Morning Briefing
Summaries of health policy coverage from major news organizations
No Surprises Act Blocked 2 Million Bills In 2 Months, Insurers Say
Modern Healthcare: Insurers Estimate No Surprises Act Blocked 2M Bills In Two Months
The No Surprises Act shielded private health insurance enrollees from an estimated 2 million surprise bills during the first two months of the year, according to a report health insurance industry groups released Tuesday. AHIP and the Blue Cross Blue Shield Association surveyed more than 80 commercial health insurance companies, 31 of which responded. Those insurers represent 115 million commercial health plan members. These companies reported receiving 600,000 claims covered by the surprise billing law in January and February. Based on claims experiences from prior years and factoring in processing delays this year, the insurance groups estimate that the true amount of such bills at 2 million. (Berryman, 5/24)
In other health industry news —
Modern Healthcare: Advocate Aurora Health Sued For Allegedly Inflating Prices
A self-insured pharmacy sued Advocate Aurora Health on Tuesday for allegedly using all-or-nothing contracts to force Wisconsin employers to pay inflated prices rather than steer patients to lower-cost hospitals outside the health system. Advocate Aurora allegedly charges more than its competitors for routine services like a colonoscopy with a biopsy, which costs $10,700 at Advocate Aurora compared to $4,700 at Froedtert & the Medical College of Wisconsin, according to the lawsuit filed Tuesday in a Wisconsin federal court by Uriel Pharmacy, which offers a self-funded health plan for its employees in East Troy, Wisconsin. The not-for-profit health system operates 27 hospitals in Wisconsin and Illinois. (Kacik, 5/24)
Modern Healthcare: AMA: Insurers Not Sticking To Prior Authorizations Deal From 2018
Health insurance companies haven't adequately implemented changes to the prior authorization process that insurers and providers devised in 2018, according to survey results the American Medical Association published Tuesday. Four years ago, the AMA, AHIP, the Blue Cross Blue Shield Association and other healthcare groups agreed to encourage reviews of medical services and drugs subject to prior authorization, better communication about prior authorization processes, exemptions for some physicians and services, policies to promote continuity of care, and the adoption of electronic prior authorization systems. But the AMA now says insurers haven't upheld their end of the bargain. (Goldman, 5/24)
Stat: Top Privacy Researchers Urge Health Care Industry To Safeguard Patient Data
Patient data might be the biggest business you’ve never heard of. As a STAT investigation published Monday revealed, data brokers are quietly trafficking in Americans’ health information — often without their knowledge or consent, and beyond the reach of federal health privacy laws. This market in medical records has become highly lucrative — $13.5 billion annually — thanks to advances in artificial intelligence that enable the slicing, dicing, and cross-referencing of that data in powerful new ways. (Molteni, 5/24)
Stat: Inclusion Of People With Disabilities Is 'Lacking' In Health Care, Researcher Says
Something as simple as getting a Covid-19 test can be complicated for Joshua Miele, a principal accessibility researcher at Amazon. Miele is blind. When he got his rapid test results at the STAT Health Tech Summit in San Francisco on Tuesday morning, the clinician handed a sheet of paper with his result not to Miele, but to a sighted STAT reporter standing beside him. That is just one example of the erasure people with disabilities face when seeking health care, especially when that care is unrelated to disability, he later told the audience at the Commonwealth Club. (Cueto, 5/24)
Also —
WUSF Public Media: Johns Hopkins All Children’s Hospital Recognized As One Of The Nation’s Best For Pediatric Surge
Johns Hopkins All Children’s Hospital in St. Petersburg is now a Level 1 Children’s Surgery Center. The designation means the hospital is among the top institutions in the country for pediatric surgery. The American College of Surgeons has awarded the status to only two other hospitals in Florida and fewer than 50 around the nation. For All Children’s, it comes just a few years after regulators demanded changes at the hospital because of a spike in the mortality rate among pediatric heart surgery patients. (Ochoa, 5/24)
Modern Healthcare: NFL Unveils HBCU Sports Medicine Initiative
The National Football League on Tuesday unveiled a partnership with historically Black colleges and universities to give 16 medical students an opportunity to practice sports medicine in the league. Starting next football season, the NFL Diversity in Sports Medicine Pipeline Initiative will give HBCU students a one-month clinical rotation at one of eight NFL teams: the Atlanta Falcons, Cincinnati Bengals, Los Angeles Chargers, Los Angeles Rams, New York Giants, San Francisco 49ers, Tennessee Titans and Washington Commanders. (Abrams, 5/24)
