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A New Twist on Telehealth

Residents of urban areas often have the same access-to-care problems as rural residents, although the latter receive far more attention. So concludes a new report published on the Health Affairs Blog. According to the analysis, urban and rural residents have similar access problems – and among urban residents, the problems in some instances are even greater.  One distinction: …while rural America has access problems because there are not enough doctors, urban America has access problems because there are not enough appointments. One potential solution to this problem, the report suggests, is focusing on access instead of geography and making telehealth services more available to rural and urban residents alike.  To date, most telehealth efforts have focused on serving residents of … Read More

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Wolf Nominates Four for Health-Related Posts

Pennsylvania Governor Tom Wolf has nominated four acting department secretaries to assume those positions permanently. His nominees are: Rachel Levine, to be Secretary of the Department of Health Teresa Miller, to be Secretary of the Department of Human Services Jennifer Smith, to be Secretary of Drug and Alcohol Programs Jessica Altman, to be state Insurance Commissioner Learn more about the nominations and the nominees in this Central Penn Business Journal article.

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House Committee to Hold 340B Hearing

The House Energy and Commerce Committee’s oversight subcommittee will hold a hearing on Wednesday about the 340B Drug Pricing Program. At the hearing, titled “Examining How Covered Entities Utilize the 340B Drug Pricing Program,” the subcommittee hopes …to hear directly from entities participating in the program to get a better understanding of how the program is used, including how much money is saved, the types of drugs purchased and prescribed within the program, how entities track their savings, and how those savings are used to improve patient care. All Pennsylvania safety-net hospitals participate in the 340B program. Learn more about the hearing and the witness list from the subcommittee’s news release on the subject.

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Suit Claims Low Medicaid Rates are Discriminatory

A lawsuit filed in state courts in California argues that the state’s low Medicaid payments amount to discrimination against the state’s large Hispanic Medicaid population. California pays among the lowest rates in the country to physicians, making health care inaccessible for some, and the suit maintains that this is a civil rights issue in which low rates amount to discrimination. The suit is based on state anti-discrimination and equal protection laws, and many other states have similar laws on the books.  Observers question whether the low rates constitute discrimination against the suit’s Hispanic plaintiffs because the low rates affect the state’s entire Medicaid population, but health advocates around the country will be watching the suit’s progress closely as they consider … Read More

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PA Drug Monitoring Program Showing Results

Pennsylvanians are having a harder time inappropriately obtaining prescriptions for opioids and other dangerous prescription drugs because of continued implementation of the state’s prescription drug monitoring program. Under the program, introduced last year, anyone who can prescribe Schedule II-V class drugs must query a state database before doing so and report any prescriptions they write by the end of the next business day. The idea is to prevent people from going from doctor and doctor and pharmacy to pharmacy seeking prescriptions for dangerous drugs, and it appears to be working.  The state’s Department of Health reports that the number of people who visited five or more doctors to obtain prosecutions for drugs covered by the program fell 86 percent in … Read More

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U.S. House Committee Looks at 340B

Are hospitals using the savings generated by their participation in the section 340B prescription drug discount program to help their low-income and uninsured patients? That’s what the U.S. House Energy and Commerce Committee’s Health Subcommittee is asking. Earlier this year the committee requested such information from the Health Services and Resources Administration, which runs the 340B program, and now it’s asking hospitals as well. Specifically, the subcommittee sent five-page letters to 19 providers that participate in the 340B program asking them about: the quantity of 340B-purchased drugs they dispense to Medicare beneficiaries, Medicaid beneficiaries, and those with private insurance the quantity of 340B-purchased drugs they dispense to uninsured patients their savings from the 340B program and how they calculate those … Read More

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Overutilization of ERs May Not be as Great as Perceived

Far fewer hospital emergency room visits are for medical problems better addressed in other settings, according to a new study. In a review of six years worth of data encompassing 424 million ER visits, researchers found that only 3.3 percent of those visits were truly “avoidable,” with the avoidable visits mostly involving problems ERs are not equipped to address, such as dental and mental health issues. This finding flies in the face of the conventional wisdom that people turn too quickly to hospital ERs for routine medical problems or use ERs because they lack access to more appropriate care. Learn more about the study and its findings in this Fierce Healthcare article or go here for a link to the … Read More

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Leave 340B Alone, CMS Advisory Group Says

The Centers for Medicare & Medicaid Services should not significantly reduce Medicare payments for some prescription drugs. Or so says one of CMS’s own advisory panels. The agency’s Advisory Panel on Outpatient Prospective Payment reached this conclusion after listening to testimony from hospital industry stakeholders who told of the savings the federal government’s 340B prescription drug discount program produces and how those savings enable hospitals in low-income areas to help low-income patients who would not otherwise be able to afford their drugs and help improve access to care for low-income patients with very limited health care options. The panel’s recommendation came just a month after CMS proposed reducing Medicare reimbursement for 340B drugs from its current level, average sales price … Read More

Posted in Medicare, Pennsylvania safety-net hospitals, Uncategorized

SNAP Writes to House Ways and Means Committee About Medicaid DSH Audits

The federal government should give states the option of monitoring Medicaid disproportionate share payments (Medicaid DSH) to hospitals through prospective DSH limit calculations rather than through retroactive DSH audits. SNAP recently shared this view with the House Ways and Means Committee’s Health Subcommittee in response to that subcommittee’s request for suggestions from stakeholders on ways to improve the delivery of Medicare services and eliminate statutory and regulatory obstacles to more effective care delivery.  According to SNAP, retroactive DSH audits are cumbersome, burdensome, and expensive, give rise to many disputes and appeals, and in the end yield results very similar to much simpler prospective DSH limit calculations performed by the very state governments that distribute Medicaid DSH funds.  See SNAP’s comments … Read More

Posted in Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania, Uncategorized

Congress Looks at 340B Program

Last week the House Energy and Commerce Committee took a look at the 340B prescription drug discount program, which requires pharmaceutical companies to sell discounted drugs for outpatient use to hospitals that care for especially large numbers of low-income patients. The previous week, the Centers for Medicare & Medicaid Services issued a proposed Medicare regulation calling for significant reductions in Medicare payments for such drugs. The hearing touched on the CMS proposal to reduce Medicare payments for 340B drugs, the high prices of prescription drugs, the 340B program’s growth over the years, the possibility that the program is being abused by hospitals and clinics, and more. The 340B program is an essential tool in the efforts of Pennsylvania safety-net hospitals … Read More

Posted in Medicare, Pennsylvania safety-net hospitals, Uncategorized
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