AUGUST's ABL-HEALTH
ZOOM TABLES

• 8/04 - Orange County (& Beyond) - Cybercrime & Ransomware Expert Panel: "Defending Yourself and Your Company from Cyberattacks," featuring: Oli Thordarson, CEO of Alvaka Networks; Scott Koller, Partner at Baker & Hostetler LLP; Pierson Clair, Managing Director, Cyber Risk, at Kroll; Dave Cunningham, Alvaka's Business Technology Officer; and Len Tateyama, Alvaka's Director of IT
  (See Mimi's blog below, "A Case in Point: The High Cost of Cybercrime by the Numbers," based on the UF Health Central Florida cyberbreach debacle)


• 8/10 - Silicon Valley Table - Discussion Topic: "Care Without Walls" - Featured Presenters: Mark Godwin, Founder, President & CEO of OverSightMD, and Larry Blitz, Managing Partner of MDR Resources


• 8/11 - San Francisco Table - Discussion Topic: "New Technology for Serving Multi-Lingual Frail Seniors at Home" - Featured Member Presenter: Grace Chen, Co-Founder & CEO, LucidAct Health


• 8/19 - Oakland Table - Discussion Topic: "Takeaways from HIMSS21, Other Hot Topics" and Open Discussion


• 8/20 - Los Angeles Table - Discussion Topic: "Care Without Walls" - Featured Presenters: Mark Godwin, Founder, President & CEO of OverSightMD, and Larry Blitz, Managing Partner of MDR Resources


• Explore Membership in ABL's Executive Round Tables >>>

• Alvaka Provides List of Mitigations to Reduce Risk of Cyber Attacks
• Bayer's BlueRock Therapeutics Gets FDA Fast-Track Designation for Parkinson's Treatment
• Biospectal Raises $4.3 Million Funding Led by Digital Health Investor, SeedLink
• Choice in Aging's Learning Division Named "Best of the Bay"
• Cigna + Oscar Expands Convenient Access to Virtual Primary Care
• Covered California Announces 2022 Plans: Full Year of American Rescue Plan Benefits, More Consumer Choice and Low Rate Change
• Elemeno Health Raising Growth Funds on StartEngine + Signs Major Channel Partnership
• GeBBS Healthcare Acquires Aviacode & Earns HITRUST CSF Certification
• HumanGood Teams with Wilshire Health + Wins Awards
• Kaiser Permanente Hospitals Among Nation's Best + Tops 2021 U.S. Consumer Net Promoter Scores
• King & Spalding Among Most Recommended + Announces Upcoming Healthcare Events
• LigoLab's TestDirectly Offers Direct-to-Consumer Business Model
• MedWand Projected to "Revolutionize the Healthcare Industry"
• Mission Hospice Offers Classes on Advanced Healthcare Directives & Healing Touch + Announces Fall Gala
• Nelson Hardiman Interviewed on Legality of Vaccine Mandates & on "Next Opioid Legal Frontier"
• PreludeDx and GenesisCare Form Precision Medicine Global Partnership
• Providence Digital Innovation Group Discusses Behavioral Health Solutions
• Royal Ambulance Helps El Camino Health Improve Discharges Before Noon
• Satellite Healthcare Named a Best Company for Women to Advance
• Savi Group Suggests Solutions for Avoiding Physician Burnout
• VivaLNK Spotlighted in Business Insider Article
• Wipfli Earns Recognitions & Announces Upcoming Healthcare Events

HEALTHCARE INDUSTRY NEWS & TRENDS

Citing increasing COVID-19 hospitalizations and ICU patients because of the Delta variant, the California Department of Public Health issued an order August 5 requiring workers in healthcare to be fully vaccinated, or receive their second shot by September 30. The order applies to workers in hospitals, SNFs, intermediate care facilities, ASCs, and in most other healthcare settings. Workers may be exempt from the vaccination requirement if they are granted an exemption for religious beliefs or qualifying medical reasons. Unvaccinated exempt workers must meet testing and safety requirements.
The California Health Department also issued an order Aug. 5 directing hospitals, SNFs, and intermediate care facilities to verify that visitors are fully vaccinated, or to verify documentation of a negative coronavirus test for unvaccinated or partially vaccinated visitors. (https://www.beckershospitalreview.com/workforce/california-orders-vaccination-of-healthcare-workers-by-sept-30.html)

The number of hospitals and health systems requiring COVID-19 vaccination for employees is growing. Becker's Hospital Review is regularly updating a list of healthcare organizations who have announced mandates. In California, they include Kaiser Permanente, Sutter Health, MemorialCare, California Dept of Public Health. (https://www.beckershospitalreview.com/workforce/california-requires-proof-of-vaccination-or-testing-for-healthcare-workers.html)
Also, the University of California will require COVID-19 vaccines for faculty, staff, academic appointees and students accessing UC campuses this fall, the system said June 14. (https://www.beckershospitalreview.com/workforce/hospitals-health-systems-mandating-vaccines-for-workersjune17.html)

The Pentagon will require members of the U.S. military to get the COVID-19 vaccine by Sept. 15, according to a memo obtained by The Associated Press. That deadline could be pushed up if the vaccine receives final FDA approval or infection rates continue to rise. The decision will add the COVID-19 vaccine to a list of other inoculations that service members are already required to get. Depending on their location around the world, service members can get as many as 17 different vaccines. (https://www.kxly.com/i/pentagon-to-require-covid-vaccine-for-all-troops-by-sept-15/)

More companies are enacting requirements that employees receive a COVID-19 vaccine before returning to the workplace. Under some orders, those who remain unvaccinated must follow strict safety guidelines including regular testing, social distancing and mask mandates. Some exceptions are being made for those who qualify for medical or religious exemptions. The Los Angeles Times has published a list of some private sector employers that have announced some form of vaccine mandates; they include: Cisco; DoorDash, Facebook, Microsoft; Frontier Airlines, Google, Hollywood workers; Tyson Foods, United Airlines, Walgreens, Walt Disney Co., Walmart, and The Washington Post. (https://www.latimes.com/business/story/2021-08-07/list-employers-with-covid-19-vaccine-mandates?utm_id=35034&sfmc_id=486066)

More than 193 million people, or 58.2% of all Americans, have received at least one dose of a COVID-19 vaccine, according to CDC data. The seven-day average of newly vaccinated people has risen 44% in the last two weeks, White House Data Director Cyrus Shahpar, MD, said, suggesting more unvaccinated people are getting their shots. Of the population eligible for the shots, 58.4% have been fully vaccinated. (https://www.beckershospitalreview.com/pharmacy/half-of-us-population-fully-vaccinated-white-house-says.html)

The speed of new COVID-19 vaccinations is increasing in nearly every part of California, and some of the biggest boosts are coming in counties with low cumulative vaccination rates or where the Delta variant's recent surge has hit hardest. First-dose vaccinations for the seven days ending July 26 were up 21% statewide compared to the previous week, a Sacramento Bee review of California Department of Public Health data found, continuing a trend that started around the time health officials began giving dire warnings about the highly contagious Delta variant. And the pace has increased faster than that average in all five counties with the highest recent case rates, as well as in four of the five counties with the lowest proportions of their populations at least partially vaccinated. (https://www.sacbee.com/article253112048.html)
Meanwhile, all 50 States Report Rising Vaccination Rates: Vaccinations statewide increased by approximately 100% in the last two weeks of July. (https://abcnews.go.com/Politics/50-states-report-rising-vaccination-rates-covid-infections/story?id=79224863)

The San Francisco Department of Public Health is now allowing people who received Johnson & Johnson's single-shot COVID-19 vaccine to get a "supplemental dose" of Pfizer or Moderna's mRNA vaccine, CNBC reported Aug. 3. The health department decided to allow the extra doses in response to a high number of requests from residents. To receive the second shot, interested J&J vaccine recipients can send a special request to the health department. (https://www.beckershospitalreview.com/public-health/san-francisco-allowing-j-j-vaccine-recipients-to-get-supplemental-pfizer-or-moderna-dose.html)

The COVID-19 Delta variant contains genetic changes that allow it to spread twice as fast as the original strain, Kaiser Health News reported and Becker's Hospital Review cited. Delta has an incubation period of four days versus six, which means infected individuals are contagious sooner. People infected with Delta infect six people on average, compared to an average of two to three people in the early days of the pandemic. The Delta variant has the potential to kill more people because it infects so many more, said Eric Topol, MD, cardiologist and founder and director of the Scripps Research Translational Institute. COVID-19 vaccines remain mostly effective against the Delta variant. (https://www.beckershospitalreview.com/quality/why-delta-is-the-most-transmissible-variant-yet-9-things-to-know.html )
However, at least 233 staff members at two major San Francisco hospitals, most of them fully vaccinated (75-80%), tested positive for the coronavirus in July, and most, according to a hospital official, involved the highly contagious Delta variant. Some of the cases were asymptomatic, most involved mild to moderate symptoms, and only two required hospitalization, officials said. (https://www.nytimes.com/2021/07/31/us/covid-san-francisco-hospital-delta.html)

California spent nearly $200 million to set up, operate and staff alternate care sites that ultimately provided little help when the state's worst coronavirus surge spiraled out of control last winter, forcing exhausted hospital workers to treat patients in tents and cafeterias. It was a costly way to learn California's hospital system is far more elastic than was thought at the start of the pandemic. Through desperation and innovation, the system was able to expand enough to accommodate patients even during the dire surge that saw hospitalizations top 20,000 and nearly 700 people die weekly. (https://www.kqed.org/news/11883351/california-learns-costly-pandemic-lesson-about-hospitals)

Arthie Southam, MD, EVP of Kaiser Permanente Health Plan Ops & Chief Growth Officer, and Tony Pfannkuche, Ph.D., CEO of Bridge Executive Corporation, both heartily recommend the new book by Andy Slavitt, former CMS Acting Administrator: Preventable: The Inside Story of How Leadership Failures, Politics, and Selfishness Doomed the U.S. Coronavirus Response. Artie also "read it back to back with Michael Lewis' book on the pandemic: [The Premonition: A Pandemic Story]" According to Tony, "Slavitt frames the failures in the larger context of the fundamental weaknesses of the design of American healthcare system; he knows what he's talking about; he's an excellent writer."

The White House recently announced that President Biden issued an expansive executive order designed to enhance competition across multiple sectors of the U.S. economy, including healthcare, technology, and more. In sum, the order involves 72 initiatives by more than a dozen federal agencies, specifically targeting "competition problems" that President Biden said have led to higher prices across various sectors.
Regarding healthcare, the order (1) emphasizes that hospital mergers can be harmful to patients and encourages the DOJ and FTC to review and revise their merger guidelines to ensure patients are not harmed by such mergers, (2) calls to allow the import of "safe and cheaper" drugs from Canada, (3) would permit hearing aids to be sold over the counter, and (4) directs HHS to standardize plan options in the National Health Insurance Marketplace so people can comparison shop more easily. (King & Spalding Health Headlines, 7/9/21: https://www.kslaw.com/news-and-insights/white-house-issues-executive-order-on-promoting-competition-in-the-american-economy)

Senate Democrats unveiled a budget resolution Monday that maps $3.5 trillion in spending boosts and tax breaks aimed at strengthening social and environmental programs. The measure lays the groundwork for legislation later this year that over a decade would pour mountains of federal resources into their top priorities. Included would be more money for health care, education, family services and environmental programs and tax breaks for families, with much of it paid for with tax increases on the rich and corporations.
Included is establishing paid family and sick leave; expanded Medicare coverage to cover dental, hearing and vision benefits; increased spending for home health care; and reducing the prices the federal government pays for pharmaceuticals it buys for Medicare recipients. (https://www.kxly.com/i/senate-dems-unveil-3-5t-budget-for-social-climate-efforts-2/)

CMS published on August 2 the Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) final rule for federal fiscal year 2022. The final rule updates Medicare payment policies, quality reporting programs, and rates for operating and capital-related costs of inpatient hospitals. This article from King & Spalding Health Headlines provides an overview of key components of the final rule.
Additionally, CMS Issued Four Payment Rules for FY 2022: On July 29, CMS issued final rules for FY 2022 in its yearly update to Medicare payment policies under the Skilled Nursing Facility prospective payment system, Inpatient Rehabilitation Facilities PPS, and Inpatient Psychiatric Facilities PPS. CMS also issued an update to hospice payment rates for FY 2022. In each of these updates, CMS also updated measures to the quality reporting programs and made adjustments to data collection to account for the COVID-19 public health emergency. King & Spalding highlights some of the proposed changes in each final rule.

On July 19, CMS published a proposed rule to update the payment policies, payment rates and other provisions for services furnished under the Medicare Outpatient Prospective Payment System and the Ambulatory Surgery Center Payment System in calendar year 2022. Highlights include increasing the civil monetary penalties for noncompliance with the price transparency rules, halting the elimination of the inpatient only list, changing the list of covered procedures, and continuing the payment rate of ASP minus 22.5% for 340B drugs. CMS is also soliciting comments and information on whether it should make permanent certain temporary policies adopted during the public health emergency for COVID-19, and the implementation of policies for Rural Emergency Hospitals. (King & Spalding Health Headlines, 7/26/21: https://kslawemail.com/128/8127/pages/article.asp?sid=0382c426-eaf1-4708-af3e-0e6aef451ff9)

CMS published a proposed rule on July 13 that would amend certain regulations under the Stark Law relating to indirect compensation arrangements. CMS recently addressed indirect compensation arrangements in December 2020 when it made revisions to the regulatory definition which narrowed the scope of arrangements that are subject to scrutiny. The Proposed Rule would effectively roll back these changes for indirect arrangements in which the physician's direct compensation involves compensation for anything other than services which are personally performed by the physician. Comments on the Proposed Rule are due no later than 5 p.m. on September 13, 2021. (King & Spalding Health Headlines, 7/19/21: https://kslawemail.com/128/8119/pages/article-1.asp?sid=ee4719d6-81f6-4658-ab27-824e7d09cfc7)

CMS released the Calendar Year 2022 Physician Fee Schedule proposed rule on July 13, which includes proposed policy changes for Medicare payments under the Physician Fee Schedule and other Medicare Part B issues for claims occurring on or after January 1, 2022. The Proposed Rule changes aim to address the widening gap in health equity that has particularly affected underserved populations and has been recently highlighted by the COVID-19 public health emergency. Comments to the Proposed Rule are due by 5:00 p.m. on September 13, 2021. (King & Spalding Health Headlines, 7/19/21: https://kslawemail.com/128/8119/pages/article-2.asp?sid=ee4719d6-81f6-4658-ab27-824e7d09cfc7)

HHS has released five new Frequently Asked Questions regarding payments distributed to providers via the CARES Act Provider Relief Fund. They cover a wide range of topics, including how to return unused funds partially spent, reporting contractual adjustments and charity care adjustments, appealing or disputing a decision made, and more. (King & Spalding Health Headlines, 7/19/21: https://kslawemail.com/128/8119/pages/article-3.asp?sid=ee4719d6-81f6-4658-ab27-824e7d09cfc7)

OIG recently posted an Advisory Opinion relating to a proposed arrangement between a Medigap Plan and a Preferred Hospital Organization. The proposed arrangement involves (i) a discount on policyholder's Medicare Part A deductible, (ii) a policyholder premium credit, and (iii) a monthly administrative fee to the PHO. It's designed to incentivize the Medigap plan's policyholders to seek inpatient care from a hospital within the PHO network. OIG concluded that the proposed arrangement poses a sufficiently low risk of fraud and abuse under the Federal Anti-Kickback Statute and it would not impose administrative sanctions under the Beneficiary Inducements Civil Monetary Penalty in connection with the proposed arrangement. (King & Spalding Health Headlines, 7/12/21: https://kslawemail.com/128/8086/pages/article5.asp?sid=fd3fdae4-37ad-495d-bf50-fcfc08c97ea9)

Telehealth use overall has stabilized at levels 38 times higher than before the COVID-19 pandemic, ranging from 13% to 17% of visits across all specialties, according to new data from McKinsey. And though usage has dropped since its peak in spring 2020, patient and physician attitudes toward telehealth have improved. About 40% of surveyed consumers said they planned to continue using telehealth moving forward, up from 11% prior to COVID-19. (https://www.healthcaredive.com/news/telehealth-use-stabilizing-at-38-times-pre-covid-19-levels-mckinsey-says/603153/)

Kaiser Permanente and Providence Southern California expect to spend up to $1 billion on their joint hospital in Victorville, CA, expected to be fully functional by 2028. The unusual pairing of very different health care giants - a Catholic chain and an HMO-only model - will result in a facility available to both systems' patients. KP will contribute 30% of the capital to build it, and Providence 70%. They hope to win state approval for their plan and sign a definitive agreement by year's end. (https://khn.org/news/article/providence-kp-team-up-to-attract-patients-in-californias-growing-high-desert-region/)

Thanks to the pandemic, there is heightened interest in new effective options for preventing and treating anxiety, depression, and other psychiatric illnesses. HR managers are looking for new ways to support their employees. Data from the CDC suggests that the mental health of younger people and minorities has been especially impacted. In the last 12 months, a research team at the division of digital psychiatry at Beth Israel Deaconess Medical Center, an affiliate of Harvard Medical School, fielded a dramatic increase in questions related to digital mental health - specifically apps. Harvard Business Review answers several common questions that arose in conversations with physicians, senior executives, and HR managers: https://hbr-org.cdn.ampproject.org/c/s/hbr.org/amp/2021/07/should-your-company-provide-mental-health-apps-to-employees

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