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THE HOTTEST HEALTHCARE NEWS
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"If you stay here, you will die," Tampa Mayor Declares as Milton Approaches + Thursday Oct. 10 Report |
Hurricane Milton made landfall near Sarasota, Fla., as a Category 3 storm at 8:30 p.m. Wednesday. According to a Becker's Hospital Review article, widespread power outages pose a critical risk for individuals dependent on power for medical equipment in their homes, requiring transfers to shelters or hospitals for care. The Florida Hospital Association is working closely with hospitals statewide to coordinate these transfers.
At press time, all hospitals that remained open before the hurricane are still operational, with the exception of HCA Florida Largo Hospital, which evacuated about 230 patients early Wednesday due to flooding in the facility's basement. The facility remains temporarily closed. Tampa General experienced minor water leaks, but its power, water and supplies are secure, the system said. St. Petersburg was forced to shut down the city's water supply around midnight on Oct. 9 due to a water line break, affecting three hospitals in the area. Flooding and storm damage is expected to disrupt outpatient and community-based services, including pharmacies, which will likely contribute to increased volumes at emergency departments. [Many hospitals' websites and social media channels did not yet have storm updates as of 7 a.m. CT Thursday. Becker's will continue to monitor for new information and updates to this story.]
Before the hurricane made landfall, 313 healthcare facilities in the state reported evacuations, including 17 hospitals. MEANWHILE, Hurricane Helene damaged Baxter's North Carolina facility where it manufactures IV solutions, so hospitals are deploying strategies to conserve them. (https://www.beckershospitalreview.com/care-coordination/hospitals-and-milton-9-things-to-know.html)
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Kamala Harris Proposes Medicare Home Health Expansion |
The VP's presidential campaign plan would create more generous Medicare coverage for long-term care at home, allowing CMS to pay for home health aides, personal care attendants, and other essential services for seniors. Harris highlighted that the plan would be funded by savings from Medicare's expanded drug price negotiations, helping reduce the overall cost burden. (https://apnews.com/article/harris-home-health-care-sandwhich-generation-098a7ed48dfd94d11fb0efcd5d63b42b)
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Overdose Deaths Dropped 10.6% in A Year |
Reversing the trend, according to the CDC over 11,000 fewer people died from an overdose between April of 2023 and 2024. Carrying naloxone, telehealth treatments, tracking prescriptions, and earning gift cards for negative tests all seems to be working. (https://www.npr.org/2024/09/18/nx-s1-5107417/overdose-fatal-fentanyl-death-opioid?)
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The 2025 Medicare Advantage Market Is Starting to Take Shape |
Amid the turmoil, the MA market landscape will look mostly the same next year, although with lower capitation rates - especially for Star-downgraded companies UnitedHealthcare and Humana. Insurers will likely aim to boost their margins with benefit cuts and greater cost sharing. (https://www.modernhealthcare.com/insurance/medicare-advantage-aetna-humana-elevance-2025) (https://www.cms.gov/newsroom/press-releases/medicare-advantage-and-medicare-prescription-drug-programs-remain-stable-cms-implements-improvements)
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CALIFORNIA GOVERNMENT & HEALTHCARE
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Governor Newsom Signs AI Bills that Will Regulate AI Usage by Providers & Insurers |
SB 1120 mandates that health insurers using AI tools for decisions about healthcare services and insurance claims must ensure that those decisions are supervised by licensed physicians. The goal is to maintain human oversight in critical medical decisions to prevent errors and ensure patient safety.
AB 3030 requires healthcare providers to disclose to patients when AI tools are being used to communicate with them. This transparency ensures that patients are fully informed about the involvement of AI in their healthcare, preserving trust and accountability. (https://www.gov.ca.gov/2024/09/29/governor-newsom-announces-new-initiatives-to-advance-safe-and-responsible-ai-protect-californians/)
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Governor Vetoes Bill to Require Prior Approval of Private Equity Health Care Transactions |
California Governor Newsom recently vetoed Assembly Bill 3129, which would have required private equity groups and hedge funds to receive the consent of the California Attorney General before entering into a transaction between the private equity group or hedge fund and a health care facility, provider, or provider group. In support of his veto, the Governor cited that the California Office of Healthcare Affordability already has the authority to: (a) evaluate health care consolidation transactions; and (b) refer such transactions to the Attorney General if OHCA believes that additional review is required. (https://www.sheppardhealthlaw.com/2024/10/articles/office-of-health-care-affordability-ohca/update-governor-newsom-vetoes-californias-ab-3129-targeting-healthcare-private-equity-deals/) (https://kslawemail.com/128/11730/pages/article-4.asp?sid=bb670848-cfb7-44cc-bba9-c16d0cbb3c32)
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Newsom Vetoes Bill Delaying Earthquake Operational Standards |
California Gov. Newsom has vetoed a bill that would have delayed earthquake operational standards for hospitals. "Any extensions considered for the 2030 deadline must balance the increased risk to patients, hardworking hospital staff, emergency responders and the people living in that community," Newsom wrote. "Providing an extended deadline should be limited in scope, granted only on a case-by-case basis to hospitals with demonstrated need and a clear path to compliance, alongside strong accountability and enforcement mechanisms. This bill's proposal to allow any hospital a five-year compliance extension is too long. I encourage hospitals at risk of non-compliance with the 2030 deadline to prioritize remaining work." The 2030 deadline follows the 1994 Northridge earthquake, which led to stricter earthquake-resistance standards. By 2030, all hospital buildings in California must be able to remain fully operational after an earthquake. (https://www.beckershospitalreview.com/capital/california-governor-vetoes-bill-delaying-earthquake-safety-measures.html)
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FEDERAL GOVERNMENT & HEALTHCARE
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Biden Administration Announces Nearly $100 Million to Grow the Health Workforce |
The Health Resources and Services Administration (HRSA) recently announced nearly $100 million in awards to grow, support, and strengthen the health workforce and improve access to quality care in high-need areas across the country. The Awards include investments in: Growing the nursing workforce for acute and long-term care - $19+ million over four years to five schools; Increasing the primary care physician workforce in high-need areas - nearly $12 million in 2024 to three medical schools; Responding to the nation's opioid crisis - $63+ million over four years to 32 organizations; and Integrating mental health care in pediatric care - an additional $4.6 million to existing grantees. (https://www.hhs.gov/about/news/2024/09/17/biden-harris-administration-announces-nearly-100-million-grow-health-workforce.html) (https://www.hrsa.gov/about/news/fy24-workforce-award-announcements)
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CMS Needs to Strengthen its Oversight of Remote Patient Monitoring - OIG Report |
OIG recently released a report recommending that CMS exercise additional oversight of remote patient monitoring (RPM) services provided to Medicare beneficiaries. Medicare reimburses RPM for any chronic or acute condition. OIG issued the report in response to the significant uptick in the use of RPM in recent years with an expectation of expanded use in the Medicare population in the coming years. (https://kslawemail.com/128/11707/pages/article-2.asp?sid=d37de5ba-7f82-4af4-8a51-b222bcd14df4)
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HHS Releases Final Guidance for Second Cycle of Medicare Drug Price Negotiation Program |
HHS, through CMS, has released final guidance outlining the process for the second cycle of negotiations under the Medicare Drug Price Negotiation Program. In August, the Biden Administration announced the negotiated prices for the 10 drugs selected for the first cycle of negotiations. The negotiated prices are estimated to save people enrolled in Medicare prescription drug coverage $1.5 billion in out-of-pocket costs in 2026 when they go into effect. CMS will announce the selection of up to 15 additional drugs covered by Part D for the second cycle of negotiations by February 1, 2025. (https://www.hhs.gov/about/news/2024/10/02/hhs-releases-final-guidance-second-cycle-historic-medicare-drug-price-negotiation-program.html)
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HRSA Makes First Multi-Vendor Awards to Modernize the Nation's Organ Transplant System |
HRSA recently announced contract awards to modernize the nation's organ transplant system to improve transparency, performance, governance, and efficiency of the organ donation and transplantation system for the more than 100,000 people on the organ transplant waitlist. As part of the Administration's transformation of the Organ Procurement and Transplantation Network (OPTN), for the first time in 40 years, multiple contractors will provide their proven experience to improve the national organ transplant system. According to an HHS release, "This transition from a single vendor to multiple vendors to support OPTN operations is a critical step in advancing innovation in the transplant system to better serve patients and implements the bipartisan Securing the U.S. Organ Procurement and Transplantation Network Act signed by the President in September 2023." (https://www.hhs.gov/about/news/2024/09/19/hrsa-makes-first-ever-multi-vendor-awards-to-modernize-the-nations-organ-transplant-system.html)
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HHS Finalizes Federal Health IT Strategy |
HHS, through the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (hereafter ASTP), has published the final 2024-2030 Federal Health IT Strategic Plan in accordance with the Health Information Technology for Economic and Clinical Health (HITECH Act.) The Strategic Plan presents federal health IT goals and objectives to achieve a future state where health IT and electronic health information are used to: Promote health and wellness; Enhance the delivery and experience of care; Accelerate research and innovation; and Connect the health system with health data. (https://www.hhs.gov/about/news/2024/09/30/hhs-finalizes-federal-health-it-strategy-drive-systemic-improvements-health-care.html)
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CMS Teases New Cybersecurity Policies for Third-Party Vendors |
CMS is planning oversight of third-party healthcare vendors in the wake of the Change Healthcare cyberattack, said Jonathan Blum, the agency's principal deputy administrator. Blum, who also serves as chief operating officer for CMS, said that the agency is working to determine what levers it can pull to ensure severe disruptions in care like those linked to the cyberattack on the UnitedHealth Group subsidiary aren't repeated. CMS declined to provide any details of its oversight strategy, but said it is collaborating with other partners across the HHS to "promote high-impact cybersecurity practices and enhance accountability for healthcare organizations and their vendors." (https://www.porh.psu.edu/cms-teases-new-cybersecurity-policies-for-third-party-vendors/) (https://www.modernhealthcare.com/policy/cybersecurity-oversight-cms-policies-jonathan-blum)
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MORE HEALTHCARE NEWS & TRENDS
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United Healthcare Releases Nationwide Line-Item Denial Policy |
United Healthcare's new policy states that it will begin performing line-item denials on facility bills for services provided to members of United's commercial benefit plans effective December 2024. Line-item denials occur when a health plan unilaterally disallows specific line items on a hospital or professional bill, which can significantly reduce hospital reimbursement, particularly for contracts paid on a percentage of charge basis or with stop loss provisions. United intends to start disallowing charges for what the plan calls "routine" items and services based on United's position that these charges should be bundled into other charges such as the room or procedure charge, and these services and items will be considered ineligible for separate reimbursement. (https://www.kslaw.com/news-and-insights/health-headlines-september-30-2024; https://www.dwt.com/insights/2024/10/unitedhealthcare-line-item-denial-policy-change#)
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Wegovy Beats Rival Drug in Comparative Weight Loss Trial |
For nearly 3,400 patients with obesity, the average weight loss achieved with semaglutide (Wegovy and Ozempic) was more than twice that achieved with liraglutide (Saxenda and Victoza). Cleveland Clinic researchers investigated the weight outcomes of 3,389 obese patients who were prescribed either semaglutide or liraglutide. After one year, semaglutide resulted in an average 5.1% reduction in body weight, and liraglutide saw a 2.2% reduction, according to the results published Sept. 13 in JAMA. (https://www.beckershospitalreview.com/glp-1s/wegovy-beats-rival-drug-in-comparative-weight-loss-trial.html)
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Glendale, CA-based Healthcare Systems of America Assumes Control of Several Steward Health Care Facilities |
U.S. Bankruptcy Court Judge Christopher Lopez authorized an interim settlement agreement for Dallas-based Steward Health Care to transition many of its remaining hospitals to its landlord, Medical Properties Trust, or applicable designated operators, effective Sept. 11. Healthcare Systems of America, an affiliate of Glendale, Calif.-based American Healthcare Systems, is taking on interim management for eight of the Steward hospitals under the settlement. HSA says after a brief transition period, it'll assume full ownership of the facilities in Texas, Louisiana. and Florida. (https://www.beckershospitalreview.com/legal-regulatory-issues/steward-gets-interim-approval-to-transfer-management-of-15-hospitals.html) (https://kfdm.com/news/local/california-based-company-assumes-operations-of-medical-center-of-southeast-texas)
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- Using AI to Solve Monolithic Real-World Problems
You can listen, discuss, and meet with
a great panel of speakers
- and others who'll be with us for this special event; also featuring lunch and a Round Table. 9 am to 3 pm.
**ABL Members have already received an Event Invitation by Separate Email - with Event Location and RSVP Link - RSVP Today!** Or Call Mimi Grant at 714-975-1422 for attendance details.
