October 17, 2019 | Everything old is new again
INDUSTRY NEWS
GAO flags Medicaid work requirements
CMS approved state plans to impose work requirements on Medicaid recipients even though estimated implementation costs are in the hundreds of millions of dollars, according to the Government Accountability Office. Specifically, CMS allowed states to add work requirements without requiring projections on the administrative costs, which is inconsistent with federal control standards. Overall, implementing controversial work requirements in five states cost taxpayers nearly $408 million. Currently, the question of work requirements is before the U.S. Court of Appeals. (The Wall Street Journal)
Stark, anti-kickback regs may become more value-friendly
Health and Human Services has released two long-awaited proposed changes to two anti-fraud laws. If enacted, they would create permanent Stark Law exceptions and anti-kickback safe harbors. The goal: Make it easier for healthcare providers to coordinate care and offer value-based arrangements; HHS says the changes will spur innovation among healthcare providers. While they will reduce the burden of compliance, the changes will keep in place strong safeguards against fraud and abuse, according to HHS. (Bloomberg Law; HealthLeaders Media)
INNOVATION & TRANSFORMATION
House calls continue to make a comeback. They afford physicians flexibility and allows them to provide more patient-centered care. Norman Wall, DO, tells Health eCareers that he started offering house calls because his patients requested them. “You want to give the most appropriate care when and where patients need it,” he says. The doctors interviewed had various reasons for embracing this model, but most agreed on the biggest hurdle: reimbursement from insurance companies. (Health eCareers)
Pharmacists can dispense PrEP, PEP, sans prescription
Pharmacists in California will be able to dispense HIV prevention pills to patients without a doctor’s prescription after Gov. Gavin Newsom signed SB159. California is the first state to authorize pre-exposure prophylaxis, also called PrEP, and post-exposure prophylaxis, known as PEP, without prescriptions—a move that supporters say is an important step toward ending the AIDS epidemic in the United States. Studies have found that the drugs are very effective, but many people at high risk of infection do not take them. (Associated Press)
CONSUMERS & PROVIDERS
After scrutiny, VCU to stop suing patients
VCU Health, the major Richmond, Virginia medical system that includes the state’s largest teaching hospital, says it will no longer file lawsuits against its patients. VCU’s in-house physician group filed more than 56,000 lawsuits against patients for $81 million over the seven years ending in 2018, according to a Kaiser Health News analysis of district court data. Now, those suits will end. In addition, VCU will increase financial assistance for lower-income families, according to Melinda Hancock, VCU Health’s chief administrative and financial officer. (Richmond Times-Dispatch)
PG&E blackouts affect hospitals, clinics
Last week’s blackouts in Northern California—created by Pacific Gas & Electric--have affected hospitals in the region. None had to close down, but many had to cancel elective procedures. Several outpatient clinics also had to close temporarily. Sutter Health, which operates hospitals in both the Bay Area and Sacramento, appeared to be the most affected. Overall, roughly 250 hospitals are in areas where power was turned off, so they likely lost power and relied on generators. (Healthcare Dive; Modern Healthcare)
NEW & NOTED
Harassment in health care persists: In a first-person piece, recent med school graduate Jennifer Tsai discusses her experiences with—and the data on—sexual harassment and violence in medical training. The title says it all: “I'm a female doctor. I often face sexual harassment at the hospital. And I’m not the only one.” (The Washington Post)
Flagging the abusers: Effective Oct. 23, CMS will make it easier for consumers to find out about nursing homes that have violated rules about abuse, neglect or exploitation. The agency’s Nursing Home Compare website will add an icon next to nursing homes with reported violations. (Modern Healthcare)
MULTI-MEDIA
Dogs improve outcomes for stroke, heart attack patients
Dog owners live longer and fare better after a heart attack or stroke compared with those who have no canine companions, two studies published in Circulation: Cardiovascular Quality and Outcomes last Tuesday suggest (NBC News; Circulation: Cardiovascular Quality and Outcomes)
MARKETVOICES...QUOTES WORTH READING
“I had many patients who were bed-bound. One had cerebral palsy, and a lot of others were elderly and living alone. While some had family as caregivers, picking them up, taking them to the clinic, and getting them back home could add up to a half day’s worth or more of lost wages. So, I decided to start seeing them where they were and became the go-to doctor for patients who were elderly or had dementia.”—Norman Wall, DO, on why he started doing house calls, quoted in Health eCareers