DCMedical News: Friday, July 24, 2020
DCMedical News-DCMN
Washington, D.C.
Friday, July 24, 2020
DCMedical News is published every day both the House and the Senate are in session and on pre-pandemic Regularly Scheduled Session days (see CQ calendar, below). .
THE BIG STORY IN HEALTH CARE
Tracking by Johns Hopkins shows on 7-23 at 8:00 p.m. EST worldwide 15,429,889 confirmed COVID-19 cases; 631,680 deaths worldwide; 144,072 U.S. deaths (23%).
Treatment: A multi-site study from Brazil reported in the New England Journal of Medicine (here) found that “Among patients hospitalized with mild-to-moderate Covid-19, the use of hydroxychloroquine, alone or with azithromycin, did not improve clinical status at 15 days as compared with standard care,” although patients given those drugs did have some EKG anomalies and elevated liver enzymes. And a word on dexamethasone, also (here) from the NEJM: “The reduction in mortality [from dexamethasone] was greatest in those on mechanical ventilation; people who were not on oxygen did not benefit and might have experienced harm.” More: “Before the completion of the trial, many Covid-19 treatment guidelines stated that the use of glucocorticoids was either contraindicated or not recommended. Dexamethasone is on the list of essential medicines of the World Health Organization and is readily available worldwide at low cost.”
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
HCA Reports Q2 Profit, Volume Down, Profit Up, as Hospital Giant Benefits from CARES
Bruce Japsen of Forbes reports (here) that second-quarter revenue at the Hospital Corporation of America declined to nearly $11.1 billion from $12.6 billion in the second quarter of last year, but net profits jumped to nearly $1.1 billion, “surprising Wall Street analysts who follow the company.” HCA’s statement (here) said “Same facility admissions declined 12.8 percent while same facility equivalent admissions declined 20.1 percent in the second quarter of 2020, compared to the prior year period. Same facility inpatient surgeries declined 15.7 percent, while same facility outpatient surgeries declined 32.6 percent in the second quarter of 2020, compared to the same period of 2019. Same facility revenue per equivalent admission increased 10.0 percent in the second quarter of 2020, compared to the second quarter of 2019 . . . Results for the six months ended June 30, 2020 include government stimulus income of $822 million ($590 million net of tax).” HCA shares were up 12%. Earnings call transcript from Seeking Alpha, here.
Community Health Needs Assessment (CHNA) Filing Date (Further) Postponed
JDSupra reports that “Tax-exempt hospital organizations filing Forms 990 must indicate on Schedule H if they have conducted a CHNA in the current taxable year or in either of the two immediately preceding taxable years, and if they have adopted an implementation strategy to meet the significant health needs identified through the most recently completed CHNA. Because these requirements affect the hospital’s tax-exempt status and the law imposes a $50,000 penalty for each hospital facility that fails to meet the requirements, the extension can provide significant relief.” The IRS notice (here) provides postponement, until December 31, 2020, of the due dates for performing any CHNA requirements due to be completed on or after April 1, 2020, and before December 31, 2020.
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
Health Programs for FY21 in House Appropriations Bill
The budget proposal, passed by the Appropriations Committee (bill here, press release and summary here, Committee report here) has total funds $2.4 billion above those appropriated in FY20 and $24 billion in public health support measures.
Medicaid and CHIP Enrollment Report for April
The enrollment report for April (here) shows “72,347,760 individuals were enrolled in Medicaid and CHIP [Children’s Health Insurance Program] in the 51 states that reported enrollment data for April 2020.”
DRUGS & DEVICES
Reference Pricing Order May Come Today
The Hill reports that the President “is likely to sign executive orders on Friday aimed at lowering drug prices” with one order “a version of a proposal to reduce some U.S. drug prices by tying them to the lower prices paid in other countries.”
340 Savings—Who Covers the Cost?
Drug Channels’ Adam Fein publishes a multi-part series (here) on the drug discount 340B program. His conclusion: “Patients covered by commercial insurance and Medicare Part D are footing the bill for 340B savings.”
READINGS & REFERENCES
FAIR Health Examines Coronavirus Impact, Cost, Utilization
FAIR Health, the New York-based non-profit which tracks hospital and physician charges, has published four studies (to date) on the costs of medical and hospital care associated with the Coronavirus pandemic. The first (report here, press release here), on March 25, discussed the projected economic impact of the coronavirus pandemic on the US health care system. The second (report here, press release here), published May 12, explored the financial impact of COVID-19 care on hospitals and health systems. The third report, published June 10 (report here, press release here), explored revenue and utilization issues for health professionals. The most recent report, July 14, (report here, press release here), examined the characteristics of COVID-19 patients, based on commercial health insurance claims. FAIR Health was developed and funded in the settlement of claims by the AMA that the health insurance industry (especially UnitedHealth’s Ingenix, now Optum) systematically underpaid physicians based on distorted calculation of what physician “usual and customary” charges were. The litigation was led by then-Attorney General, now-Governor Andrew Cuomo of New York.
Coronavirus Public Health Resources and References (alphabetical):
Association of American Medical Colleges Clinical Guidance Repository, here.
AMA resource page for physicians here. AMA guide to medical education and COVID-19, here.
American Public Health Association information here.
CDC information page for professionals here, Morbidity and Mortality Weekly Reports on Coronavirus, here.
CMS (Centers for Medicare & Medicaid Services) Current Emergencies website, here.
Council of State Governments, here.
JAMA Network’s COVID-19 resource center here.
Library of Congress Coronavirus Research Guide, (here) from the In Custodia Legis blog of the Library of Congress (LoC), with links to Congressional Research Service (CRS) reports.
NIH information page here.
National Library of Medicine Coronavirus page here,
New England Journal of Medicine update here, New England Journal of Medicine Journal Watch here.
The Lancet COVID-19 Resource Centre here and real-time dashboard to monitor clinical trials, here.
The New York Times Coronavirus coverage, here.
Reproduction rate (rt), website https://rt.live/ tracks the highest and lowest COVID-19 reproduction.
State actions, Kaiser Family Foundation, here.
UC Hastings College of Law’s “The Source” (on health care prices and competition) COVID-19 page, here.
The White House open research dataset (CORD-19) here.
World Health Organization COVID-19 page here.
U.S. House of Representatives:
Members at https://www.house.gov/representatives
Committees and Members at https://www.house.gov/committees
U. S. Senate:
Committees and Members at https://www.senate.gov/committees
CQ 2020 Calendar of Regularly Scheduled Sessions, here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
July 27, 28, 29, 30, 31
August, none
September 8, 9, 10, 11, 14, 15, 16, 17, 22, 23, 24, 25, 30
October 1, 2
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.