Morning Briefing
Summaries of health policy coverage from major news organizations
Costs Of Cybersecurity Attack Higher For Health Industry Than Any Other
Crain's New York Business: IBM Report Finds That Cybersecurity Attacks Impact Healthcare More Than Any Other Sector
A data breach within a healthcare system could cost in excess of $10 million—more than in any other sector—according to a new report. The cost is on the rise, up about $1 million from last year. The uptick is partially due to increasingly integrated technology systems. (Neber, 8/9)
In other health care industry developments —
Dallas Morning News: Members-Only One Medical Is Opening Two Dallas Clinics
While its acquisition by Amazon is in the works, health clinic operator One Medical is moving ahead with its entry into the Dallas market with two locations. The difference at One Medical is that customers have to buy a membership to get care there. Amazon said in July that it plans to acquire San Francisco-based One Medical in a deal valued at $3.9 billion. The deal hasn’t closed. (Halkias, 8/9)
Modern Healthcare: Insurers To Crack Down On Unscheduled Procedures
Insurers are zeroing in on providers evaluation and management claims that include modifier 25. Providers use evaluation and management codes on claims for assessing or controlling patient health, such as when they hold office visits or perform surgical procedures. They add a modifier 25 when they provide significant and separately identifiable services during the same patient visits, such as removing a mole. (Tepper, 8/9)
Modern Healthcare: CMS Removes Prior Authorization For Select Orthopedic Devices
The Centers for Medicare and Medicaid Services removed prior authorization requirements for a small set of orthopedic procedures as regulators continue to adjust the controversial approval process. CMS issued a final rule Tuesday that indefinitely suspended prior authorization for urgently needed procedures involving spine and knee braces. The agency announced in January that it will more frequently update the mandatory list of durable medical equipment, prosthetic and orthotic procedures requiring insurers’ approval before providers are paid. (Kacik, 8/9)
Modern Healthcare: HCA, J&J Strike Wide-Ranging Partnership
The for-profit health system and the drug, medical device and consumer products company will begin their partnership with a focus on three areas: developing a pilot project to support early detection of lung cancer in Black patients; nurse education and training by HCA Healthcare and its affiliated Galen College of Nursing; and studying how digital technology can improve care for patients with cardiovascular diseases. The companies didn't disclose the financial terms of the arrangement. (Kim Cohen, 8/9)
Modern Healthcare: Hospitals Grapple With CEO Turnover
A wave of CEO departures is hitting the hospital sector as executives hope the worst of the pandemic has passed. But less than half of hospitals are fully prepared, research shows, portending a range of financial and organizational consequences, industry observers said. (Kacik, 8/9)
In legal news —
Modern Healthcare: Blue Cross $2.67B Antitrust Settlement Approved By Judge
Barring an appeal, this would mark the end of policyholders’ 10-year legal battle against 34 Blues plans. The plaintiffs alleged that the Blue Cross Blue Shield Association’s rules limiting the amount of revenue member plans may generate from non-Blues-branded businesses, and geographic limits to their reach, violated the Sherman Antitrust Act of 1890. Judge David Proctor’s ruling, handed down in the U.S. District Court for the Northern District of Alabama, orders Blues plans to begin paying consumers their portion of the settlement after 30 days. (Tepper, 8/9)
Becker's Hospital Review: Cerner To Pay $1.8M In Racial Discrimination Case
Cerner has agreed to pay $1.8 million in back pay and interest over claims it discriminated against Black and Asian applicants, according to an Aug. 9 U.S. Labor Department news release. The EHR vendor will pay the amount to 1,870 applicants who sought work as medical billing account and patient account specialists, system engineers, software interns and technical solutions analysts at Cerner facilities in Kansas and Missouri between 2015 and 2019. (Bruce, 8/9)
The New York Times: Employee Kept Arsenal, Including Assault Rifle, At Hospital, Police Say
A New Jersey hospital’s marketing director stockpiled an assault rifle fitted with a high-capacity magazine along with dozens of other guns and ammunition in an unlocked closet at his workplace, the police said on Tuesday. The cache of weapons was found after Hudson Regional Hospital in Secaucus, N.J., got a call last month warning of a bomb there, the police said. The threat turned out to be a hoax, but a police dog involved in a safety sweep of the hospital led officers to the guns, officials said. (Shanahan, 8/9)
In nursing home news —
Indianapolis Star: Indiana Hospitals Sued By IndyStar For Obscuring Nursing-Home Spending
Eight Indiana hospitals are violating state records laws by withholding information on how they are spending public funding they’ve received for their nursing homes, according to a new lawsuit filed by IndyStar. (Magdaleno, 8/10)
AP: 2 Pennsylvania Nursing Homes Accused Of Health Care Fraud
Managers at two skilled nursing facilities in western Pennsylvania fabricated records of staff time and residents’ conditions to defraud state and federal agencies, prosecutors alleged Tuesday in announcing criminal charges. Brighton Rehabilitation and Wellness Center in Beaver and Mt. Lebanon Rehabilitation and Wellness Center in Allegheny County were accused of health care fraud, along with five people who managed their operations. (8/9)
On billing transparency —
USA Today: Are Hospitals Meeting Requirement Of Medical Billing Transparency Law?
Only two hospitals have been fined for failure to post prices, an indication that enforcement by the Centers for Medicare and Medicaid Services has been “lukewarm” and needs to get tougher, said Ge Bai, a Johns Hopkins University professor of accounting and health policy and management. (Alltucker, 8/9)
KHN: Rapper Fat Joe Says No One Is Making Sure Hospitals Post Their Prices
Rapper Fat Joe takes on hospital industry executives in an advertisement, contending that many hospitals are disobeying a law that requires them to publicly post the prices they charge cash-paying patients and insurance companies for every service they offer. The ad, paid for by a group called Power to the Patients, states, correctly, that hospitals must list their negotiated prices and asserts that the rule helps patients by making it harder for them to be overcharged. The ad also blames politicians and regulators because the price information is still not necessarily available. (Appleby, 8/10)
