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Leading health IT groups are criticizing the Trump administration's move to abruptly change how hospitals report COVID-19 data, saying it jeopardizes public trust and hampers the industry's ability to respond to the pandemic...the Trump administration directed hospitals to sidestep the Centers for Disease Control and Prevention and send critical information about COVID-19 hospitalizations and equipment to a different federal database set up by the Department of Health and Human Services...The American Medical Informatics Association and the American College of Medical Informatics wrote an open letter claiming this shift in reporting will create data gaps, "hindering efforts to recognize, understand, and evaluate important trends related to COVID-19."...READ MORE

The American Hospital Association and Association of American Medical Colleges announced...they are seeking a rehearing on the ruling earlier this month from the U.S. Court of Appeals for the District of Columbia. The ruling upheld the Department of Health and Human Services’ authority to install Medicare payment cuts to off-campus hospital clinics to bring them to the same payment level as physician offices...“These illegal cuts directly undercut the clear intent of Congress to protect hospital outpatient deaprtments because of the many real and crucial differences between them and other sites of care,” the AHA and AAMC said in a statement...READ MORE

Oswald Bilotta blew the whistle on Novartis’ alleged doctor kickback scheme while working as a sales rep at the Swiss drugmaker, leading to U.S. government intervention in a lawsuit in 2013...Now, as Novartis has agreed to resolve the case by paying a $678 million settlement, Bilotta stands to get $109.4 million, plus additional interest, for his role as the whistleblower...According to the complaint, Novartis set up sham speaker programs as venues for paying physicians kickbacks to boost scripts of its drugs Lotrel, Valturna, Starlix, Tekturna, Tekamlo, Diovan and Exforge. These events often involved lavish meals, fishing trips and other entertainment, according to the suit...READ MORE

Insurers are worried a raft of proposed changes to the Medicaid Drug Rebate Program could lead to drug manufacturers gaming the system to charge higher prices...Several insurer groups commented on the proposed rule that the Centers for Medicare & Medicaid Services released last month to get states and drugmakers to create more value-based payment arrangements...If finalized, the rule would relax some of the requirements for the average manufacturer price and best price that manufacturers must provide for Medicaid. Under the new rule, a manufacturer could report multiple best prices for a therapy under the Medicaid Drug Rebate Program, but any best price has to be tied to a value-based purchasing agreement...READ MORE

The stunning growth of specialty pharmacies in the 340B Drug Pricing Program has accelerated a troubling trend: Patients covered by commercial insurance and Medicare Part D are footing the bill for 340B savings...That's the uncomfortable reality of the 340B program’s hidden prescription economics...Whenever a prescription is eligible for 340B pricing, an insured patient could pay thousands of dollars out of pocket—even as the 340B hospital and its contract pharmacy generate substantial profits. Meanwhile, private health plans and Medicare pay full price for drugs that are sold to 340B covered entities at deep discounts, further subsidizing hospitals and PBM-owned specialty pharmacies...340B Health, which lobbies for hospitals that participate in the 340B Drug Pricing Program, argues that the program “does not cost taxpayers any money.” Be wary of this misleading half-truth. The harsh reality is that patients and payers are funding the savings that flow back to 340B covered entities and their contract pharmacies...This fundamental unfairness is discussed rarely if ever. Rather than touting how hospitals spend their 340B savings, it’s time to start asking where those savings come from...READ MORE

340B advocates are furious that Merck is asking hospitals to provide claims data for contract pharmacies on certain drugs...Major drug makers Eli Lilly and Merck are going to war with 340B contract pharmacies by installing new requirements and in some cases refusing to provide their products...The advocacy group 340B Coalition, a group of healthcare advocates and providers, wrote to the Department of Health and Human Services last week objecting to several moves made by manufacturers Eli Lilly and Merck...The group was furious Lilly declined to provide a discount for three formulations of the erectile dysfunction drug Cialis if the product is sent to a contract pharmacy, and that Merck wants pharmacies to provide claims data...READ MORE

The Trump administration unveiled four executive orders on Friday aimed at bringing down pharmaceutical prices...1) he (Trump) announced a one-month ultimatum for drug manufacturers to propose alternative plans to reduce drug prices...“We’re going to hold that until August 24, hoping that the pharmaceutical companies will come up with something that will substantially reduce drug prices,” Trump said...2) A second order...revives a...plan that would eliminate the rebates drug makers pay to insurers...The executive order...includes a caveat that the plan cannot be implemented if it will raise premiums...3)...the Trump administration is expanding its efforts to allow Americans to import medicines...the administration was now allowing personal importation, a phrase used to describe when individual consumers buy drugs from other countries...The order says HHS will facilitate “grants to individuals of waivers of the prohibition of importation of prescription drugs.”...4) The fourth order would force certain health centers to pass negotiated discounts on insulin and EpiPens to patients...READ MORE

Leading health IT groups are criticizing the Trump administration's move to abruptly change how hospitals report COVID-19 data, saying it jeopardizes public trust and hampers the industry's ability to respond to the pandemic...the Trump administration directed hospitals to sidestep the Centers for Disease Control and Prevention and send critical information about COVID-19 hospitalizations and equipment to a different federal database set up by the Department of Health and Human Services...The American Medical Informatics Association and the American College of Medical Informatics wrote an open letter claiming this shift in reporting will create data gaps, "hindering efforts to recognize, understand, and evaluate important trends related to COVID-19."...READ MORE

A new report from the hospital industry predicts half of all U.S. hospitals will be operating in the red by the end of the year unless more federal relief is approved...The report...prepared on behalf of the American Hospital Association, paints a grim picture of the impact of the COVID-19 pandemic on hospital operating margins...Hospital margins could sink to negative 7% in the second half of 2020, and half of all hospitals are likely to operate with a negative margin...Hospitals were slammed financially by low patient volume and cancellation of elective procedures to preserve capacity to combat COVID-19...Normally, hospitals overall operate with a 3.5% operating margin. But margins are expected to drop to negative 3% in the second quarter of this year...That drop would have been negative 15% without funding from Congress, which gave providers $175 billion a few months ago...READ MORE

Herd immunity is exactly what the spike in cases indicates is developing, and we need it to continue. Politicians have been reimposing and maintaining lockdowns and mask mandates due to media furor over “spikes” in coronavirus cases. This has happened in 21 states and many more localities, says The New York Times. One of the many problems with this is that the nation needs people to keep getting coronavirus...That’s because coronavirus spread is a natural vaccine that protects those who survive  — which is the vast majority — and even those who don’t catch it, through herd immunity. This natural vaccine is our only antidote to the virus until a manufactured vaccine can be made, a process that experts say is still at least a year away, and possibly as many as four years or even never...READ MORE