Uncategorized

HHS Acts on IV Shortage

The Department of Health and Human Services has initiated a series of steps to help restore the supply of IV solution that was greatly reduced by damage to a Baxter International Inc.’s facility in North Carolina during Hurricane Helene. Among those steps are: posting FDA guidance providing flexibility for compounding IV solution alternatives; extending the expiration dates of existing IV products; airlifting new supplies into and around the country; working with other manufacturers to increase production capacity; helping Baxter clean up and restore its North Carolina plant and invoking the Defense Production Act toward that end; and more. Learn more [...]

joe2024-10-15T17:30:39-04:00October 16, 2024|Uncategorized|

Administration Launches Patient Safety Initiatives

In response to World Patient Safety Day, the administration has launched a multi-faceted approach to reducing harm for patients and workers in the delivery of health care. The initiative will fall under the umbrella of a new multi-agency, public/private National Action Alliance for Patient and Workforce Safety administered by the Department of Health and Human Services’ Agency for Health Care Research and Quality. Other federal agencies to be involved in the initiative include the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, the Veterans Health Administration, the Department of Defense, the Health Resources and Services [...]

joe2024-09-19T17:44:03-04:00September 23, 2024|Centers for Medicare & Medicaid Services, Uncategorized|

Court Rejects Non-Compete Ban

A federal court has rejected a Federal Trade Commission regulation that banned non-compete agreements between employers and employees under most circumstances. In a suit brought in Texas by the U.S. Chamber of Commerce, the Business Roundtable, the Texas Association of Business, and others, the court found that the FTC exceeded its authority in promulgating the regulation and that the rule itself was “arbitrary and capricious,” based on limited evidence, and without either a rationale for such a sweeping approach nor any evidence that the agency considered a more limited approach to the challenges it identified as the basis for advancing [...]

joe2024-08-21T11:42:58-04:00August 21, 2024|Uncategorized|

Court Sides Again With Providers on No Surprises Act

A federal appellate court has affirmed a lower court ruling that the manner in which federal regulations tell No Surprises Act dispute arbiters to evaluate competing fee claims unfairly favors health care payers over providers. At issue is a regulatory directive that arbiters weigh what is known as the qualifying payment amount – the median of what insurers contract to pay providers in a given geographic area – when deciding on payments. In February a federal court ruled that using this measure in what is known as the independent dispute resolution process unfairly stacked the arbitration process in favor of [...]

joe2024-08-08T16:52:09-04:00August 12, 2024|Uncategorized|

The “Other” Supreme Court Decision

While much attention has focused on recent Supreme Court decisions involving reproductive care rights and presidential immunity, a less-noticed case has potential implications for the health care industry. In the case of Securities and Exchange Commission v. Jarkesy, the Supreme Court ruled last week that the SEC’s use of administrative proceedings to levy a fine against a hedge fund manager for misleading investors deprived that manager of the right to a court trial. While the immediate ruling addresses only the SEC case, the underlying rationale has implications across the federal government – including health care agencies. Currently, the Department of [...]

joe2024-07-03T16:18:15-04:00July 5, 2024|Uncategorized|

The Times Looks at PBMs

The New York Times this week began an in-depth look at pharmacy benefit managers: the companies that administer the prescription drug benefits of more than 200 million Americans. As the Times notes, only three companies dominate the market, and its report examines when, how, and if PBMs save money for insurers and consumers; how they charge for prescription drugs; how they influence consumer access to prescription drugs – and the timeliness of that access; the effect they are having on independent pharmacies; how they make money; the influence they have on the price of prescription drugs; and more. Learn more [...]

joe2024-06-25T19:58:47-04:00June 26, 2024|Uncategorized|

Federal Health Policy Update for March 21

The following is the latest health policy news from the federal government for March 15-21. Some of the language used below is taken directly from government documents. The White House The White House has announced new actions to advance women’s health research and innovation and issued an executive order in support of that objective. The order directs executive branch agencies to integrate women’s health across the federal research portfolio; prioritize investments in women’s health research; pursue new research on women’s midlife health; and assess unmet needs to support women’s health research. Learn more from this White House fact sheet, which [...]

Providers Faring Well in Surprisingly Busy Dispute Resolution Process

Health care providers are winning more than three-quarters of all payment disputes being brought through an unexpectedly active federal Independent Dispute Resolution process. The process, created under the 2020 No Surprises Act to settle payment disagreements between providers and payers and to spare consumers surprise medical bills – especially for receiving emergency care from providers outside of their insurer’s network. 2023 saw 13 times more disputes during the first half of 2023 – nearly 300,000 cases in all – than federal officials anticipated. With more than 20 percent of the disputes submitted for resolution rejected as ineligible for the process, [...]

joe2024-02-20T21:23:48-05:00February 21, 2024|Uncategorized|

No Surprises Act Implementation Yields Mixed Results

Is the No Surprises Act working? Is it protecting patients from surprise medical bills? Are providers and insurers happy? The Washington Post reports mixed results. On one hand, millions of people have been protected from surprise medical bills. But on the other hand… Experts thought that once the terms of the program were understood there would be only about 22,000 cases sent to arbitration – the law’s Independent Dispute Resolution process – in 2022. Instead, nearly 500,000 cases went that route, with nearly half of the requests for arbitration coming from physician staffing companies owned by private equity firms. At [...]

joe2024-02-14T16:33:47-05:00February 14, 2024|Uncategorized|

States Not Depending on Federal Action on Prior Authorization

Unwilling to leave the challenge of addressing the troubling prior authorization practices of many health insurers, officials in some states are trying to take matters into their own hands. Last year, lawmakers in 29 states considered 90 different bills to impose varying prior authorization requirements on health insurers serving their constituents. Among the changes these proposals seek: shorter response times for requests for authorization and mandatory public reporting of insurers’ prior authorization activity. In addition, last year five states required insurers to engage in a practice known as gold carding: waiving prior authorization for requested items and services for individual [...]

joe2024-02-13T16:56:53-05:00February 14, 2024|Uncategorized|