Here are 3 major policy areas that health industry groups are closely watching in $3.5T infrastructure bill: A good, concise review.
About Covid-19
Texas Supreme Court sides with governor and temporarily blocks mask mandates: The latest on a previously reported story:
”The Texas Supreme Court sided with Gov. Greg Abbott on Sunday in a ruling that temporarily blocks mask mandates recently issued in San Antonio and Dallas, though local officials said they will continue to enforce at least a portion of the mask mandates.
The Texas high court granted stay orders Sunday, but previously scheduled hearings on local mask mandates in lower courts in Bexar and Dallas counties will proceed as scheduled.”
Israel expands COVID vaccine booster campaign to over 50s, health workers: “Those eligible will be ‘people over 50, health care workers, people with severe risk factors for the coronavirus, prisoners and wardens,’ the health ministry said.
Israelis aged 60 and over started receiving the booster two weeks ago, ahead of any third-dose approval by the FDA. The US agency on Thursday authorised booster doses for people with compromised immune systems.” And in a related article: Biden administration plans for vaccine boosters, perhaps by fall
Does COVID cause babies to develop differently? - prelim data: “Children born during the coronavirus pandemic have significantly reduced verbal, motor and overall cognitive performance compared to children born before the pandemic, and this discrepancy is particularly pronounced in males, as well as in children in lower socioeconomic families, according to preliminary data presented in a preprint study. Researchers believe that this highlights that even in the absence of infection and illness, the pandemic has had a significant, negative impact on infant and child development.
In the study, not yet-peer reviewed and uploaded as preprint in medRxiv on Wednesday, researchers from Brown University examined data from an ongoing longitudinal study of child neurodevelopment, comparing scores in 2020 and 2021 to scores from 2011 to 2019.”
About health insurance
Updated Guidance Related to Planning for the Resumption of Normal State Medicaid, Children’s Health Insurance Program (CHIP), and Basic Health Program (BHP) Operations Upon Conclusion of the COVID-19 Public Health Emergency [PHE]: “Specifically, CMS is revising the guidance in the December 2020 SHO in two key areas, as follows.
Extending the timeframe for states to complete pending eligibility and enrollment actions to up to 12 months after the month in which the PHE ends…
Completing an additional redetermination for individuals determined ineligible for Medicaid during the PHE” [Emphasis in the original]
Medicaid Programs Call for Medicare Coverage of Alzheimer’s Drug: “The National Association of Medicaid Directors (NAMD) is recommending that CMS approve Medicare coverage for Alzheimer’s disease therapies.
’The outcome of Medicare’s coverage decision for this therapy will have enormous ramifications for the Medicaid program,’ the Medicaid directors stressed. ‘Should Medicare not cover the drug, then Medicaid would become the primary source of coverage for duals and dramatically increase Medicaid spending.’
If Medicare does not cover aducanumab—an Alzheimer’s drug that has received FDA approval—then Medicaid spending could increase by approximately 250 percent nationwide, NAMD experts estimated. Some states could see spending increases of up to 500 percent.” And in a related article: Excellus BlueCross BlueShield Says It Won’t Cover Aduhelm
About diagnostics
New DNA Blood Test Could Pinpoint Cancer’s Source in the Body: Much has been written recently about so-called liquid biopsies- detecting tumors in the blood from DNA fragments. This “new test (called GETMap, for genetic-epigenetic tissue mapping) also measures a phenomenon called DNA methylation. Cells add molecular groups to certain DNA sequences to turn genes on and off; this so-called methylation fingerprint can reveal the original tissue source for the DNA.” Gene mapping most often does not pick up these crucial epigenetic changes.
About hospitals and health systems
Medicare Holds Off on Hospital Price Disclosure Fines for Now: CMS ”is giving hospitals time to adjust to its price transparency rule, so far refraining from penalizing providers despite recently proposing to increase sanctions for those that don’t comply…
The vast majority of hospitals—94.4%—haven’t met one or more of the requirements since the rule took effect Jan. 1, 2021, according to a recent sample of 500 hospital websites conducted by Patient Rights Advocate. Right now many hospitals are getting warning letters if they don’t comply.
Rather than rescinding or modifying the Trump-era rule, the Biden administration has also proposed tougher sanctions. The Centers for Medicare & Medicaid Services suggested increasing the penalty for noncompliant hospitals in a July proposed rule (RIN 0938-AU43) regulating outpatient payment rates for acute care hospitals.
Hospitals can currently be fined up to $300 a day. If the proposal is finalized, the penalty would increase to at least $300 a day for smaller hospitals and $10 a bed a day for larger hospitals, but no more than $5,500 a day.”
About pharma
Optum quietly revamps online pharmacy, sells virtual care for cash: “UnitedHealth subsidiary Optum is offering virtual care and discounted drugs to patients who pay with cash, presenting new competition to digital health startups and telehealth providers..