Volume V, Issue 30

July 23, 2018
Trump administration proposes altering rule on drug rebates
WH
The Trump administration has proposed a rule that would scale back protections currently in place that allow rebates pills2.jpg between drug manufacturers and insurers and pharmacy benefits managers, according to the Office of Management and Budget (OMB) website. Details of the proposed rule have not yet been made public, but its title on the OMB site refers to removing the safe harbor protection for rebates from the anti-kickback law.

WIM
The move is the first concrete sign that the Trump administration has started to review the legal status of these rebates since Food and Drug Administration Commissioner Scott Gottlieb raised the idea early this year that they should not be exempted from anti-kickback law.

Read more from Reuters, July 19  HERE .
Good or bad idea? Some worry that E/M coding update could underpay doctors with sickest patients
WH
If you listen to the Centers for Medicare & Medicaid Services (CMS), the organization's plans to update Evaluation and Management (E/M) codes could simplify documentation and free up doctors' time to spend with patients, according to by Joanne Finnegan in a July 18, 2018 Fierce Healthcare post. Or, it could leave physicians who treat high-acuity patients underpaid. Ms. Finnegan reports that several healthcare organizations have reacted negatively to the recent CMS announcement, a proposed rule on the 2019 physician fee schedule.

WIM
"Their scheme to pay a physician the same amount for evaluating a case of sniffles and a complex brain cancer simply defies all logic. It is the antithesis of value-based healthcare and cheapens the medical care seniors are entitled to under Medicare," Ted Okon, Executive Director of Community Oncology Alliance, said in a statement, posted the day after CMS released the proposed rule.
Alcohol-related cirrhosis deaths skyrocket in young adults
WH
Liver disease deaths jumped by 65 percent in the United States, from 1999-2016, disproportionately affecting adults ages 25-34. The increase in deaths among young adults was driven entirely by alcohol-related liver disease, according to a new study by Michigan Medicine - University of Michigan. The data was published recently in the journal BMJ. According to a story summarizing the research, posted to Science Daily on 7.18.18, mortality due to cirrhosis began increasing in 2009 - around the time of the Great Recession when the economic downturn led to loss of people's savings, homes and jobs. This may offer a clue as to the cause.

WIM
"We suspect that there is a connection between increased alcohol use and unemployment associated with the global financial crisis. But more research is needed," states study co-author and liver specialist Elliot B. Tapper, MD.

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Florida Health Industry Week in Review is published every Monday by
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Each Monday morning, we share the top healthcare headlines of the previous week and summarize
What Happened (WH) and
Why It Matters (WIM).

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