Local, state and national news of interest to the physician community

March 13, 2024

HAPPY SAINT PATRICK'S DAY!!

MARCH 17, 2024

Claims Change Healthcare to Return Online This Week;

Distressed Docs Skeptical; CMS to Accelerate, Advance Pay

"UnitedHealth Group said it plans to test connections to its Change Healthcare's medical claims software and network starting Monday, March 18, and restore service through the week," WSJ Pro reports.

It's the first timeline update provided by the claims processor since the February 21 cyberattack that brought it to its knees, initiating a weeks-long period of financial strains and existential worries to pharmacies and practices small and large.

"Pharmacy claims and payment systems are back up and running as of Thursday [March 7] and its electronic payments platform will be available from March 15," UHC told WSJ Pro, but as Reuters reports, UHC "is likely to need several months to make a full recovery." Read more about Change's struggles to return online here.

Cash Crunches & Criticisms

However, "financially strapped doctors, hospitals and medical providers on Friday sharply criticized UnitedHealth Group's latest estimate," The New York Times says, as "desperate providers that have been borrowing money to cover expenses and employee payrolls expressed skepticism." Axios says "disruptions are costing health providers as much as $1 billion a day and creating enough of a drag to depress first-quarter earnings."

Last week, CMS announced "a program of accelerated payments to Medicare Part A providers and advance payments to Part B providers," AMA reports. Here's a link to the fact sheet. Previously, "UnitedHealth said it would expand stopgap funding for its providers. This additional program, which is separate from an Optum loan program launched on Feb. 29, will apply to United Healthcare's medical, dental and vision providers." It has encouraged other payers to follow suit.

Government Response

The White House met with UnitedHealth Group CEO Andrew Witty and representatives from across the healthcare industry Tuesday (Reuters), following a letter two days earlier in which government officials urged UHC to take "responsibility to ensure no provider is compromised by their cash flow challenges stemming from this cyberattack on Change Healthcare" by expediting payments to providers. (Reuters; Axios)

Additionally, CMS has extended the 2023 MIPS data submission deadline until April 15 due to the incident.

Alabama's Governor Kay Ivey signed into law a bill granting in vitro fertilization (IVF) providers civil and criminal immunity, convincing providers in the state to announce resumption of the procedure, WSJ reports.

However, CNN notes some observers acknowledge that the new legal "patch" is not ironclad, as it does not "address the issue of personhood at the heart of last month's unprecedented ruling," which suddenly thrust Alabama physicians into a precarious state of civil and criminal liability.

In Virginia, a spokesperson for Governor Glenn Youngkin informed WTKR News 3 that "Governor Youngkin unequivocally supports access to IVF for Virginians hoping to experience the blessing of a family."

And in the U.S. Congress, a "federal bill that Virginia Sens. Mark Warner and Tim Kaine co-sponsored to protect IVF treatment failed last week in Congress" after Senate Republicans blocked the legislation, Axios and AP report.

It's official: Besides its indication for weight loss, semaglutide (Wegovy) can now be prescribed "to reduce the risk of cardiovascular death, heart attack, and stroke in adults with cardiovascular disease and either obesity or overweight, the FDA announced on Friday" and MedPageToday reports.

The agency's announcement declares history has been made as semaglutide is now the "first treatment to reduce risk of serious heart problems specifically in adults with obesity or overweight."

The release notes that the drug should "be used in conjunction with a reduced calorie diet and increased physical activity."

IN RELATED NEWS... Semaglutide (Ozempic) reduced the amount of liver fat by nearly a third in people with HIV and metabolic dysfunction-associated steatotic liver disease (MASLD) (MedPageToday)... Novo Nordisk teams up with global authorities to combat dangerous fake Ozempic (Reuters).

RAM member Richard P. Wenzel, M.D., M.Sc., Emeritus Professor and Chair Department of Internal Medicine, Virginia Commonwealth University, and Editor-At-Large, The New England Journal of Medicine, recently penned his reflections on the COVID-19 pandemic, with emphasis on the concepts of solitude and isolation and how they affected us both then and now, and how solitary reflection can help us remember lessons learned and better plan for the future. Read his article here.

Two-year-old startup health clinic Remission Medical has announced partnerships with OrthoVirginia and Sentara Healthcare to bring virtual rheumatology services to those larger systems' patients. Remission, which currently has 11 practitioners seeing 500 patients, says the new contracts will be advantageous to all parties, allowing OrthoVirginia and Sentara to be more responsive to patients while providing a funding boost for Remission. Read more at Richmond BizSense.

Facing heat amidst the crusade for lower drug prices, German drugmaker Boehringer Ingelheim has announced that, starting June 1, it will place a $35 cap on all of its chronic obstructive pulmonary disease (COPD) and asthma inhalers in the U.S., The Hill reports.

The program will "dramatically decrease costs at the pharmacy counter for patients," Reuters reports, and is "aimed at patients with employer-sponsored insurance, and those who are underinsured and uninsured, meaning they likely have to pay cash," says The Hill.

The news may come as a breath of fresh air to patients who depend on inhalers, especially after the January discontinuation of Flovent. Unfortunately, many pediatricians are still scrambling to find an alternative for young patients with severe asthma, The Hill says.

Boehringer's announcement comes as the drugmaker faces a U.S. lawsuit accusing it of misusing "several patents related to its Respimat inhaler to extend its monopoly on the drugs by up to 10 years, from 2020 to 2030," Reuters says.

Every week, we report on things that are not always positive, yet they can have a tremendous effect on not only your professional life but your personal well-being as well. We know being a physician presents monumental, unprecedented, highly stressful challenges, so we want to let you know that if you are feeling down, you are not alone: there is somewhere you can turn to if you need extra support.

If you or a fellow physician is going through a tough time, consider reaching out to the Physician Support Line, staffed by volunteer psychiatrists who provide their services for free and in a confidential manner. Everything is anonymous and nothing is reported. Check out their website here or call 1 (888) 409-0141.

One of very few treatments for amyotrophic lateral sclerosis (ALS), Relyvrio, was granted an emergency approval by the FDA less than two years ago. Now, drugmaker Amylyx says the drug has failed to slow disease progression in its clinical trial and is considering withdrawing it from the market, ALS News Today reports.

Originally, "the agency decided to greenlight the medication instead of waiting two years for results of a large clinical trial, citing data showing the treatment to be safe and the desperation of patients with a disease that often causes death within two to five years." Nearly 4,000 patients have received the treatment, which costs an average of $158,000 per year.

"Results of the 48-week trial of 664 patients are in, and they showed that the treatment did not work better than a placebo," The New York Times says.

RAM Events & News

LAST CALL TO REGISTER!!

Are you in your first ten years of practice

or new to Richmond for five years or less?

Then RYPE 'N RVA (RAM Young Physician Engagement, or RYPE for short) is the perfect group for you!

We're excited to announce the re-launch of RYPE, designed specifically for new-to-newish physicians like you. Our aim is to create a community where you can connect with peers, discuss professional and personal issues, and grow your network.

To kick things off, we're hosting a RYPE Redux Social at Basic City Beer on Wednesday, March 20 from 6 to 8 p.m. This will be a great opportunity to meet other physicians in a relaxed and friendly atmosphere, and to help us plan upcoming events. So come join us and be a part of the growing community of physicians in Richmond. We can't wait to meet you and support you as you navigate this exciting new chapter in your career!

Free to RAM members and a guest - bring a colleague or your spouse and make it a date night! Cheers to new beginnings!

RAM Family Day at the Metro Richmond Zoo

Saturday, April 13

10:00 a.m. - 2:00 p.m.

RAM Members & their immediate families are invited to join us at the Metro Richmond Zoo on Saturday, April 13, from 10 a.m. - 2 p.m.!

The family ticket price of $25 gets your immediate family all-day admission to the zoo and one zoo treat cup per family. We'll have pavilions 11, 12 and 13 reserved for our group to mingle and enjoy grab-and-go snacks and drinks! Pack a picnic lunch and sit at one of the tables under a pavilion or on the lawn near our reserved area.

Snack bar and rides are available but not included with your RAM admission.

Medi¢: The Business of Medicine

On Friday, the Senate passed a 2024 appropriations package that included a provision that mitigated about one-half of the 3.4% Medicare fee schedule conversion factor that became effective on January 1. The 1.68% increase in current payment levels will take effect on March 9 and continue through the calendar year. President Biden is expected to sign the bill shortly.

"The current situation illustrates the need to keep up the pressure on Congress to enact comprehensive Medicare physician payment reform," AMA says.

Other Medical Business News:

• Cigna's PBM launches program aiming to cap annual cost increases for health insurance providers and employers from new weight-loss drugs at 15%. (Reuters)
• Federal appeals court rules that Arkansas can block drugmakers from limiting the availability of discounted drugs at certain pharmacies. (Axios)
• Strain from healthcare labor shortages stands to be amplified as the U.S. population continues to age. (Axios)

Today marks the four-year anniversary of the COVID-19 pandemic national emergency. Here's a look at how the world has changed.

• Is the pandemic over? Axios reviews the conflicting signs that make this a tough call to make.
• Feds extend airport nasal swabbing to Chicago and Miami. (AP)
• COVID-19 affects women and men differently - Find out how here and here.
• By 2022, COVID-19 had slashed over a year and a half off the global life expectancy. (CIDRAP)
• Mortality for high-risk gastrointestinal cancers "largely unaffected" by COVID-19 pandemic. (Healio)

National News

• Federal agencies are soliciting public comments for an investigation into private equity and "corporate profiteering" in healthcare. (Axios; MedPageToday)
• The American Academy of Dermatology voted to reject a proposal to end its diversity, equity and inclusion programs. (NBC News)
• Paul Alexander, 78, "Polio Paul" who lived most of his life in an iron lung and was subject of a previous Leg.Up "Fun Fact of the Week," died March 11. (CBS)

Drug & Tech News

• Novo Nordisk's experimental weight loss drug amycretin strongly outperforms Wegovy in trials. (Reuters)
• Eli Lilly discovers bacteria and high levels of impurities in knock-off compounded versions of Zepbound. (Reuters)
• Originally expected to be FDA-approved this month, Alzheimer's drug donanemab has been hit with a delay as the agency will require a panel of experts to consider the drug. (NYT)
• Osteoporosis drug denosumab may reduce diabetes risk. (Healio)
• FDA grants "breakthrough therapy" status to LSD formulation to treat generalized anxiety. (CNN)

FDA Approvals

• Accelerated approval to zanubrutinib (Brukinsa) plus obinutuzumab (Gazyva) as a third-line option in follicular lymphoma. (FDA)
• Expanded approval of inotuzumab ozogamicin (Besponsa) for treatment of certain pediatric patients with advanced leukemia. (FDA; Healio)
• Medtronic’s OsteoCool 2.0 bone tumor ablation system.

Medical Miscellany

• Microplastics discovered in arteries can raise heart attack, stroke, and death risks, a new study finds. (NBC News)
• Pediatric emergency room visits for melatonin consumption quadrupled from 2009 to 2020. (CDC; WSJ)
• A recent Mayo Clinic study examining the effects of daylight saving time (DST) on heart health suggests that the impact is likely minimal, as sleep doctors urge abandoning the clock-changing practice (AMA).
• Why are so many Asian American women getting lung cancer despite not smoking? (NBC News)
• Middle-aged and older Americans with higher BMIs may more likely have severe depressive symptoms. (Healio)
• Study finds PCOS diet is unlikely to ease symptoms. (The New York Times)
• People with essential tremor face heightened risk of dementia. (MedPageToday)
• Getting too little sleep increases risks of type 2 diabetes. (Healio)
• Is there a link between "lazy eye" and heart attack risk? (MedPageToday)
• Dangerous Goods: High lead in cinnamon products (AP); carcinogens in brand-name acne treatments (Reuters).

Pathogen & Vax Report

• First rabies case of 2024 in Henrico County, a raccoon. (RTD)
• More measles in Michigan and Florida (USA Today; NBC News) as CDC heads for Chicago (The Hill) and public health officials worry (MedPageToday)... Is U.S status of "eliminating" the virus in jeopardy? (The Hill)
• Mumps outbreak reported in New Jersey. (NorthJersey.com)
• Man dies of the plague in New Mexico. (ABC News)
• American man's migraines caused by tapeworm larvae in the brain. (NBC News)
• RSV antibody therapy nirsevimab was 90% effective in protecting infants from hospitalizations. (Reuters)
• Yamagata flu virus strains will not be included in the next batch of trivalent vaccines this fall. (Stat; CNN)
• Routinely screen for HIV, STIs, viral hepatitis and latent TB infection using AMA's new toolkit.

FUN FACT OF THE WEEK

What happens when you get 217 COVID shots? A 62-year-old German man is being studied after it was revealed he had done just that between 2021 and 2023. Researchers have determined that "although the man’s 'hypervaccination' did not result in any side effects, it also did not significantly improve his immune response," The Hill reports. "Researchers noted that he received the vaccines outside of a clinical study and against national vaccine recommendations."

Thanks for reading The Leg.Up!



Also, keep an eye on your mailbox for your copy of RAM's Winter 2024 RAMifications newsletter, covering topics from weight loss drugs and chronic pain management to peer review and prior authorization! Feel free to send me your feedback!



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Click here for past editions of The Leg.Up.

Scott C. Matthew

RAM Director of Communications

Richmond Academy of Medicine

www.ramdocs.org

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