Federal agencies open online portal for reporting anticompetitive practices in healthcare “Thursday, the Federal Trade Commission (FTC), the Department of Justice (DOJ) and the Department of Health and Human Services (HHS) unveiled HealthyCompetition.gov, an online portal where anyone can submit a healthcare competition complaint for potential investigation.”
These submissions, the agencies said, can help the agencies ensure healthcare organizations provide quality care and pay their employees a fair wage.
About health insurance/insurers
Medicare’s Push To Improve Chronic Care Attracts Businesses, but Not Many Doctors “Federal data from 2019 shows just 4% of potentially eligible enrollees participated in the program, a figure that appears to have held steady through 2023, according to a Mathematica analysis. About 12,000 physicians billed Medicare under the CCM mantle in 2021, according to the latest Medicare data analyzed by KFF Health News. (The Medicare data includes doctors who have annually billed CCM at least a dozen times.)
By comparison, federal data shows about 1 million providers participate in Medicare.”
About pharma
Employers feel the side effects of drugmaker control over Wegovy, Ozempic costs Good review of the topic, with examples from different states.
HHS finalizes rule on 340B Administrative Dispute Resolution process “The Department of Health and Human Services April 18 finalized its rule to establish a 340B Administrative Dispute Resolution process as required under the Affordable Care Act. The rule establishes an ADR process that allows all 340B covered entities, regardless of the size of the organization or monetary value of the claim, to avail themselves of this important process to address claims at dispute with drug companies.
Specifically, the new finalized ADR process would:
Create a more conventional administrative process that is less trial-like consisting of 340B program subject matter experts from the Health Resources and Services Administration’s Office of Pharmacy Affairs.
Allow covered entities to bring forth claims where they have been overcharged by a drug company including where the drug company or its wholesaler denies access to 340B pricing.
Allow claims for ADR panel review even if the particular issue at stake is subject to concurrent federal court review.
Require decisions be reached by the ADR process within one year of submission of claims for ADR review.
Include a reconsideration process for parties dissatisfied with the 340B ADR panel decision.”
About the public’s health
For the first time, U.S. may force polluters to clean up these ‘forever chemicals’ “The Biden administration on Friday moved to force polluters to clean up two of the most pervasive forms of “forever chemicals,” designating them as hazardous substances under the nation’s Superfund law.
The long-awaited rule from the Environmental Protection Agency could mean billions of dollars of liabilities for major chemical manufacturers and users of certain types of compounds known as polyfluoroalkyl and perfluoroalkyl substances, or PFAS.”
Advancing Racial Equity in U.S. Health Care The Commonwealth Fund 2024 State Health Disparities Report An excellent overview of a pervasive problem. At least look at Exhibit 1.
About healthcare IT
AI-Powered World Health Chatbot Is Flubbing Some Answers
“· SARAH doesn’t have up-to-date medical data, can ‘hallucinate’
· WHO bot falls back on ‘consult with your health-care provider’
The World Health Organization is wading into the world of AI to provide basic health information through a human-like avatar. But while the bot responds sympathetically to users’ facial expressions, it doesn’t always know what it’s talking about.
SARAH, short for Smart AI Resource Assistant for Health, is a virtual health worker that’s available to talk 24/7 in eight different languages to explain topics like mental health, tobacco use and healthy eating. It’s part of the WHO’s campaign to find technology that can both educate people and fill staffing gaps with the world facing a health-care worker shortage.”
Two-thirds of top 20 pharmas have banned ChatGPT—and many in life sci call AI ‘overrated,’ survey finds “In a recent ZoomRx survey of more than 200 life sciences professionals, more than half said their companies have banned employees from using OpenAI’s popular generative AI tool ChatGPT, including 65% of the top 20 Big Pharmas. Respondents said those policies were largely linked to concerns that sensitive internal data could be leaked to competitors.”
About healthcare finance
States Aim to Combat Private-Equity Healthcare Takeovers “More than a dozen states are pushing back against private-equity-backed consolidation of medical businesses.”