News Headlines

News Headlines
Health care news from around the state and nation

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The Health 202: Trump will call on Congress to protect Americans from surprise medical bills
Washington Post

In an address scheduled shortly before noon today, President Trump will call on Congress to pass legislation protecting Americans from the all-too-common problem of surprise medical bills, incurred after a patient receives care from a doctor who is outside his or her health plan’s network.

The president — who in January directed Health and Human Services Secretary Alex Azar and Labor Secretary Alex Acosta to pursue a fix — is expected to lay out principles he wants upheld in any legislation on surprise billing Congress might consider, lobbyists and advocates confirmed to The Health

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ACA uncertainty created financial boon for health insurers
Modern Healthcare

Insurers selling plans on the Affordable Care Act marketplace are expected to pay consumers $800 million in 2019 as a result of excess premiums, according to a new review of preliminary estimates.

The Kaiser Family Foundation on Tuesday released a report that found uncertainty over the future of the ACA’s individual health insurance market in 2018 led to spikes in premiums and some of the best annual performances by insurers.

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Medicare’s Primary Care First model gets bipartisan boost in Senate hearing
Modern Healthcare

Senators across the aisle voiced support on Wednesday for the Trump administration’s recently announced plan to offer primary-care contracts with physician practices through Medicare fee for service.

During a Senate Finance Committee hearing, Sen. Ron Wyden (D-Ore.) said he sees the Center for Medicare and Medicaid Innovation’s Primary Care First policy as an opportunity for more chronically ill patients to be cared for in their home.

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Drug Prices Will Soon Appear in Many TV Ads
New York Times

The Trump administration for the first time will require pharmaceutical companies to include the price of prescription drugs in television advertisements if the cost exceeds $35 per month.

The move, announced on Wednesday by Alex M. Azar II, the health and human services secretary, is the most visible action the administration has taken so far to address the rising cost of prescription drugs. It has been a key issue for American voters and one that both Republicans and Democrats have vowed to address.

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Drug prices must be in TV ads under CMS final rule
Modern Healthcare

The CMS on Wednesday finalized a rule that forces drug manufacturers to provide the list price for their products in direct-to-consumer ads, a policy aimed at increasing transparency and vehemently opposed by industry.

The new policy will apply to drugs or biologics with list prices greater than $35 for a month’s supply or the normal course of therapy, which HHS Secretary Alex Azar said is what consumers would be accustomed to pay because it’s close to an insurance plan’s average copayment for these drugs.

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Will Displaying Drug List Prices In Ads Help Lower Costs?
National Public Radio

The Trump administration moved forward on Wednesday with its plan to lower prescription drug prices by requiring drugmakers to display the list price “in a legible textual statement at the end of the advertisement.”

Secretary of Health and Human Services Alex Azar said today that when it comes to changing prescription drug prices, “putting prices in TV ads may be the most significant single step any administration has ever taken.” But patient advocates are not convinced it will have an immediate impact on drug pricing.

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House appropriators eye MA prior-authorization, critical access denials
Modern Healthcare

House appropriators included a trove of provisions for hospitals in their report that will accompany their bill to fund HHS.

Congress is far from reaching a bicameral budget deal as the government races toward a deadline to raise the debt limit.

That said, the House report included a wide-range of asks from the healthcare industry— and some could win support from the upper chamber.

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Bill to stiffen California’s vaccine law must first get past single-issue voters
Los Angeles Times

Some bills are just more trouble than they’re worth for nervous legislators who must worry about voter support.

One such bill is a current measure to tighten the requirement that children be vaccinated against contagious diseases — like measles — before being admitted to school for the first time.

Kids can be excused from that edict for medical reasons, such as having a weak immune system caused by leukemia.

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Genetically Modified Viruses Help Save A Patient With A ‘Superbug’ Infection
National Public Radio

For the first time, scientists have used genetically modified viruses to treat a patient fighting an antibiotic-resistant infection.

Isabelle Carnell-Holdaway, 17, began the experimental treatment after doctors lost all hope. She was struggling with a life-threatening infection after a lung transplant. With the new treatment, she has not been completely cured. But the Faversham, England, teenager has recovered so much that she has resumed a near-normal life.

“I think it’s amazing,” Carnell-Holdaway says. “It kind of shows that there is completely no limit to what they can come up with really.”

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Justice Department sheds light on limiting False Claims Act damages
Modern Healthcare

The Justice Department on Tuesday gave companies new guidance to obtain greater leniency in False Claims Act investigations and limit their potential liability.

False Claims Act cases in the healthcare industry grew to 506 in 2018 from 291 in 2008, and companies and physicians shelled out $2.5 billion in FCA settlements and judgments in fiscal 2018, making them a potentially costly concern.

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One Physician’s Frustrations of Practicing Amidst the CHIPHIT Complex and Implications for the Future of the U.S. Healthcare System
The Health Care Blog

The high cost, low quality and systemic inequities of the U.S. healthcare system have been the impetus for its redesign. Our healthcare system is now controlled by Consolidated Healthcare institutions, Insurance companies, Pharmaceutical companies and Health Information Technology companies (CHIPHIT complex). The CHIPHIT complex, along with the Federal Government, will create and control our future healthcare system.

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How the U.S. health-care system puts people with diabetes in danger
The Washington Post

The blood sugar rises, and nausea and vomiting follow. The blood acidifies, the breath hastens, dehydration and then delirium ensue: That’s how ketoacidosis, a feared complication of diabetes, progresses. Diabetic ketoacidosis, which results in nearly 190,000 hospitalizations a year, is a condition I treat frequently as an ICU physician: We infuse intravenous insulin, saline and electrolytes, while carefully tracking sugar levels and blood chemistries and vital signs. If all goes well, the sugar normalizes, acid levels fall, the breath begins to slow, the appetite returns. Not always, however: Every year, hundreds of people die of the condition.

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In This Doctor’s Office, a Physical Exam Like No Other
New York Times

To scientists like Michael Snyder, chair of the genetics department at Stanford University, the future of medicine is data — lots and lots of data. He and others predict that one day doctors won’t just take your blood pressure and check your temperature. They will scrutinize your genome for risk factors and track tens of thousands of molecules active in your body. By doing so, the doctors of the future will identify diseases, and treat them, long before symptoms appear.

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U.S. disaster preparedness slows, illustrating fragile healthcare safety net
Modern Healthcare

The U.S. is better equipped than in the past to manage health emergencies, but progress slowed last year as regional inequities in preparedness persist, according to new data.

The U.S. scored a 6.7 on the 10-point scale of the 2019 National Health Security Preparedness Index. That’s a 3.1% boost over the year prior, and a 11.7% increase since the Centers for Disease Control and Prevention launched the index in 2013. At the current pace, it will take a decade to reach a strong health security level of at least 9.

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‘The people that most need this drug can’t afford it’: HIV advocates target Gilead meeting, but company says they’re wrong
San Francisco Business Times

In shout-down with Gilead management, groups say company’s patent for Truvada — the only drug approved for preventing new HIV infections — should be stripped.

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As S.F. General ends controversial billing practice, hospital eyes select deals with commercial insurers
San Francisco Business Times

The hospital expects to lose between $1.9 million to $2.2 million in revenue annually from the policy change.

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