ABL Healthcare Member News & Industry Trendletter * August 10, 2021
  • 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 >>>
Click on Headlines to Read Articles

A Case in Point: The High Cost of Cybercrime by the Numbers

                     Blog by Mimi Grant

Last Wednesday, Oli Thordarson, CEO of Alvaka Networks - and ABL Member for nearly 26 years, headed an all-star cast of cyber-defenders who presented "Defending Yourself and Your Company from Cyberattacks." As Bob Rose, President of MedWand Solutions, enthused afterwards, it was "One of the best sessions EVER. The panel and the content were AMAZING!"

Among the reasons the session was so enthusiastically embraced was its timeliness. For example, Oli kicked-off the session by sharing a financial analysis of the probable cost of a massive hack of the University of Florida Health's Central Florida's system, that was just reported in Becker's Health IT on August 2nd, entitled, After nearly 1 month of EHR downtime, UF Health says patient data was compromised during IT attack. Talk about taking a hit when you're already down: after being hacked and basically shuttered by ransomware black hats in late May, UF Health's computer network was compromised so that the names, Social Security numbers, addresses, birth dates, health insurance, and treatment details became available to cyber thieves to extort. Since the government requires that patients be notified and offered ID theft protection, when personal information could have been exposed, costs to inform and offer breach coverage, were on top of having to resort to paper documentation, while the EHR and other IT systems were down for nearly a month.

As Oli explained to his ABL audience: "We have this calculator we created to estimate the cost of a ransomware breach."

He continues, "I looked up UF Central Florida revenue, which was at $1.6B in 2019 [the year before it was acquired by University of Florida Health]. I estimated 6,000 employees at $250k/year revenue each. That would put their IT staff at around 60-plus employees. They probably have 600ish servers. I estimated half their servers got hit. I presume they had a $10M ransom."

"Notice our calculator estimates they should have been fully down six days and 12 days for most operations to return. We know from the article it took them 30 days. I don't think they had the right team helping them," Oli concluded.

Oli included the chart below as an example, created using Alvaka's Ransomware Recovery Cost Calculator. A number of our attendees resonated with Bob Rose's takeaway from the panel's presentations: "This is the one issue that keeps me up not just at night but all day, too, and now I'm even more scared, but I'm also even more motivated to take the advice and guidance of today's presenters and do everything we can to proactively protect our company and our customers." And, as Dave Brown, CEO of CHEQS, concluded: "I didn't expect to find it so captivating -- but it's so current and real. Definitely amping up my use of TFA [Two Factor Authentication]!"


Click on Headlines to Read Articles
Alvaka Provides List of Mitigations to Reduce Risk of Cyber Attacks

In Reduce the Risk of Ransomware & Other Cyber Attacks, Alvaka Networks declares that ransomware is an existential threat to every business - large and small - so it's crucial that companies take steps to reduce the risk of cyber attacks. The average ransom amount for just one of the hundreds of ransomware variants has risen to $939,063 per victim. Additional expenses include lawyers, incident response (including forensics and remediation), reputational damage, new computing devices, potential breach notification, lawsuits, fines, loss of employees and clients. These expenses are often multiples of the ransom paid and cannot be avoided, even if you choose not to pay the ransom demand or have a fully viable backup. Alvaka then provides a list of mitigations to reduce the risk of cyber attacks. (Oli Thordarson, OC)

Bayer's BlueRock Therapeutics Gets FDA Fast-Track Designation for Parkinson's Treatment

BlueRock Therapeutics, a clinical stage biopharmaceutical company and wholly owned subsidiary of Bayer AG, announced that the FDA has granted Fast Track designation for DA01 for advanced Parkinson's disease (PD). DA01, BlueRock's pluripotent stem cell-derived dopaminergic neuron therapy, is under evaluation in a Phase 1 study. The designation is intended to facilitate the development and review of drug candidates that treat serious conditions and address an unmet medical need. This drug candidate may be eligible for more frequent interaction with the FDA to discuss its development plan as well as eligibility for accelerated approval and priority review. (Rama Penta, SV)

Biospectal Raises $4.3 Million Funding Led by Digital Health Investor, SeedLink

Biospectal SA, the remote patient monitoring and biosensing software company, recently announced the closing of a $4.3 million round of seed funding led by digital health investor, SeedLink, with additional funding from LabCorp, Athensmed, Swiss-based Privilege Ventures, and other European and US investors. Biospectal will leverage the new funds to scale its OptiBP smartphone blood pressure monitoring application and data platform technology worldwide. View a short video of how Biospectal OptiBP works here. (Eliott Jones, SV)

Choice in Aging's Learning Division Named "Best of the Bay"

For the third consecutive year, Choice in Learning, part of Choice in Aging, has been voted best of the bay by Parents' Press - named 2021's best Montessori Preschool, Independent Preschool, and Childcare. Meanwhile, watch recent episodes of "Dishing with Debbie" here, a video series in which CEO Debbie Toth speaks with guests on relevant topics. (Debbie Toth, OAK)

Cigna + Oscar Expands Convenient Access to Virtual Primary Care

Cigna and Oscar Health, Inc. announced that they are launching Oscar Virtual Primary Care on select Cigna + Oscar plans, beginning in 2022, available to small businesses in Tennessee and Georgia. Oscar's Virtual Primary Care is powered by a versatile and comprehensive care model that spans virtual and in-person touch points and can help members manage chronic conditions, receive preventive care, coordinate specialty care, and lower overall costs for both the member and the small business owner. (Chris De Rosa, OC)

Covered California Announces 2022 Plans: Full Year of American Rescue Plan Benefits, More Consumer Choice and Low Rate Change

Covered California announced its plans and rates for the 2022 coverage year, which will include a full year of lower premiums under the American Rescue Plan. The new and expanded financial help provided by the law has led to a record 1.6 million people enrolled in Covered California, which contributes to the state having one of the healthiest consumer pools in the nation, resulting in a low rate change for a third straight year. (Kathy Keeshen, JD, SF)

Elemeno Health Raising Growth Funds on StartEngine + Signs Major Channel Partnership

Elemeno Health recently launched a fundraising campaign on StartEngine and so far has raised over $723,400 from 104+ investors.
Also, Elemeno announced its first major channel partnership - with the National Perinatal Information Center, which represents 90 major perinatal hospitals across the US, and which will market Elemeno to their clients with an associated revenue share. "With this raise, we are leveraging our learnings from the past 3 years to optimize our platform for scalability, simplify and accelerate client onboarding, and improve margin. And that sets us up to multiply our channels and resultant sales," Elemeno added. (Arup Roy-Burman, MD, OAK)

GeBBS Healthcare Acquires Aviacode & Earns HITRUST CSF Certification

GeBBS Healthcare Solutions announced the acquisition of Aviacode, a Salt Lake City-based provider of medical coding and compliance services to hospitals and physician groups - part of GeBBS' growth strategy, supported by its investors, ChrysCapital. Aviacode clients will benefit from GeBBS' end-to-end RCM services, workflow/automation tools, and large geographic footprint. And GeBBS will expand its US-based delivery capabilities and medical coding/audit/CDI services portfolio.
Also, GeBBS's iCode platform and SaaS applications, along with its supporting infrastructure, have earned Certified status for information security by HITRUST and received certification against the NIST Cybersecurity Framework, which consists of standards, guidelines, and best practices to manage cybersecurity risk. (Gabe Stein, LA)

HumanGood Teams with Wilshire Health + Wins Awards

Judson Terrace Homes and Judson Lodge, HumanGood affordable housing communities in San Luis Obispo, CA, have partnered with Wilshire Health and Community Services to deliver in-residence medical care for residents. Resident service coordinators at both communities coordinate care with Wilshire Health. Program costs are covered through Medicare/Medi-Cal and the residents' medical insurance.
Meanwhile, HumanGood received honors in several categories from the 2021 National Mature Media Awards and HumanGood was named a recipient of NRC Health's third-annual award recognizing senior living organizations for delivering exceptional customer and employee experiences. (Tara McGuinness, OAK)

Kaiser Permanente Hospitals Among Nation's Best + Tops 2021 U.S. Consumer Net Promoter Scores

Kaiser Permanente (KP) hospitals are among the best in the nation for delivering high-quality care, according to U.S. News & World Report's 2021-22 Best Hospitals rankings. All 39 KP hospitals are "high performing" for 1 or more measures; 19 KP hospitals in California are ranked among the best in the state for overall care.
Also, when it comes to the most highly recommended health plan, KP is number one, according to the NICE Satmetrix 2021 U.S. consumer Net Promoter Score Benchmarks study. For the 11th year in a row, KP rated highest in the annual study of health plan providers, receiving a Net Promoter Score of 48, nearly double the industry average of 27. In addition, KP's 2021 score is 14 points higher than its score of 34 last year. (Marcos Vasconcelos, OAK)

King & Spalding Among Most Recommended + Announces Upcoming Healthcare Events

BTI Consulting Group has named King & Spalding (K&S) among the top 11 firms most frequently recommended by top legal decisionmakers. BTI conducted 350+ interviews of in-house leaders at large companies with $700+ million in revenue to learn which law firms they would be most likely to recommend to their peers.
Meanwhile, on September 9-10, K&S will host its virtual 14th Annual Medical Device Summit, and on Sept. 20, will host its 30th Annual Health Law & Policy Forum (more details to come).
And, on August 26, K&S will hold a webinar - Post-Acute Care False Claims Act Trends, which will explore recent government enforcement trends and current scrutiny of post-acute providers, including hospice, home health, SNFs, and inpatient rehabilitation facilities. (Marcia Augsburger, JD, SF)

LigoLab's TestDirectly Offers Direct-to-Consumer Business Model

In Expand Laboratory Services to the Home and Improve Patient Engagement with New Direct-to-Consumer Business Models, LigoLab Information Systems describes its TestDirectly direct-to-consumer web portal which integrates with all laboratory information systems and simplifies the collection, testing, and reporting of specimen samples. It does this by replacing paper forms and manual processes with an electronic workflow that eliminates the potential for human errors, order entry bottlenecks, and reporting delays.
Also, LigoLab is highlighted in Medical Lab Management Magazine, in How Reditus Laboratories is Capitalizing on Revenue Cycle Management. (Suren Avunjian, LA)

MedWand Projected to "Revolutionize the Healthcare Industry"

TechRound featured MedWand in a recent article - The Future of TeleMedicine Includes Physical Exams Thanks to Award-Winning Start-up: MedWand, which includes: "Created by a primary care physician and a team of expert medical device engineers, the award winning, one-of-a-kind, clinical-grade telemedicine device, MedWand, is projected to revolutionise the healthcare industry. Housing up to 10 diagnostic tools in one device, MedWand is not only leading the way for the future of virtual healthcare, but the company also provides what is currently missing in telehealth - physical exams. When conceiving which diagnostics would go into MedWand, the MedWand team selected tools most commonly used in the specialty of family medicine, designed to make the job of primary care clinicians easier and healthcare more accessible. (Bob Rose, OC)

Mission Hospice Offers Classes on Advanced Healthcare Directives & Healing Touch + Announces Fall Gala

On August 19 and Aug. 26, Mission Hospice will present a free online class - Take Charge! - Guided Advance Care Planning, in which participants will learn more about advance health care directives and the steps to take to help get the care you want, based on what matters most to you.
And, on Aug. 21, Mission will present Healing Touch Level 1 Training, which provides training in a gentle, complementary energy-based approach to health and healing.
Meanwhile, save October 9th for Mission Hospice Auxiliary's virtual fall gala - Diamonds & Denim. (Dolores Gomez, SF)

Nelson Hardiman Interviewed on Legality of Vaccine Mandates & on "Next Opioid Legal Frontier"

Spectrum News recently turned to Nelson Hardiman's Harry Nelson for answers on the legality of vaccine mandates - in this video.
And, Bloomberg Law interviewed Harry regarding the J&J and three opioid distributors' $26 billion deal to resolve thousands of lawsuits over their role in the addiction crisis. The deal shifts the focus to major pharmacies and may also offer a glimpse into the future of opioid cases. "We haven't seen historically, in previous drug litigation, major action against the distributors," said Harry. (Harry Nelson, JD, LA)

PreludeDx & GenesisCare Form Precision Medicine Global Partnership; PreludeDx Nominated for Award

GenesisCare, a leading global provider of integrated cancer care, has taken a minority equity position in Prelude Corporation (PreludeDx), a leader in molecular diagnostics and precision medicine. The investment represents the second partnership for the two companies - it follows the clinically-led strategic partnership to rapidly increase patient access to a new risk assessment tool, DCISionRT, for patients with ductal carcinoma in situ globally. The investment will accelerate the global data registry established by both companies, expand the rollout of DCISionRT to patients in need, and fast-track the active development of a new early-stage invasive breast cancer assay by PreludeDx.
Also, PreludeDx's Co-Founder and Chief Scientific Officer, Dr. Troy Bremer, has been nominated for the Orange County Business Journal's 2021 Innovator of the Year Award, which celebrates OC innovators who are creating game-changing ideas, processes, products, services and business models. (Dan Forche, OC)

Providence Digital Innovation Group Discusses Behavioral Health Solutions

Providence Digital Innovation Group (DIG) recently hosted a live online discussion, "It's Behavioral Health's Time, Finally," available to watch here. Providence reports that roughly 1 in 5 people will have a behavioral health need each year, and COVID-19 has caused those numbers to increase. This discussion shares how the Providence DIG is working on solutions to keep up with the need. (Marcee Chmait, LA)

Royal Ambulance Helps El Camino Health Improve Discharges Before Noon

Royal Ambulance recently announced, "We are proud of the work that our Customer Success team did in partnership with El Camino Health (ECH) and our post-acute partners to help ECH improve their discharge before noon! Through our collaboration, ECH increased their discharge to SNF before noon by 33 points in less than one year, resulting in nearly $300K saved annually due to reduced bed hours."
Meanwhile, in WorkSpace Connect's recent article - Giving Employee Experience the Royal Treatment - an HR exec for Royal Ambulance shares how the company uses Workplace from Facebook as a platform for communications, collaboration, connectivity, and community. (Steve Grau & Cecile Currier, SV)

Satellite Healthcare Named a Best Company for Women to Advance

Satellite Healthcare has been named to the Parity.org "Best Companies for Women to Advance List 2021," for the second consecutive year. Companies on the 2021 list share many common best practices that are known to support women, such as work-from-home or telecommuting options (97%), flexible work hours (94%), and equal paid family leave for men and women (88%). Nearly every company on the List measures and reports on gender parity to the executive team (97%), and regularly communicates their gender-parity values to employees, encourages men to take their full family leave, and has a zero-tolerance policy for harassment. (Jim Glafkides, SV, and Bernadette Vincent, OAK)

Savi Group Suggests Solutions for Avoiding Physician Burnout

In How Physician Burnout Hurts Medical Practices, Savi Group identifies many negative effects of burnout and declares that for physicians and medical practice managers, it's essential to define clear work responsibilities among internal staff. Taking the time to think about who should do what and why can be tremendously beneficial in avoiding burnout within the organization. Physicians also need support within the healthcare industry when facing mental struggles, stress, and anxiety. It can be difficult to rise out of depression, especially when you are afraid of potentially losing your medical license. A supportive and understanding network is vital in helping doctors struggling with burnout. (Sumit Mahendru, OC)

VivaLNK Spotlighted in Business Insider Article

A recent Business Insider article - 5 examples of popular wearable devices in healthcare - features VivaLNK and its ECG monitor, which records data on heart rate, RR interval, and respiratory rate, designed for in-clinic and remote patient monitoring applications. Business Insider reports that more than one-fifth of the US population is expected to use a smart wearable device this year. (Jiang Li, Ph.D., SV)

Wipfli Earns Recognitions & Announces Upcoming Healthcare Events

Wipfli LLP was named 2021 Microsoft Nonprofit Partner of the Year, selected among a global field of top Microsoft partners for demonstrating excellence in innovation and implementing customer solutions based on Microsoft technology.
Also, for the 10th year in a row, Wipfli has been named to the Bob Scott's Top 100 VARs list, which are chosen from organizations specializing in the sale and implementation of enterprise resource planning and accounting software, and based on annual revenue generated by each reseller.
Meanwhile, Wipfli:
>> Published 5 strategic steps to meet looming HHS reporting deadline;
>> Will host a webinar on August 17: Financial planning strategies for busy healthcare professionals - New ways to manage your financial well-being; and
>> Will present Critical Access Hospital & Rural Health Clinic Conference, an in-person event in Reno, NV, on September 14-16. (Jeff Johnson, John Dao, & Steve Rousso, OAK)

California Orders Vaccination of Healthcare Workers by Sept. 30

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)

Hospitals, Health Systems Mandating Vaccines for Workers

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)

Pentagon to Require COVID Vaccine for All Troops by Sept. 15

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/)

These Companies are Requiring Employees Get Vaccinated

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)

Half of US Population Fully Vaccinated, White House Says

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)

More People in California Are Getting Vaccinated for COVID

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)

San Francisco Allowing J&J Vaccine Recipients to Get 'Supplemental' Pfizer or Moderna Dose

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)

Why Delta Is the Most Transmissible Variant Yet

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 Learns Costly Pandemic Lesson About Hospitals

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."

White House Issues Executive Order on Promoting Competition in the American Economy, Including Healthcare

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 Dems Unveil $3.5 Trillion Budget, Including More Money for Healthcare

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 Issues Medicare IPPS and LTCH Final Rule for FY 2022

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.

CMS Issues Outpatient Prospective Payment System Proposed Rule for CY 2022

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)

Changes Proposed to Stark Law Rules for Indirect Compensation Arrangements

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 Issues CY 2022 Physician Fee Schedule Proposed Rule

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 Releases New FAQs Regarding CARES Act Provider Relief Funds

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 Issues Additional Favorable Advisory Opinion Regarding Medigap Plan and Preferred Hospital Organization Arrangement

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 Stabilizing at 38 Times Pre-COVID Levels, McKinsey Says

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/)

New Kaiser-Providence Hospital to Cost $1B, and Open in 2028

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/)

Should Your Company Provide Mental Health Apps to Employees?

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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