline draft. Screening should continue at recommended intervals until age 75, the draft states. For patients ages 76 to 85, the decision to continue screening should be based on an individualized assessment of the benefits and harms associated with screening.
Currently FEHB plans are required to cover CRC screening with no member cost sharing for members beginning at age 50. If this guideline is finalized in 2020, the no cost sharing coverage requirement would drop to age 45 on January 1, 2022 pursuant to the Affordable Care Act’s requirements.
Here is a list of all of the USPSTF Grade A and B preventive service for adults recommendations which are eligible for cost free coverage starting in the plan year that begins on or after exactly one year from the issue date. FEHB plan years follow the calendar year, but not all health plans do.
Healthcare Dive reports that Utah-based “Intermountain Healthcare and South Dakota-based Sanford Health announced Monday that the two had signed a letter of intent to merge. Together the two will operate 70 hospitals — many of which will be located in rural communities across the country — and 435 clinics and insure 1.1 million people.” Intermountain participates in the FEHB under the name of its affiliate SelectHealth.
The Labor Department’s Employee Benefit Security Administration (“EBSA”) released its 2020 edition of its federal mental health and substance use disorder parity self compliance tool for health plans. The first edition was released in April 2018. What’s more on Thursday October 29 at 2 pm ET EBSA will hold a free compliance assistance webcast on this complicated law.
Here’s a link to OPM’s third quarter 2020 report on the development of its Master Enrollment Index for the FEHBP.
The Centers for Medicare and Medicaid Services posted information today about the ACA federal marketplace open enrollment period which begins on Saturday November 1 and ends on December 15, 2020.
Over the weekend, the FEHBlog read in the Wall Street Journal’s Numbers column about COVID-19 mortality predictions. The author explains that
Now, as many as 50 different research groups make predictions, but one of the most accurate assembles all of the individual models, calculates the median value and looks no more than four weeks into the future.
The ensemble forecast was founded by the Reich Lab at the University of Massachusetts, Amherst, in collaboration with the Centers for Disease Control and Prevention and is based in part on models previously developed to forecast influenza and other infectious diseases.
In the next four weeks, it predicts the total number of deaths attributed to the new coronavirus will surpass 240,000—adding roughly 17,000 deaths to the current tally.
Such projections help policy makers and health-care officials decide how to manage resources and implement or relax interventions intended to curb the spread of the disease.
A Covid-19 vaccine being developed by the University of Oxford and AstraZeneca AZN 2.06% PLC showed a promising immune response and low levels of adverse reactions in the elderly and older adults, according to an interim analysis that the drugmaker said was encouraging.
The vaccine, now in late-stage human trials aimed at showing its efficacy and safety, is a front-runner in the global sprint for a shot to protect lives and jump-start economies hobbled by the pandemic. Trials in the U.K. could produce results before year-end, fueling hopes among scientists and government leaders that a vaccine might be available for high-risk groups here by early 2021.
Fierce Healthcare informs us that “CVS views its pharmacists as playing a key role in assuaging fears, CEO Larry Merlo said Friday. Merlo, speaking at an event hosted by The Washington Post, said that pharmacists “are among the most trusted professionals” in the industry and as such will be able to educate patients about the safety and efficacy of the vaccine.”
Fierce Healthcare also recognizes “ten women who have risen to the challenges posed by COVID, as well as played a role in positioning their respective companies to be where they are today.” For example, Anthem Blue Cross’ Liz Kwo M.D. is scaling digital products to improve outcomes. Bravo to all of the winners.
The House of Representatives is now on a district work period / the campaign trail until after election day. According to the Hill, the Senate which had planned to hold votes this week will be switching to pro-forma session for the next two week as three Republican Senators unfortunately have been diagnosed with COVID-19. The Senate Majority Leader expects to resume holding votes during the week of October 19.
Over the summer, the House leadership changed its rules to permit remote House floor voting during the COVID-19 public health emergency. That action permits the House leadership to rapidly schedule a House vote in October if necessary. The FEHBlog wonders whether the Senate leadership will take the same action this month.
The House and Senate will be holding a handful of Committee meetings this week.
The FEHBlog is confident that this will be the week that OPM publicizes 2021 premiums for FEHBP and FEDVIP carriers.
Tomorrow, being the first Monday in October, the U.S. Supreme Court will begin its October 2020 Term with virtual oral arguments. The Court will virtually hear argument in a blockbuster ERISA state law preemption case on Tuesday October 6. Courts tend to read certain aspects of the ERISA and FEHBA state law preemption provisions similarly.
Last Friday, the Internal Revenue Service announced delays and flexibilities in 2020 ACA Form 1095-B and 1095-C reporting similar to those that were in effect for 2019, the first reporting year in which the individual mandate penalty was zeroed out. These reports are now ordinarily used for the six jurisdictions that have reinstated the individual mandate penalty for their respective residents.
Health Payer Intelligence offers a helpful overview of three categories of telehealth that payers cover – synchronous communication between members and providers of care by telephone, tablet, or PC; asynchrouous secure direct messaging between members and providers, and remote monitoring of member health.
For example, UnitedHealth Group designed its new diabetes program, Level2, around a remote patient monitoring device. The company transformed the continuous glucose monitor—which is usually used for patients with type 1 diabetes—into a tool for those with type 2 diabetes.
The monitor delivered hundreds of readings per day. These readings go into the member’s individual health record. By looking at the readings over time, the payer can assess potential trends.
However, the remote patient monitoring device provides instantaneous information, meaning that the payer can also address health concerns the moment they occur even though the member is not in a provider’s office.
If a member had a sugar spike, the payer’s platform would let the member know certain steps he could take to control his sugar levels, through exercise or food consumption, for example.
Section 1557 is the individual non-discrimination provision of the Affordable Care Act. In June 2020, the Department of Health and Human Services issued a final rule making numerous changes to the Obama Administration’s rule. Both rule makings sparked lawsuits challenging their legality.
Last time around, the lead case, Franciscan Alliance v. HHS, was filed in the Northern District of Texas. That case is still pending on appeal before the U.S. Court of Appeals for the Fifth Circuit.
This time around, the lead case, Whitman-Walker Clinic v. HHS, was filed in Washington, D.C. Roughly one month following oral argument in the case, U.S. District Judge James Boasberg this afternoon denied the plaintiffs’ motion for a preliminary injunction against enforcement of HHS’s revised Section 1557 rule with two exceptions:
The Court preliminarily enjoined the revised rule’s repeal of the sex discrimination definition found in the replaced Obama Administration rule. That definition afforded express protection to transgendered people.
The Court also preliminarily enjoined the revised rule’s religious organization exception to the law’s sex discrimination restrictions.
Here is a link to the lengthy yet illuminating opinion and the implementing order. The decision called to the FEHBlog’s attention another interesting civil rights provision of the ACA — Section 1554. This provision places limits on the HHS Secretary’s broad reaching regulatory powers under the ACA.
Judge Boasberg’s decision expands on the Brooklyn federal court decision issued August 17, 2020, that stayed enforcement of the sex discrimination definition repeal. While the federal government has not appealed the Brooklyn decision, the plaintiffs in the FEHBlog’s opinion are likely to appeal the denial of their preliminary injunction motion in the Whitman-Walker Clinic case. And so it goes.
The Centers for Medicare and Medicaid today released its final Medicare Part A inpatient prospective payment system rule for the government fiscal year beginning October 1, 2020.
The increase in operating payment rates for general acute care hospitals paid under the IPPS that successfully participate in the Hospital Inpatient Quality Reporting (IQR) Program and are meaningful electronic health record (EHR) users is approximately 2.9 percent. This reflects the projected hospital market basket update of 2.4 percent and a 0.0 percentage point productivity adjustment. This also reflects a +0.5 percentage point adjustment required by legislation.
Hospitals may be subject to other payment adjustments under the IPPS, including:
— Penalties for excess readmissions, which reflect an adjustment to a hospital’s performance relative to other hospitals with a similar proportion of patients who are dually eligible for Medicare and full-benefit Medicaid — Penalty (1 percent) for worst-performing quartile under the Hospital-Acquired Condition Reduction Program — Upward and downward adjustments under the Hospital Value-Based Purchasing Program
Medicare is one complicated program. Medicare is relevant to the FEHBP because the program impact the prices that FEHB plans pay for patient care and there is a large cadre of annuitant enrollees with Medicare Part A coverage.
In other healthcare related news —
Reuters reports that “President Donald Trump said on Tuesday he planned to meet with pharmaceutical companies this week regarding his so-called most- favored-nation executive order aimed at lowering drug prices paid by the U.S. federal government.”
A new analysis of several studies in which [inexpensive] steroid drugs were used to treat severely ill Covid-19 patients found the drugs significantly helped reduce patient deaths, bolstering earlier, preliminary evidence for the benefit of these medications. In multiple studies involving a total of 1,700 patients, a number of corticosteroids—anti-inflammatory drugs that can damp the effects of an overactive immune system—helped reduce deaths from Covid-19 by about a third, compared with patients who didn’t receive steroids, according to the analysis published Wednesday in the Journal of the American Medical Association.
HHS’s Office for Civil Rights, which enforces the HIPAA Privacy and Security Rules, has created a consolidate website regarding HIPAA and Health Apps. The site includes links to generally helpful technical information on cloud computing and HIPAA and HIPAA and health IT. Check it out.
The Wall Street Journal reports this evening that “White House and Democratic negotiators emerged frustrated from their [latest COVID-19 relief bill} meeting Wednesday. White House officials said Democrats were dragging their feet on talks, and Democrats countered that Republicans were thinking too small.” “Absent an agreement [by this Friday, [Treasury Secretary Steven] Mnuchin said, “We’ll have to look at the president taking actions under his executive authority.”
On the vaccine front —
Kaiser Health News reports that obese people are less responsive to vaccines than other folks. ” Dr. Timothy Garvey, an endocrinologist and director of diabetes research at the University of Alabama, was among those who stressed that, despite the lingering questions, it’s still safer for obese people to get vaccinated than not. “The influenza vaccine still works in patients with obesity, but just not as well,” Garvey said. “We still want them to get vaccinated.” FEHBP plans typically offer effective coaching problems to help plan members with weight reduction.
On the brighter side, the Wall Street Journal reports that “Researchers and companies developing Covid-19 vaccines are taking new steps to tackle a longtime challenge: Those who need the vaccines most urgently, including Black and Latino people, are least likely to participate in clinical trials to determine whether they work safely.” Health plans may be able to offer support here to researchers.
Publicly traded healthcare companies have been report second quarter results recently. Healthcare Dive reports that “All of the nation’s largest insurers, Anthem, Centene, Cigna, Molina, UnitedHealth Group (which operates UnitedHealthcare) and CVS (which owns Aetna), all reported a surge in second quarter profits due to lower medical usage among members.” To the extent that these profits stem from health insurance premiums, the ACA’s requirement that health insurers rebate premium income when they fall below the minimum medical loss ratio threshold (80% for individual coverage and 85% for group coverage) is designed to prevent excess profits.
For more details on second quarter results CVS Health and Humana reported today. Becker’s Hospital Review inform us about other major insurer results here.
Forbes advises us that according to a recent study, deferral of care during the great hunkering down in March and April caused a concerning drop in new cancer diagnoses. “This report demonstrates that our initial response to the pandemic of limiting so-called elective screening and diagnostic tests has consequences,” said Craig Bunnell, MD, Dana-Farber Cancer Institute Chief Medical Officer. “The true incidence of these cancers did not drop. The decline clearly represents a delay in making the diagnoses, and delays matter with cancer,” Bunnell added. But physicians are keen to stress that for symptoms that cannot wait such as anything which might indicate cancer, people must not hesitate to seek medical care, despite the pandemic. “We need to safely perform these diagnostic tests and the public needs to not think of them as optional. Their lives could depend on them,” said Bunnell.
How true. Becker’s Hospital Review provides additional perspective on this issue by publishing a Census Bureau ranking of the states by the estimated percentage of deferred care due to the COVID-19 emergency.
Nationwide, 40 percent of Americans are still delaying care, according to a survey from the U.S. Census Bureau. The agency launched its Household Pulse Survey April 23, polling roughly 1 million Americans weekly on how the pandemic is affecting their household. Over the past 12 weeks, the percentage of U.S. adults delaying care has hovered around 40 percent with little fluctuation.
Finally, there was a big healthcare industry transaction announced today. STAT reports that “telemedicine provider Teladoc Health has reached an agreement to buy the diabetes coaching company Livongo in an $18.5 billion deal.” Both companies are publicly traded. The Wall Street Journal explains that
Under the deal, each share of Livongo will be exchanged for 0.5920 shares of Teladoc, plus cash consideration of $11.33 for each Livongo share. Upon completion of the merger, existing Teladoc shareholders will own 58% of the combined company, and existing Livongo shareholders will own 42%. The transaction is expected to close by the end of this year.
The House of Representatives has joined the Senate in deciding to conduct legislative and committee business at least through the end of this week as Congress seeks to reach a compromise with the White House on another COVID-19 emergency relief bill.
Govexec.com reports that on Friday July 31 the House passed its second minimus appropriations bill (HR 7617) which includes financial services and general government appropriations for the next government fiscal year that begins on October 1, 2020. Surprisingly, the bill defers to the President on setting the civil service raise for the 2021 calendar year. The President has stated his plan to give the civil service a 1% increase across the board (meaning no increase in locality pay). The military is expected to receive a 3% increase in its pay for 2021.
Tomorrow at 2 pm Eastern, Federal District Court Judge James E. Boasberg will hear oral argument over the Whitman-Walker Clinic’s motion for a preliminary injunction to stay the upcoming effective date for the recently revised Health and Human Services Department final rule implementing the Affordable Care Act’s individual non-discrimination provision, Section 1557. The FEHBlog discovered on Friday that the public can call into listen to the hearing, and he will be doing so (as long as his schedule permits).
In other litigation news, Healthcare Dive reports that the U.S. Court of Appeals for the District of Columbia Circuit handed the American Hospital Association its second recent loss on Friday July 31. The Court upheld an CMS Medicare drug pricing rule affecting hospitals. “The 2-1 ruling overturns a district court decision that HHS overstepped its bounds when it cut the reimbursement rate for a certain category of outpatient drugs by 28.5% for hospitals enrolled in the 340B drug discount program.”
What’s more –
Pharmalive.com reports on large scale COVID-19 clinical tests which the National Institutes of Health is supporting. Fingers crossed.
NPR Shots discusses the importance of manufacturing transparent masks for protections against COVID-19:
At least one company — ClearMask, based in Baltimore — has gone so far as to seek and earn FDA “clearance” that its mask with a transparent panel is “substantially equivalent” to a medical-grade surgical mask for hospitals and other front-line uses. ClearMask’s founder and CEO Aaron Hsu says it took three years of research and development to develop a clear material that won’t fog up. “For a lot of children communication is nonverbal,” says Hsu. “Being able to see who we’re talking to is fundamental to how we communicate and connect.” [Of course the transparent masks also are helpful to disabled people who rely on lipreading and the elderly.] The company was started in 2017, he says, by four Johns Hopkins University students who identified the need for a niche medical product for deaf people. But now its appeal has gone global.”
Healio reports on the American Thoracic Society’s updated guidelines on smoking cessation which rely heavily on Pfizer’s Chantix / varenicline treatment over patches or bupropion. “Clinicians can begin varenicline treatment in tobacco-dependent adults who are not ready to discontinue tobacco use rather than waiting until they are ready to stop (strong recommendation).”
We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. By clicking “Accept”, you consent to the use of ALL the cookies.
This website uses cookies to improve your experience while you navigate through the website. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may affect your browsing experience.
Necessary cookies are absolutely essential for the website to function properly. These cookies ensure basic functionalities and security features of the website, anonymously.
Cookie
Duration
Description
cookielawinfo-checbox-analytics
11 months
This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Analytics".
cookielawinfo-checbox-functional
11 months
The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional".
cookielawinfo-checbox-others
11 months
This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other.
cookielawinfo-checkbox-necessary
11 months
This cookie is set by GDPR Cookie Consent plugin. The cookies is used to store the user consent for the cookies in the category "Necessary".
cookielawinfo-checkbox-performance
11 months
This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Performance".
viewed_cookie_policy
11 months
The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. It does not store any personal data.
Functional cookies help to perform certain functionalities like sharing the content of the website on social media platforms, collect feedbacks, and other third-party features.
Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors.
Analytical cookies are used to understand how visitors interact with the website. These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc.
Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. These cookies track visitors across websites and collect information to provide customized ads.
