About Covid-19
The Top COVID-19 Hot Spots in the U.S. FYI. Check the interactive map for your county.
About health insurance/insurers
Congress Sidesteps Site-Neutral Hospital Payment Reform in Upcoming Funding Package “In a move that has reignited the debate over healthcare affordability and equity, Congress has decided not to include a site-neutral hospital pay policy in the next government funding package. This decision has broad implications for how outpatient services are billed across the United States, potentially affecting the cost of healthcare for millions of Americans. At its core, the debate centers on whether hospitals should receive higher payments than standalone physicians’ offices for the same outpatient services, a practice that the site-neutral policy sought to eliminate.”
MA Advance Notice Does Not Offset Rising Medical Costs and Could Lead to Reduced Healthcare Value for Beneficiaries “BRG forecasts how the three major impacts to 2025 payment could affect MA buy-down of premiums, cost sharing, and supplemental benefit offerings:
(1) Net risk scores will drop by 2.9% due to changes in normalization factors and the continued phase-in of the new risk model V28
2) Star rating changes will lower payment by 0.5%
(3) Growth factor will increase by 2.4%
One main reason why BRG expects a larger reduction than CMS estimates is that BRG expects medical inflation for MA plans to increase by 4% to 6% in 2025. Medical costs per MA member per month grew by an estimated 7.3% for the first nine months of 2023, based on analysis of NAIC1 statutory filing data for plans that represent 85% of MA lives. The fourth quarter of 2023 had similar growth for MA plans…”
About hospitals and healthcare systems
20 hospitals that won the most NIH money in 2023 — and how much they got FYI. Five of the top ten are in Boston.
About pharma
FDA Approves Humira Biosimilar Adalimumab-ryvk “The US Food and Drug Administration (FDA) has approved adalimumab-ryvk (Simlandi), the first interchangeable, high-concentration, citrate-free biosimilar to adalimumab (Humira), according to a press release published by Alvotech and Teva Pharmaceuticals.1 The tumor necrosis factor (TNF) inhibitor is approved for the treatment of a variety of autoimmune conditions, including rheumatoid arthritis (RA), juvenile idiopathic arthritis, Crohn’s disease, ulcerative colitis, psoriatic arthritis, plaque psoriasis, ankylosing spondylitis, uveitis, and hidradenitis suppurativa.”
Comment: Humor sales have been strong despite the other available generics. Perhaps this one, being interchangeable, will make a dent in the brand’s sales.
US pharmacy outage triggered by 'Blackcat' ransomware at UnitedHealth unit, sources say “Hackers working for the 'Blackcat' ransomware gang are behind the outage at UnitedHealth's technology unit that has snarled prescription deliveries for six days, two people familiar with the matter told Reuters on Monday.
The problems began last week after hackers gained access to Change Healthcare's information technology systems and has led to disruptions at pharmacies across the United States.”
Comment: Change Healthcare says service should be restored in the next day or so.
Novo Nordisk joins protein degradation race in $1.4B+ deal with Neomorph “Novo Nordisk signed its first protein degradation deal Monday and is looking to take the molecular glue modality – most often used in oncology – into the cardiometabolic and rare disease spaces. The Danish drugmaker partnered with Neomorph in a multi-target deal worth $1.46 billion in biobucks…
Under the deal – the recently launched biotech’s first – Neomorph will lead discovery and preclinical activities against selected targets, and Novo Nordisk will have the right to exclusively pursue further clinical development and commercialisation of the compounds.”
About the public’s health
Biden-Harris Administration Announces New Funding to Increase Capacity for Behavioral Health Services “Today, the U.S. Department of Health and Human Services (HHS), through the Substance Abuse and Mental Health Services Administration (SAMHSA), announced $36.9 million in notices of funding opportunities for grant programs supporting behavioral health services across the country. Additionally, HHS, through the Centers for Medicare & Medicaid Services (CMS), issued guidance that allows states to expand the pool of behavioral health care providers eligible for enhanced federal Medicaid funding, which will better support this critical workforce as well as improve access to care. The guidance also allows states to claim federal dollars for nurse advice lines.”
The announcement also details the spend on each activity.
About healthcare IT
HHS Delivers Reports to Congress on HIPAA Compliance, Enforcement “The HHS Office for Civil Rights (OCR) delivered two reports to Congress on HIPAA compliance and enforcement efforts logged by the department during the 2022 calendar year. HHS is required to submit these reports to Congress each year under the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009…
OCR received more than 30,000 new complaints alleging HIPAA violations in 2022, and resolved more than 32,000 cases in the 2022 calendar year. OCR also completed 846 compliance reviews and required entities to take corrective actions or pay a monetary penalty in 80 percent of those investigations.
OCR has seen a 17 percent increase in HIPAA complaints received from 2018 to 2022 and a 107 percent increase in large breaches reported in that timeframe.”