About Covid-19
CDC recommends Pfizer booster shot for kids ages 5 to 11 as Covid cases rise across the U.S. The recommendation follows on the heels of FDA approval.
About health insurance
Association Between Medicaid Expansion Under the Affordable Care Act and Survival Among Newly Diagnosed Cancer Patients “The 2-year overall survival increased from 80.58% pre-ACA to 82.23% post-ACA in expansion states and from 78.71% to 80.04% in nonexpansion states, resulting in a net increase of 0.44 percentage points (ppt) (95% confidence interval [CI] = 0.24ppt to 0.64ppt) in expansion states after adjusting for sociodemographic factors.”
In expansion states, certain cancer-specific overall survival rates were much higher than those averages (see the article for details).
Court tosses $300,000 hospital bill for promised $1,300 charge An important case for enforcement of “surprise medical bills.”
”Colorado's Supreme Court has ruled in favor of a woman who expected to pay about $1,300 for spinal fusion surgery but was billed more than $300,000 by a suburban Denver hospital that allegedly included charges it never disclosed she might be liable for.
This week's ruling in favor of Lisa French, who underwent two surgeries in 2014, follows efforts by many U.S. states and the federal government to help curb health care costs by restricting or eliminating so-called "surprise billing" and requiring increased price transparency for consumers.
In a unanimous opinion, the Colorado justices ruled Monday that agreements French signed before surgery at St. Anthony North Health Campus in Westminster don't compel her to pay the extra charges, which stemmed from a then-secret list of prices for services that hadn't been disclosed to her.”
Virginia’s ACA Section 1332 State Innovation Waiver “On May 18, 2022, federal reviewers issued a letter approving Virginia’s State Innovation Waiver application to establish the Commonwealth Health Reinsurance Program (CHRP) for an initial period of up to five years, beginning in 2023. Per enactment language, the remaining Virginia statutes establishing the CHRP will become effective on June 17, 2022, 30 days after the Commission provided notice of federal approval.
The CHRP is designed to operate as a traditional reinsurance program by reimbursing ACA individual market health insurers for a percentage of an enrollee’s claims costs exceeding a specified threshold (or “attachment point”) and up to a specified ceiling (or “reinsurance cap”). Specifically, in 2023, the approved program would reimburse claims between an attachment point of $40,000 and an estimated $155,000 cap with a coinsurance rate of 70%. This program is projected to reduce individual premiums in the ACA marketplace by 15.6% for plan year 2023.
The CHRP is designed to be funded in large part through pass-through funds provided by the federal government based on federal premium tax credit savings from lower premium costs in the Virginia marketplace.”
The Manatt State Cost Containment Update “Manatt examines how benchmarking programs can elevate the importance of primary care and behavioral health care investments and allow for the measurement of spending on these critical preventive services.”
The survey of state-specific initiatives is particularly interesting.
About hospitals and healthcare systems
Mayo Clinic posts $142M operating gain, bucking national trend “Mayo Clinic ended the first quarter of this year with an operating gain of $142 million. In the same quarter last year, Mayo posted operating income of $243 million.
The health system also recorded nonoperating losses of $369 million in the first quarter of 2022.
Despite losses from nonoperating items, Mayo Clinic ended the quarter with $17.5 billion in net assets, up from $13.2 billion recorded in the same period one year prior.”
About pharma
Maine Joins Two Other States Considering Making Their Own Insulin “The State of Maine has enacted legislation that will create a commission to assess whether the state has the resources to manufacture its own insulin…
Maine is the third state, along with California and Michigan, to consider producing its own insulin in an effort to make the essential drug more affordable.”
FDA Urges Drug Manufacturers to Develop Risk Management Plans to Promote a Stronger, Resilient Drug Supply Chain “In 2019, in an effort to address the national drug shortage problem, the federal Drug Shortages Task Force released a report that called for the adoption of risk management plans to proactively assess risk and to predict and prevent supply disruptions that could potentially lead to a drug shortage. Then in 2020, Congress passed the CARES Act to require certain manufacturers to develop, maintain, and implement, as appropriate, risk management plans that identify and evaluate risks to a drug’s supply.
To further assist manufacturers with these requirements, we are issuing a draft guidance, Risk Management Plans to Mitigate the Potential for Drug Shortages, intended to help with the development, maintenance and implementation of risk management plans.
The draft guidance describes a framework for stakeholders to consider when developing risk management plans that aligns with principles stated in the International Council for Harmonisation guidance for industry, Q9 Quality Risk Management, and identifies risk factors to consider when developing the content of risk management plans. The steps needed to reduce risks of a disruption in drug supply may vary among the different manufacturers in the supply chain for a given drug.”
HHS commits $300M to global accelerator targeting antibiotic-resistant bacteria “The Department of Health and Human Services announced Thursday morning a $300 million commitment to supporting a public-private antibiotic-resistant bacteria accelerator over the next decade.
Called the Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator (CARB-X), the accelerator was jointly launched in 2016 by HHS’ Biomedical Advanced Research and Development Authority (BARDA), the National Institute of Allergy and Infectious Diseases (NIAID) and global health charity Wellcome.
The Boston University-led program funds and offers technical, regulatory and business support to private companies in the early stages of developing new products to address antimicrobial-resistant infections.”
About the public’s health
Oklahoma lawmakers pass bill banning abortions after ‘fertilization’ Oklahoma lawmakers on Thursday passed a bill that would ban abortions from the moment of ‘fertilization,’ effectively prohibiting almost all abortions in the state…
The Oklahoma bill is similar in its enforcement mechanism to the one that was signed into law in Texas last year, allowing civilians to file lawsuits against those who perform or help facilitate an abortion…
The bill states a lawsuit cannot be brought against a woman who had or seeks to have an abortion…
It explicitly allows for the use of the Plan B pill, a widely used form of emergency contraception, but would prohibit medical abortions using pills. The bill exempts from its definition of abortion any procedure to ‘save the life or preserve the health of the unborn child,’ to ‘remove a dead unborn child caused by spontaneous abortion’ or to remove an ectopic pregnancy, in which the fetus grows outside the uterus.”
HHS announces $1.5B grant for states to address ongoing opioid epidemic “The grant funding opportunity will be available through the Substance Abuse and Mental Health Services Administration (SAMHSA)…
The funding will be made available to those increasing access to medications for opioid use disorder (OUD) and supporting prevention, harm reduction, treatment and recovery support services for OUD and other substance use disorders. A portion is earmarked for those with the highest mortality rates. States and territories will also be asked to develop naloxone distribution plans to increase access.”
HHS Announces $2 Million Funding Opportunity to Establish National Center of Excellence on Social Media and Mental Wellness “U.S. Department of Health and Human Services (HHS), through the Substance Abuse and Mental Health Services Administration (SAMHSA), is announcing $2 million in funding to establish a national center of excellence (CoE) on social media and mental wellness. The purpose of the CoE will be to develop and disseminate information, guidance, and training on the impact—including benefits and risks—that social media use has on children and youth, especially the risks to their mental health. This CoE will also examine clinical and social interventions that can be used to mitigate the risks. Social media use can be associated with negative mental health outcomes, and children and youth are particularly vulnerable.”
Trends in Cancer Mortality Among Black Individuals in the US From 1999 to 2019 “In this cross-sectional study of 1 361 663 deaths from cancer among Black individuals, although cancer mortality decreased considerably among Black individuals from 1999 to 2019, the cancer mortality rate was higher among Black men and women than in other racial and ethnic groups in 2019.”
AMA, Brigham and Women's, Joint Commission's new peer network helps health systems embed equity in care “The American Medical Association (AMA), Brigham and Women’s Hospital and the Joint Commission have launched a new network designed to teach health systems how to better incorporate racial justice equity into their quality and safety practices.
Announced Thursday, the so-called Advancing Equity through Quality and Safety Peer Network is a one-year mentorship and networking program that will be piloted by eight hospitals and health systems including the Dana-Farber Cancer Institute and Vanderbilt University Medical Center.”
Federal judge blocks HHS gender transition coverage requirement after challenge from Christian group “A federal judge in North Dakota has temporarily blocked HHS and the Equal Employment Opportunity Commission from requiring the Christian Employers Alliance and its members to provide health plans that cover employees' gender transition procedures.
The U.S. District Court for the District of North Dakota ruled May 16 that the requirement adopted in 2021 by the two federal agencies applying to most health plans would force the Christian group and its members to violate their religious beliefs and cause irreparable injury.”
About health technology
Anti-Mullerian Hormone [AMH] as Predictor of Future and Ongoing Bone Loss During the Menopause Transition AMH below 100 pg/mL will detect [higher risk for bone loss] with sensitivity of 50% in premenopause, 80% in early perimenopause, and 98% in late perimenopause. These findings suggest that AMH measurement can help flag women at the brink of significant bone loss for early intervention.”