July 1, 2019

Senate Committee Passes Surprise Billing Package Favoring Insurers
A key Senate committee last week passed sweeping bi-partisan legislation aimed at tackling surprise billing, increasing transparency of drug pricing and numerous other changes. By a vote of 20-3, the committee sent the package containing 54 different proposals to the Senate floor that is likely to get put together with other health care price curbing bills from the Finance and Judiciary Committees. The bill would set any surprise bill to the median local in-network rate leading many providers to argue that this will put insurers firmly in the drivers seat, instead favoring a model that would create a third-party arbitration system.  Sen. Bill Cassidy (R-LA) offered an amendment to change this portion of the bill, which led to Chairman Lamar Alexander (R-TN) vowing to work with Cassidy on a compromise before the bill is voted on by the full Senate. Only Sens. Rand Paul (R-KY), Bernie Sanders (I-VT) and Elizabeth Warren (D-MA) voted against the bill in committee. In addition to the surprise billing changes, there were detailed instructions on exactly how providers are to bill patients. Click here for a Strategic Health Care memo.  Alexander wants the bill voted on by the senate in July.

  • Included in the HELP package is Senate Majority Leader Mitch McConnell’s legislation that would raise the age for purchasing tobacco products to 21 nationwide, click here.

House Committee Passes Telehealth, Chronic Care, Mental Health Bills
The House Ways and Means Committee last week voted on several health bills aimed to provide increased telehealth, chronic care, and mental health services to Medicare beneficiaries. The bills included policies to add 1,000 slots to train physicians in mental health and substance abuse disorder treatment, expand Medicare telehealth benefits for mental health counseling, eliminate cost sharing for chronic care management, support rural medical residency programs, provide flexibility for rural critical access hospitals, and extend the rural floor for Medicare physician payments. To view full summaries of all the legislation, click here.

House Committee Chairman Warns HHS: Medicaid Block Grants are Illegal
Just before leaving for leaving for the July 4th recess, House Energy and Commerce Committee Chairman, Frank Pallone (D-NJ), sent a letter to HHS Secretary Alex Azar warning that the Administration’s plan to change Medicaid funding to a block grant approach without Congressional approval is illegal. The letter comes as reports have surfaced that Tennessee is preparing to submit a 1115 waiver to receive a block grant for their Medicaid program. Pallone cautions that “The plain language of the statute prohibits the Secretary from approving a waiver that requests a block grant or per capita cap in Medicaid through a cap on federal funds.” To read the full letter, click here.

Analysis Shows 340B Hospitals Spent $56 Billion on Community Benefits in 2016
A new analysis released by the American Hospital Association shows that tax-exempt 340B hospitals provided $56.1 billion in total benefits to their communities in 2016 alone. By looking at all electronic IRS Form 990 Schedule H data submitted for the 2016 tax year by the hospitals, AHA calculated the percent of total hospital expenses and dollars spent on benefits to the community by 340B hospitals and found that the total dollars equaled 13.9 percent of hospital expenses for that year. Click here to view the summary of the findings.

New Analysis Attacks Hospital Profit Margins, Billing Practices and Recommends Policy Changes
A report  released by the liberal advocacy group, the Center for American Progress finds that hospitals have larger profit margins than the insurance or the pharmacy industry. The report says that a large portion of these profits come from patients with private insurance, and that consolidation of hospitals drives costs up because of more limited options. The report makes recommendations to reduce overall costs to patients using reference pricing, site neutral payments ‘abusive’ billing methods. For the full report click here.

  • A new report also details on how patients are fighting back against aggressive collection methods used by nonprofit hospitals. Click here.
  • A report in the New York Times says transparency could drive prices up rather than reduce them. Click here.

Study Details Skyrocketing Nursing Home Costs
In a new study from Georgetown University Medical Center, data reveals nursing home price increases generally outpaced increases in overall medical care by 20.2 percent and consumer prices 11.7 percent. For example, in California between 2002 and 2011, the median out-of-pocket cost for nursing home care increased by 56.7 percent. The data was pulled from 3900 facilities, about 27 percent of total existing free standing facilities. For the full study click here.

  • A new study found that a quarter of adults over 50 take a supplement for brain-related health. But that same study suggests that seniors should spend their money elsewhere. The supplements don’t work. Click here.

New Report Shows Youth Substance Use is Down
The White House Office of National Drug Control Policy released a report last week that examines youth substance use rates in the Drug-Free Communities programs and shows that drug and alcohol usage is trending down. The report states that there was a  24 percent decline in prescription drug misuse and a 31 percent decline in tobacco use among high school students. Middle schoolers showed a 27-percent decline in alcohol and a 17-percent decline in marijuana use. Click here to read the report.

  • CMS announced two new state Medicaid demonstrations to treat substance abuse in Minnesota and Nebraska. Click here.

FDA Puts Illegal Kratom Distributors on Notice
The FDA has issued warning letters to Cali Botanicals and Kratom for illegally selling unapproved, misbranded kratom-containing drug products with unproven claims about their ability to treat or cure opioid addiction and withdrawal symptoms. Kratom products are still being assessed by the FDA and are known to have high rates of salmonella. To view the letter for each respectively click here and here.

Apple Expands into Health Care With “One Drop” Diabetes Monitor
Select Apple stores have begun selling a diabetes monitor. It combines a blood glucose monitor with an app for iPhone or Apple Watch to help patients monitor their glucose levels. Apple CEO, Tim Cook, indicated that Apple plans to continue to expand into health care saying that Apple’s contributions to health care will be their “greatest contributions to mankind.” For more information on Apple’s One Drop click here.

Oncologists Present Plan To HHS To Cut Cancer Care Costs
The Community Oncology Alliance recently  pitched a plan, called OCM 2.0 to HHS, that builds on existing models but would lower the cost of cancer care to Medicare rates or potentially lower. For the full outline of the patient protective plan click here.

HPV Vaccination Could Eliminate Cervical Cancer in Wealthy Countries
Over the past ten years the HPV vaccine has been administered to young girls leading a significant decrease among teens and young adults in the 14 wealthy countries included in a new study. The recently published Lancet study also concluded that populations with high vaccination coverage saw even greater benefits of the HPV vaccination, including improved herd immunity. This study supports the World Health Organization’s goal to eliminate cervical cancer, as the study claims that with “sufficient vaccination coverage,” cervical cancer can be eliminated from many countries. Click here to review the study, and click here to read the corresponding New York Times article.

CMS to Award $50 Million to State Medicaid Agencies to Fight Substance Abuse 
State Medicaid Agencies have until August 9, 2019 to submit an 18 month plan to outline the treatment and recovery of substance use disorders (SUDs), including opioid use disorder (OUD). CMS stated its dedication to battling OUD and SUD and will select at least 10 of the proposals and award a total of $50 Million. Click here for the CMS Notice of Funding.

  • The Health Resources and Services Administration has awarded approximately $1 million in Ryan White HIV/AIDS Program grants to 10 metropolitan areas that are Part A jurisdictions to provide technical assistance to enhance efforts to end the HIV epidemic. Click here for details.

Benefits of a Split-Sleep Schedule for Adolescents
Previous studies have concluded that midday naps improve learning abilities for adolescents, but a new study published in Nature found that there may be additional benefits in a split sleep schedule. Participants were divided in two groups: continuous sleep (for 6.5 hours) and split sleep (for 5 hours at night and 1.5 hours during the afternoon). Adolescents were then tested on memory, factual knowledge, and response time in a controlled school-like environment for two weeks. The study found that adolescents who followed the split sleep schedule recalled information better, particularly information taught after the midday nap. To read the full study, click here.

One Cup of Coffee a Day May Encourage Weight Loss
According to a new study from the University of Nottingham, the amount of caffeine in one cup of coffee may encourage fat loss. The researchers found that when caffeine was introduced to human cells, those cells increased in metabolic rate and there was evidence that the unhealthy white fat converted to leaner, healthier brown fat. The combination of these factors can promote increased calorie burn and nutrient intake. Click here for the study.

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