About pharma
Ohio Passes Law Allowing EpiPen Alternatives: While the specifics of this article are not important, the overall issue is: whether pharmacists can substitute medications with or without permission of the prescribing physician in order to save money. Different jurisdictions in the US (and other countries) have different laws with respect to this action. Do you know what is allowed where you live?
Italian Agency Hits Chinese Heparin Manufacturer for GMP Violations: This article is another reminder that India and China are the world’s leading sources for raw materials that go into pharmaceutical manufacturing. China was the source of the heparin contamination that hit Baxter several years ago.
About hospitals
Hospitals' solution to surprise out-of-network bills: Make physicians go in-network: Patients ending up in hospitals that are contracted with their health plan often receive bills from physicians who have not signed such agreements. The problem is that many hospitals have not insisted that physicians who practice full time in the institution sign up with the same plans as the do. These physicians include practitioners in pathology, radiology, anesthesiology, and emergency medicine. Now some hospitals are finally catching on and requiring such arrangements.
Memorial Sloan Kettering Curbs Executives’ Ties to Industry After Conflict-of-Interest Scandals: What happens when a hospital executive (particularly a physician) is a highly compensated board member of a healthcare company and a conflict of interest arises from those dual roles? This situation unfolded in the past few weeks at Memorial Sloan Kettering. This new policy addresses the outside activities.
Read more about this story and hospital policy
Just looking for a problem? That's Providence St. Joseph's strategy for its new $150M venture fund:Since at least the 1980s, hospitals diversified their services and investments in an attempt to capture additional revenue. These investments ranged from real estate to starting their own health insurance companies. Now one hospital has started its own venture fund.
About insurance
Judge pauses appeal of ObamaCare ruling, cites government shutdown: Democratic state attorneys general, the House of Representatives, and the Executive Branch are all appealing the ruling that would invalidate the ACA. On Friday, the U.S. Court of Appeals for the 5th Circuit granted a pause in the appeals process because of the government slowdown from the budget impasse.
Medicaid is reducing poverty over time, study finds: Is Medicaid having an impact on poverty levels or is it just providing health coverage for its recipients? The study, published in Health Affairs, showed that Medicaid expansion reduced the rate of poverty among states who chose to expand the program under the ACA by 0.917 percentage points, or by 690,000 people. The reduction in poverty of that number of people provides another reason for program expansion.
Trump Administration Plans Effort to Let States Remodel Medicaid: The Trump administration is again considering replacing current Medicaid payments with block grants. This scheme was part of the Republican’s failed attempt to repeal the ACA in 2017. Details of how the system would be implemented and its payments calculated are not yet clear. Funding would need to be approved by the House, so chances of significant overhauls are slim.
V.A. Seeks to Redirect Billions of Dollars Into Private Care: This article was on the front page of yesterday’s New York Times. It is a well-done summary of the very long-standing debate about whether care for veterans should be privatized or stay in VA facilities. The current debate started when the last Congress passed the “Mission Act.” Its purpose was to increase access to medical care for veterans who lived far from a VA facility. Now, the current administration is trying to expand the private access to more veterans, regardless of their proximity to care. Proponents of this change will face a very powerful veterans lobby.