Morning Briefing
Summaries of health policy coverage from major news organizations
Chan Zuckerberg Initiative Plans To Add $3.4B For Health Care Research
Stat: Chan Zuckerberg Initiative Invests Another $3.4 Billion To Advance Research
As Mark Zuckerberg aims to build his social network empire into the foundation for a virtual metaverse, his other company is tying itself even more closely to the physical world and the delicate human bodies that reside there. On Tuesday, the Chan Zuckerberg Initiative — the limited liability company formed to execute the philanthropic vision of co-CEOs Priscilla Chan and her husband, Zuckerberg — announced a significant new investment into its missions of curing, preventing, or managing all disease by the end of the century. (Palmer, 12/7)
In other health care industry news —
Las Vegas Review-Journal: United Healthcare Owes $60M To ER Doctors, Jury Rules
United Healthcare Insurance Co., one of the country’s largest health insurers, must pay $60 million to a group of Nevada out-of-network emergency medical providers, a Las Vegas jury decided Tuesday. The jury in the 8th Judicial District Court case awarded the millions in punitive damages a week after it found United Healthcare liable of underpaying millions to the three Nevada-based TeamHealth affiliate providers, which includes Fremont Emergency Services (Mandavia) Ltd., Team Physicians of Nevada-Mandavia PC and the parent company of Ruby Crest Emergency Medicine. (Hudson, 12/7)
Stat: Centene To Pay $28 Million To Resolve Another State Probe Into PBMs
Centene (CNC), one of the largest health insurers in the U.S., agreed to pay nearly $28 million to Kansas to settle allegations that a pharmacy benefits subsidiary overcharged the state Medicaid program, the fifth such deal this year between the company and a state government. The deal comes after heightened scrutiny of Centene operations that were raised in a state audit and subsequent lawsuit filed earlier this year by Ohio Attorney General Dave Yost, who alleged the health insurer misrepresented pharmacy costs and, through its different subsidiaries, collected an additional $20 million in fees. (Silverman, 12/7)
Modern Healthcare: Providers Push For Surprise Billing Resolution Process Changes
"What was supposed to be an independent check on both parties is now gone. In short, the departments have forfeited this important restraint with respect to plans and issuers, while creating a nearly insurmountable set of conditions for providers," the American Hospital Association wrote in a letter. The No Surprises Act says arbitrators should consider a list of factors when deciding how much a payer should reimburse an out-of-network provider for services. The list includes the median in-network payment rate, known as the qualified payment amount. It could also factor in market share of each party, quality measurements of the provider, patient's acuity and several other factors. (Goldman, 12/7)
Philadelphia Inquirer: Vanguard Will Phase Out Popular RMA Benefit
Malvern-based Vanguard will freeze a popular medical benefit for retirees and employees, instead of cutting it entirely as announced in October, according to a letter from the mutual fund company. Current retirees and those who retire by the end of next year will retain their generous retiree medical accounts (RMAs), but the value of the benefit will no longer increase starting in 2023. (Arvedlund, 12/8)
Bloomberg: Suki Funding Sets Value At $400 Million For ‘Siri For Doctors’
Suki AI Inc., a health startup that makes a sort of Siri digital assistant for doctors, raised a new round of venture capital valuing the business at $400 million. The five-year-old company plans to announce Tuesday that it received $55 million in a deal led by growth equity firm March Capital. It also formed an agreement with Google for its cloud division to start selling Suki’s services to health companies, said Punit Soni, the startup’s chief executive officer. The upstart is also chasing a giant. In April, Microsoft said it plans to spend nearly $20 billion on Nuance Communications, a company that has provided note-taking services to doctors for over two decades. “We’re basically trying to catch up with companies that have been doing this for 20 years,” Soni said. (Bergen, 12/7)
Also —
KHN: Post-Pandemic, What’s A Phone Call From Your Physician Worth?
Maybe this has happened to you recently: Your doctor telephoned to check in with you, chatting for 11 to 20 minutes, perhaps answering a question you contacted her office with, or asking how you’re responding to a medication change. For that, your doctor got paid about $27 if you are on Medicare — maybe a bit more if you have private insurance. Behind those calls is a four-digit “virtual check-in” billing code created during the pandemic, for phone conversations lasting just within that range, which has drawn outsize interest from physician groups. (Appleby, 12/8)
