May 7, 2018

340B Hospitals Have Their Day in Court, Seek Immediate Relief

Hospitals faced HHS in the DC Court of Federal Appeals last Friday over the 340B outpatient rule that cut Medicare  payments for certain drugs by 28.5 percent starting January 1, 2018. HHS asserted that the Secretary has the authority to set prices and payments.  Lawyers representing the hospitals and the American Hospital Association argued that HHS exceeded its authority in making payment cuts.  There was also a question of whether this was even the right court to hear the case or should the case have been argued in a lower court. It is impossible to know how the court will rule on AHA’s request for an immediate injunction against the HHS rule while the case continues through court. To listen to the oral arguments, click here (sign in as guest to listen).

  • HHS Secretary Alex Azar stated in a speech last week that the president’s drug cost reduction plan will go further than what he proposed in his budget, leading many to believe further adjustments are coming to the 340B program. Click here.

House Committee to Vote On Opioid Legislation; DEA Acts Against Distributor

The House Energy and Commerce Committee will hold the first of two markup sessions to vote on opioid legislation on Wednesday. This follows the marathon session that the Health Subcommittee held prior to going to recess when they advanced 57 bills attempting to combat the opioid crisis, 48 of which passed by voice vote. The bills include policies to improve patient safety, enforcement, and prevention as well as coverage and payment issues with Medicare and Medicaid. The second markup will held on May 17th. Click here for more of the two markups from the Committee.

  • The House Energy and Commerce Health Subcommittee will hold a hearing Tuesday, May 8 on a draft bill that would allow providers and payers to more easily share patients’ medical records that contain information about substance use disorders, click here.
  • DEA suspends the registration of Louisiana pharmaceutical distributor, Morris & Dickson Company, from distributing controlled substances due to a failure to properly identify large suspicious orders for controlled substances sold to independent pharmacies with questionable need for the drugs, click here.
  • New report in JAMA details synthetic opioids, like fentanyl, are now the leading cause of opioid overdose deaths, click here.
  • The Commonwealth Fund 2018 Scorecard on State Health System Performance found that the combined rate of deaths from suicide, alcohol, opioids, and other drugs (so-called “deaths of despair”) is up by 50 percent in US since 2005, click here.

7 in 10 Medicare ACOs Would Drop Out if Required to Take Risk

According to a National Association of ACOs (NAACOS) survey about assuming risk and future participation plans for Medicare Shared Savings Program (MSSP) Track 1 ACOs, 71 percent of ACO respondents indicated they are likely to leave the MSSP as a result of having to assume risk. The web-based survey was conducted in April 2018 and based on the 82 ACOs that began the MSSP in 2012 or 2013 and remain in Track 1 in 2018, thus they are required to move to a two-sided ACO model in their third agreement period beginning in 2019. Click here for more on the survey and results.


Large Home Health Agency CEO Says Mergers Lower Costs

The CEO of LHC Group, whose company recently merger with Almost Family, says mergers can lower costs, increase services to patients, and reduce readmission rates. “Payers are putting their emphases on overall cost to lower cost, so it’s clear that home health is going to grow at a much faster rate because of the value that its generating,” Keith Myers said. “We are reducing hospitalizations, moving patients to lowest possible care setting and reducing skilled nursing utilization.” More scrutiny is focused on health care mergers from lawmakers, including a recent hearing in the House Energy and Commerce Committee last month. For more, click here.


Medicare Advantage Is the Focus of Congressional Hearing This Week

Medicare Advantage is the focus of a Tuesday, May 8th, hearing before the House Ways and Means Committee. Witnesses include Independence Blue Cross and Clover Health along with health policy academics and will examine ways to improve and grow the MA program. The Committee expects to hear about the operation of the program as well as challenges by new emerging insurers, consumer interactions with Medicare Plan Finder, and quality measurement in the program. Click here to see the full witness list and testimony, and to watch the hearing.


4 Million American Lost Insurance Coverage Since 2016

Pointing to the changes to the Affordable Care Act, a new report by the Commonwealth Fund finds that the number of uninsured has gone up to 15.5 percent in March of 2018 as compared to 12.7 percent in the same month in 2016. Specifically, the survey found that people dropping out of the exchange as the largest driver to the percentage of uninsured increase. Those in lower income brackets were impacted the most with huge premium increases. Individuals with incomes below $30,000 had an uninsured rate of 25.7 in March, up from 20.9 percent in 2016. To read the full report, click here.

NIH Kicks Off Precision Research Enrollment

NIH’s All of Us, aimed at enrolling more than 1 million people in a vast precision medicine research program, opened nationwide enrollment Sunday with community events in seven cities. Officials have already enrolled 40,000 people in a pilot phase to test the research protocol, a participant portal, a biobank and other elements of the complex program. Officials have said they expect to recruit about 60 percent of the participants through health care organizations, the others volunteering through civic organizations or individually. The NIH intends to get a thoroughly representative ethnic, geographical and sociological mix of participants. Click here for more.


Health Care Employment Is Major Factor in Lower Unemployment Rate

The growing number of jobs in health care was a major contributor to last week’s Bureau of Labor Statistics announcement that April’s unemployment rate was 3.9 percent, down from 4.1 percent in the preceding 6 months. The healthcare sector added 24,000 jobs in April, with 8,000 jobs at hospitals alone. This compares to 22,400 jobs the industry added in March. Ambulatory health care services jobs added more than 17,000 jobs. Healthcare has added 305,000 jobs over the year. Click here for the BLS report.


Illnesses From Bug Bites Have Tripled in the US: CDC

A new report from the CDC reveals that illnesses from mosquito, tick and flea bites have tripled in the past 13 years. The CDC reports that between 2004 and 2016, 642,602 cases of diseases linked insect bites were reported and at least seven new germs spread by ticks, fleas and mosquitoes were discovered. To make matters worse, the CDC states that the US is not prepared for the mosquito, tick, and flea diseases that are major causes of sickness and death worldwide and that the nation needs to be better prepared to face this public health threat. To read more from the CDC, click here.

E.Coli Outbreak Claims First Death

The E. coli outbreak linked to romaine lettuce grown near Yuma, Ariz., has spread to three new states and led to the first death, the CDC said last week. The death was reported in California. The outbreak of E. coli O157:H7 has now led to 121 reported illnesses across 25 states, with 52 hospitalizations, including 14 people who developed kidney failure. Twenty-three more illnesses in 10 states were reported since the CDC gave its most recent update last week. Kentucky, Massachusetts and Utah are added to the list of states where illnesses have been reported. Click here for the latest from the CDC.

FDA, FTC Send Warning Letters to Companies Selling e-Cigs to Kids

As part of ongoing efforts to protect youth from the dangers of nicotine and tobacco products, the Food and Drug Administration and the Federal Trade Commission issued 13 warning letters to manufacturers, distributors, and retailers for selling e-liquids used in e-cigarettes with labeling and/or advertising that cause them to resemble kid-friendly food products, such as juice boxes, candy or cookies, some of them with cartoon-like imagery. Several of the companies receiving warning letters were also cited for illegally selling the products to minors. Click here for details from the FDA.


HHS Appoints New Pain Management Best Practices Inter-Agency Task Force

HHS announced last week that it had named the 28 members of its Pain Management Inter-Agency Task Force that was established in section 101 of the Comprehensive Addiction and Recovery Act (CARA) of 2016. The duty of the task force is to propose updates to best practices and issue recommendations that address gaps or inconsistencies for managing chronic and acute pain. This is a combined effort of HHS, and the Departments of Defense and Veterans Affairs that will have its first meeting May 30-31 in Washington, DC. Click here for more on the task force and the list of the 28 members.

OIG To Investigate CMS Overpayments

The Office of Inspector General (OIG) will be scrutinizing how CMS collects overpayments, the agency stated in a update to its Work Plan.  Although the OIG conducts audits related to Medicare payments, CMS is responsible for collecting overpayments identified and agreed upon in the OIG’s audit reports. However, the OIG is looking to collect data to determine how CMS goes about collecting the funds. Click here to see the update.

Long Duration of Sitting Harms Brain Activity
Do you sit for extensive hours for the day? Well, it’s time for you to take periodic breaks by walking or jogging, according to researchers from UCLA.  They discovered that among 35 adults, aged 45–75 without dementia, who spent more time sitting in the day, had a greater risk of their medial temporal lobe thinning in their brain. Researchers analyzed links between medial temporal lobe thickness, exercise, and sitting time. Researchers did discover that people who sat for over 8 hours a day had a higher risk of the thinning of their medial temporal lobe and lost control of their glycemic levels. Click here for study.

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