The Daily Scan

August 3, 2018

Last Updated: 8:55 AM EST

Regulation

  • Yesterday, The Centers for Medicare and Medicaid Services (CMS) finalized a rule to empower patients and advance the White House MyHealthEData initiative and the CMS Patients Over Paperwork initative. This final rule will help improve access to hospital price information, give patients greater access to their health information and allow clincians to spend more time with their patients. CMS Administrator Seema Verma commented, “we’re excited to make these changes to ensure care will focus on the patient, not on needless paperwork, we’ve listened to patients and their doctors who urged us to remove the obstacles getting in the way of quality care and positive health outcomes. Today’s final rule reflects public feedback on CMS proposals issued in April, and the agency’s patient-driven priorities of improving the quality and safety of care, advancing health information exchange and usability, and removing outdated or redundant regulations on healthcare providers to make way for innovation and greater value.” (CMS.gov

  • Yesterday, the Department of Health and Human Services (HHS) announced the grantees for Title X family planning program services. The Title X program serves more than 4 million family planning clients, most of whom are low-income women. The Title X program provides a broad range of family planning methods and related preventive health services, such as contraception (including natural family planning methods), pregnancy testing and counseling, preconception health care, basic infertility services, sexually transmitted disease screening and treatment, and breast and cervical cancer screening. These grants cover all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and six Pacific jurisdictions, and support delivery of Title X services in almost 4,000 service sites. (HHS.gov

 

Litigation

  • Yesterday, four cities including Baltimore, Chicago, Columbus and Cincinnati filed lawsuit in federal court in Maryland against President Trump. The lawsuit argues that he is violating his constitutional duty to enforce law by "sabotaging" ObamaCare. The lawsuit also states that Trump's actions are "an affront to the rule of law: to our constitituional system, under which Congress enacts laws and the Presdient faithfully implements them." The lawsuit states a few administration actions to argue its case, including that it expanded insurance options that do not comply with the health care law's rules and cutting funding for outreach to help people sign up for coverage. (DemocracyForward.com)

  • William Beaumont Hospital, a regional hospital in Detroit, will pay $84.5 million to resolve allegations under the False Claims Act of improper relationships with eight referring physicians, resulting in the submission of false claims to the Medicare, Medicaid and TRICARE programs. The hospital underminded the Anti-Kickback Statute and the Physician Self-Referal Law, commonly known as the Stark Law. Acting Assistant Attorney General Chad A. Readler of the Justice Department’s Civil Division commented, “offering financial incentives to physicians in return for patient referrals undermines the integrity of our health care system, patients deserve the unfettered, independent judgment of their health care professionals.” (Justice.gov

  • Wisconsin physicians service insurance corporation claimed unallowable Medicare Part A and Part B administrative costs for fiscal year 2013. For part A final administrative cost proposal were generally allowable and in accordance with its Medicare contract and applicable Federal regulations. Of the $4.0 million that the OIG reviewed, the OIG accepted $3.9 million as allowable, allocable, and reasonable and questioned the remaining $99,649 as unallowable costs. For part B, final administrative cost proposal were generally allowable and in accordance with its Medicare contract and applicable Federal regulations. Of the $29.2 million reviewed, the OIG accepted $27.7 million as allowable, allocable, and reasonable and questioned the remaining $1.5 million as unallowable costs. (OIG.HHS.gov, Part A, Part B

Research

  • The British Medical Journal (BMJ) released a new study covering trends in opioid use in commercially insured and Medicare Advantage populations from 2007 to 2016. This study was based on information from the national database of medical and pharmacy claims for commercially insured and Medicare Advantage beneficiares in the United States. The results of the study were annual opioid use prevalence was 14% for commercial beneficiaries, 26% for aged Medicare beneficiaries, and 52% for disabled Medicare beneficiaries. Disabled Medicare beneficiaries had the highest rates of opioid use, the highest rate of long term use, and the largest average daily doses. Additionally, the study concluded that "Opioid use rates were high during the study period of 2007-16, with the highest rates in disabled Medicare beneficiaries versus aged Medicare beneficiaries and commercial beneficiaries. Opioid use and average daily dose have not substantially declined from their peaks, despite increased attention to opioid abuse and awareness of their risks." (TheBMJ.com

  • The New York Health Act, a proposal to create a single-payer health plan in the state, would result in a steep tax increased for the rich while saving most other households money, according to a new study published from the Rand Corp. and the New York State Health Foundation. The bill would expand health coverage to all New Yorkers, including undocumented immigrants, and would not require copays or deductibles. The study assumed some factors such as New York would receieve permission from the federal government to deliver Medicare and Medicaid benefits through the New York Health program while still receiving federal funds and that the state would be able to regulate provider rates and drug prices despite any evidence that doctors, hospitals and pharmaceutical manufacturers would be willing to be paid less than they are today. Richard Gottfried is hoping to introduce the study in a state Senate in the near future. (Article: ModernHealthcare.com, Analysis: NYSHealthFoundation.org)

Private Sector

  • Ascension hired a new Cheif Digital Officer, Eduardo Conrado, to join Ascension on September 1st 2018. This comes from the newly created position of Executive Vice President and Cheif Digital Officer. “As our industry and our ministry rapidly transform, new technologies and companies are disrupting the market at an ever-faster pace, and leaders are beginning to fully embrace digital solutions to unlock innovation and drive productivity, connectivity and engagement,” Dr. Tersigni said. “As Chief Digital Officer, Eduardo will help accelerate the implementation of digital initiatives across both elements of our Dual Transformation – transforming the core of our healthcare operations to optimize resilience while also creating new, transformational models that extend our reach and allow our Mission to thrive into the future.” (Ascension.org

 

 

 

 

 

 

 

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