Yesterday was the 100th issue of this blog.
Thanks to those whose encouragement and interest have kept it going.
FTC commissioner: Panel outmatched by healthcare's merger mania: This article summarizes comments by FTC Commissioner Rebecca Kelly about current antitrust prosecution problems. She says the Commission is understaffed and underfunded. Further, the McCarran-Ferguson Act is impeding investigation of insurance company mergers, since the data gathering in that sector requires Congressional action.
DOJ sides with Oscar Health in ongoing spat with Florida Blue over broker agreements: Last November, Oscar health sued the Florida Blues plan, claiming that the latter’s broker agreements prevented competitors from expanding into the local ACA exchanges. The presiding judge, citing the McCarran-Ferguson Act, was not convinced of Oscar’s argument. Now the DOJ has stepped in to encourage the trial to proceed.
Novartis may be close to settling a kickback case on the eve of a trial: After six years of sparring with the DOJ over charges that it offered lavish gifts to physicians to encourage prescription of its products, Novartis is rumored to be settling this whistleblower suit for $1 billion.
Civica Rx and Xellia Pharmaceuticals Join Forces to Reduce Chronic Drug Shortages: Civica Rx, the hospital consortium formed to combat drug shortages for its owners, signed a contract with Xellia Pharmaceuticals of Denmark to “manufacture essential antibiotics, including Vancomycin and Daptomycin…” This contract is the first definitive agreement the organizations has made.
The Death of Antibiotics: We’re Running Out of Effective Drugs to Fight Off an Army of Superbugs: This article is a good summary of the problem of antibiotic resistance. One startling statistic: “The World Health Organization predicts that worldwide death rates from drug-resistant microbes will climb from the current 700,000 per year to 10 million by 2050. At that point, they will have surpassed cancer, heart disease and diabetes to become the main cause of death in the human race.”
CMS cracks down on spread pricing by pharmacy benefit managers [PBMs]: As part of its continuing scrutiny of PBMs, CMS is now looking into their practice of “spread pricing.”
“Spread pricing occurs when health plans contract with a pharmacy benefit manager to manage their prescription drug benefits, and PBMs keep a portion of the amount paid to them by the health plans for prescription drugs, instead of passing the full payments on to pharmacies.
The spread is the amount between what the health plan pays the PBM and the amount the PBM reimburses the pharmacy for a beneficiary's prescription.”
The reason CMS is involved is that spread pricing is especially of concern for Medicaid and CHIP plans.
About healthcare IT
Express Scripts Simplifies Digital Health Technology Marketplace for Consumers and Payers: “The new formulary will help payers ensure the safety, effectiveness and usability of digital health technology tools made available to their members. Available in 2020, the digital health formulary will be a curated list of technology- and software-enabled applications and devices that help patients prevent, manage or treat a medical condition.”
Forescout Releases Inaugural Device Cloud Research Based on Leading Device Intelligence: Among the findings of this report is that “71 percent of Windows devices within these healthcare deployments are running Windows 7, Windows 2008 or Windows Mobile, with Microsoft support planned to expire on January 14, 2020. Running unsupported operating systems poses a risk that may expose vulnerabilities and has the potential to impact regulatory compliance.”
Erasing the Affordable Care Act: Using Government Web Censorship to Undermine the Law: This report from the Sunlight Foundation documents the federal actions to delete web content regarding the ACA. “The Web Integrity Project has documented 26 instances of ACA censorship — including excised words, removed links, altered paragraphs, and removed pages — on HHS websites.” If you want to get an idea of what was done, check Table 1 starting on page 15. For example, authorities removed HealthCare.gov from the header of CMS.gov.
About the public’s health
Alabama governor invokes God in banning nearly all abortions: If left standing, this new Alabama law would outlaw abortion except in cases the mother’s life is in danger. Rape and incest are not exceptions. A woman who obtains an abortions would not be prosecuted but physicians performing the procedure could get up to 99 years in prison. The expectation is that the law will be challenged in court. Supporters of the law hope the case will be taken to the Supreme Court where Roe v. Wade will be overturned.
States with the worst anti-abortion laws also have the worst infant mortality rates: The article’s title speaks for itself.
North Carolina sues Juul, setting up a fresh legal fight for the embattled e-cigarette company: In the first state action against e-cigarettes, the North Carolina Attorney General filed a lawsuit against Juul Labs, alleging that the company caused consumer addiction by “deceptively downplaying the potency and danger of the nicotine” and employed advertising campaigns that targeted people under the legal smoking age. In addition to the FDA prohibition on the sale of fruit or candy flavors in stores, North Carolina’s would also remove mint. Further, the state seeks to prohibit online sales that are not tobacco or menthol flavors.
Federal judge orders FDA to start regulating e-cigarettes: In a related story, a federal judge in Maryland ordered the Food and Drug Administration (FDA) to “speed up its reviews of thousands of electronic cigarettes currently on the market…" The order was given as a result of a lawsuit filed last year by the American Academy of Pediatrics, the Campaign for Tobacco-Free Kids and other public health groups.
About healthcare quality
Walmart Charts New Course By Steering Workers To High-Quality Imaging Centers: Walmart will financially incentivize its employees to use one of 800 high quality imaging centers when CT or MRI scans are needed. The company said that because of incorrect diagnoses from those studies “about half of the company’s workers who went to the Mayo Clinic and other specialized hospitals for back surgery in the past few years turned out not to need those operations. They were either misdiagnosed by their doctor or needed only non-surgical treatment.”
About health insurance
White House Wants Patients to Know Health-Care Prices Up Front: In February the White House floated a proposal that would make providers’ negotiated fees public. Now it also wants payers to publish these proprietary figures. Patients would still have to know what their plan’s terms are with respect to out of pocket costs.
Read the story (Wall Street Journal but appears to be open access)