About Covid-19
HHS Distributing $560 Million in Provider Relief Fund Payments to Health Care Providers Affected by the COVID-19 Pandemic: “The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is making more than $560 million in Provider Relief Fund (PRF) Phase 4 General Distribution payments to more than 4,100 providers across the country this week.”
About health insurance
Judge strikes down part of Biden surprise billing rules in win for doctors: “A federal judge in Texas on Wednesday struck down part of the Biden administration’s regulations protecting patients from getting stuck with “surprise” medical bills when they see the doctor, in a win for doctors who sued to block part of the rules.
The ruling leaves in place the protections for patients against getting bills for thousands of dollars in situations such as going to the emergency room and later finding out one of the doctors was not covered by their insurance.
But it strikes down part of the regulations that govern how much insurers will pay doctors once the patient is taken out of the middle.”
More African Americans have gained health insurance following adoption of the Affordable Care Act, HHS report finds: “Nearly 1 million Black American adults would become eligible for medical insurance if 12 holdout states expanded Medicaid eligibility under the ACA, according to the HHS report…
From 2011 to 2019, the number of Black Americans without health insurance who were younger than 65 dropped from 7.1 million people to 4.4 million — or from about 20 percent of the Black population to 12 percent, the report said.
About 37 percent of Black Americans who are uninsured live in three states: Florida, Georgia and Texas. Florida and Georgia, according to the report, have high numbers of uninsured Black children.”
DOJ sues to block UnitedHealth-Change Healthcare deal: “In an announcement, the DOJ says that the deal would harm competition in commercial health markets as well as the market for technology that insurers use to process claims and reduce healthcare costs. The deal is valued at $8 billion in cash and $5 billion in debt.
The complaint was filed Thursday in U.S. District Court for the District of Columbia.”
AFTER MEDICARE’S 14.5% PRICE INCREASE, 60% OF SENIORS WILL FACE DIFFICULTY AFFORDING HEALTHCARE IN 2022: “Key Findings
18% of Medicare recipients say affording healthcare expenses will be “very difficult” following the Medicare price increase, while 42% say it’ll be “somewhat difficult”
20% of Medicare recipients spend 50% or more of their monthly income on healthcare expenses
For those facing difficulty paying healthcare expenses, half will likely have to forgo some type of medical care in 2022
27% of seniors who anticipate difficulty affording healthcare expenses may be forced to come out of retirement and get a job; 22% will consider continuing to work, despite retirement eligibility”
About hospitals and healthcare systems
Lifespan, Care New England scrap merger plans amid regulatory opposition: “The Federal Trade Commission and Rhode Island Attorney General’s Office sued to block the deal last week, claiming it would increase prices, reduce quality and stifle wages. Lifespan and Care New England decided not to appeal nor pursue a legislative workaround, such as a Certificate of Public Advantage.”
Catholic Health hit with credit downgrade after 40-day strike: “Moody's Investors Service has assigned a ‘B1’ rating to Buffalo, N.Y.-based Catholic Health System's proposed revenue bonds and downgraded existing revenue bond ratings to ‘B1’ from ‘Baa2.’
‘The downgrade to 'B1' anticipates minimal cashflow and a further significant decline in liquidity this year, following material losses in fiscal 2021 from a 40-day labor strike and the disproportionately severe impact of the pandemic, both social risks under Moody's ESG classification,’ the credit rating agency said in a Feb. 17 report.
Catholic Health System's rating outlook is negative.”
About pharma
Michigan signs PBM reform law with new transparency requirement: Another state action less than a week after the FTC failed to go forward with PBM investigations.
”The legislation prohibits PBMs from forcing pharmacists to sign gag clauses that prevent pharmacists from telling consumers it is cheaper to purchase drugs out-of-pocket and not through their insurance.
Michigan also will now require PBMs to get licenses and to file transparency reports with state officials to give consumers information on the ‘backend cost and profits of the medications they are prescribed’…
The law bans spread pricing where a PBM can drive up costs for reimbursing a pharmacist for prescription drugs and prohibits a PBM from charging a co-pay higher than the selling cost of the drug. The state is the 15th to ban spread pricing, according to data from the National Conference of State Legislatures.
In addition, PBMs cannot discriminate against any pharmacy solely because the carrier doesn’t have a vested interest in the pharmacy nor against any 340B covered entities.”
WHO creates training hub to boost pharmaceutical production in poor countries: “The World Health Organization is establishing a facility in South Korea to provide training for drug manufacturing in poorer countries to increase local production, combat chronic diseases and enhance preparation for the next global health crisis… Health experts have said the uneven distribution of vaccines worldwide was largely because of a lack of trained staff and the concentration of jab manufacturing in richer nations. The South Korean training hub will provide technical and hands-on training in the production of a range of pharmaceutical products, including vaccines, monoclonal antibodies and cancer treatments…”
Two related stories about different approval agencies:
FDA’s Pre-Approval Inspections Fell by More Than 50 Percent in 2021, Report Says
EMA Recommended 53 Medicines With a New Active Substance in 2021, up 35 Percent Over 2020
Baxter reaches $18M settlement with SEC over decades of allegedly inflating income: “Baxter International will pay the U.S. Securities and Exchange Commission a penalty of $18 million after settling charges over the medtech giant’s alleged decades-long practice of improperly inflating its reported net income.
According to the SEC, from at least 1995 until 2019, Baxter converted its internal foreign transactions, assets and liabilities into U.S. dollars on its financial statements using a method that ‘was not in accordance with U.S. GAAP or generally accepted accounting principles.’”
About the public’s health
Firearms: the leading cause of years of potential life lost: “Firearms are now the leading cause of YPLL [individual years of potential life lost] in trauma. Firearm deaths have overtaken MVC [motor vehicle crashes] as the mechanism for the main cause of potential years of life lost since 2017. Suicide in white males accounts for more YPLL than homicides. Deaths related to firearms are potentially preventable causes of death and prevention efforts should be redirected.”
About healthcare IT
Trends Shaping the Health Economy: TELEHEALTH: A great review from Trilliant. After all the hype, one statistic that stood out: “The total addressable market for telehealth is <1% of the health economy...and declining.”