DCMedical News: Friday, May 14, 2021
DCMedical News-DCMN
Washington, D.C.
Friday, May 14, 2021
DCMedical News is published every day both the House and the Senate are scheduled to be in session. Subscription information and archives from 2018 to the present at dcmedicalnews.org, here.
THE BIG STORY IN HEALTH CARE
More Money for Public Health Training, Infrastructure
The Administration announced (here) a $7.4 billion public health workforce expansion. Funds will come from the pandemic relief law enacted in March which included $350 billion in funding for state, local and tribal governments. CQ notes that “The resources of public health departments came into sharp focus during the COVID-19 pandemic, when contact tracing efforts faltered and the vaccination push broke down at the last mile after the Trump administration declined to offer guidance or funding to officials carrying out administration.” Most of the money, $4.4 billion, will be used to expand the nation's public health department workforce, including hiring of epidemiologists, data scientists, and staff for contact tracing and testing; $400 million will be for a new AmeriCorps program focused on public health; $245 million will fund the Centers for Disease Control and Prevention's epidemic intelligence service; $80 million will be used for training on new public health data technology; $337 million will fund fellowships and internship opportunities in public health.
Public Health Credibility Challenge: Does the Public Trust Local Health Departments? About as Much as Family and Friends. The CDC? Somewhat. Nurses? Yes!
A new Robert Wood Johnson/Harvard poll on public health (here) shows that about 71 percent of Americans support substantially increasing federal spending on improving the nation's public health system. The poll shows that recommendations of local and state health departments (44%) are trusted just slightly more than recommendations from families and friends (41%). When it comes to the percentage of Americans with a high degree of trust in an institution's health advice, the NIH scores 37%, the FDA 37% and the CDC 52%. Nurses score 71%.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
OIG Struggles to Approve Health System-Surgeon ASC Ownership and Avoid Anti-Kickback Penalties
In an advisory opinion (here, Opinion 21-02), the HHS Office of Inspector General wrote to applicants (a health system, some of its surgeons and an ASC management company) for an ambulatory surgery center that, although they might generate anti-kickback income, it would not be much, it would be controlled, and it was not the central intent.
Said the OIG, “The Health System and physicians affiliated with the Health System, including Physician Investors, would be in a position to make or influence referrals of Federal health care program beneficiaries to the New ASC. To limit the ability of such physicians to make or influence referrals, the Health System would refrain from any action requiring or encouraging physicians who are its employees, independent contractors, or medical staff members (‘Affiliated Physicians’) to refer patients to the New ASC or to the Physician Investors. The Health System certified that it would not track referrals made to the New ASC by Affiliated Physicians. In addition, the Health System certified that no Affiliated Physician arrangement with the Health System, including any Physician Investor employment arrangement, would require the Affiliated Physician to refer to the New ASC. Further, any compensation for services furnished that would be paid by the Health System to Affiliated Physicians, including employee compensation that would be paid to Physician Investors, would be consistent with fair market value and would not be related, directly or indirectly, to the volume or value of referrals Affiliated Physicians may make to the New ASC or its Physician Investors.”
New York Leads In Producing Medical School Graduates
New York led all states (at 2,440, 9% of the nation’s total of 26,641) in producing medical school graduates in 2019. An Excel chart (here) based on a Kaiser Family Foundation (KFF) web site shows Pennsylvania, Texas, California and Florida (in that order) to be second through fifth in total medical school graduate production. Pennsylvania had the most (605) graduates of osteopathic medical schools. The KFF sources were the AAMC and the AACOM.
Congress Pursues Prior Authorization Limits in Medicare Advantage Plans
Modern Healthcare (here) reports that under newly proposed legislation “Medicare Advantage plans must establish electronic prior authorization programs and provide ‘real-time decisions’ for some services that are routinely approved by insurers . . . The proposal would require Medicare Advantage plans with prior authorization requirements to submit an annual report to the HHS secretary listing which services require prior approval and how many requests were approved, denied and overturned. . . and time between the submission of a prior authorization request and a determination.”
Plastic Surgery Overtakes Orthopedics as Highest Paid Specialty
A report in BeckersSpine (here) on salary surveys shows the highest paid physicians to be in Alabama, then Kentucky.
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Hospital-At-Home Gains New Participants, Payments
The “hospital-at-home” movement was bolstered by news (Healthcare Dive, here) that “Kaiser Permanente and Mayo Clinic are investing $100 million in a hospital-at-home company as the COVID-19 pandemic accelerates the push toward care settings outside a hospital's four walls.” Boston’s Medically Home has “a virtual and physical delivery model allowing providers to shift acute care typically administered in a hospital to a patient's home . . . The partnership will allow patients to be treated at home for infusions and conditions like cancer, infections and COVID-19.”
Medicare Payment for Monoclonal Antibodies for COVID-19: $310 before May 6, $450 now, $750 at home
CMS announced a payment increase for hospitals and other institutional providers (here), and also noted “Beginning on May 6, 2021, Medicare established separate coding and payment for administering COVID-19 monoclonal antibody products in a patient’s home or residence . . . the new Medicare payment rate for administering monoclonal antibody products in a patient’s home or residence is approximately $750 . . . Providers and suppliers may bill for the higher home payment rate when they furnish a COVID-19 monoclonal antibody product in a ‘home or residence,’ which includes circumstances, such as a beneficiary’s permanent residence, temporary lodging (e.g., hotel/motel, cruise ship, hostel, or homeless shelter) and homes or residences that have been made provider-based to the hospital during the COVID-19 PHE.”
Catching Up on Price Transparency
FierceHealthcare (here) summarizes recent reports and studies, with focus on first round of CMS letters to non-performers.
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
Home and Community Based Services Get Guidance, 10% FMAP One-Year Bump for Medicaid
CMS issues guidance (here, 26-pg. letter to State Medicaid Directors) on “how states can receive enhanced funding, provided through the American Rescue Plan Act of 2021 (ARP), to increase access to home and community based services (HCBS) for Medicaid beneficiaries . . The additional federal funding made available under the American Rescue Plan allows states to tailor HCBS enhancements based on the needs and priorities of its residents . . . Section 9817 of the ARP provides states with a temporary 10 percentage point increase to the federal medical assistance percentage (FMAP) for certain Medicaid HCBS from April 1, 2021 through March 31, 2022 to improve HCBS under the Medicaid program.”
DRUGS & DEVICES
Workflow Optimization in Radiology IT
Canopy Partners (reported here, in Radiology Business) conducted a national survey of radiologists which found “40% of surveyed hospitals, group practices and independent imaging centers named workflow as their most important challenge. Keeping technology updated came in at a distant second.”
READINGS & REFERENCES
Select Coronavirus Public Health Resources and References (alphabetical) may be found here.
2021 CQ Congressional Calendar here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
May 17, 18, 19, 20
June 14, 15, 16, 17, 22, 23, 24, 25
July 19, 20, 21, 22, 26, 27, 28, 29, 30
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.