UnitedHealth To End Commissions On Sales Of Medicare Drug Plans
As of now, commissions on renewals will continue to be paid. Also, Leapfrog has served a cease-and-desist after Tenet Healthcare Corp. filed a lawsuit alleging that the safety grades process was bought and paid for. Other news is on upcoding practices in outpatient care, updated industry standards for antibiotic manufacturing, and more.
Modern Healthcare:
UnitedHealth Group To Cut Medicare Drug Plan Commissions
UnitedHealth Group plans to stop paying commissions next month to brokers and sales agents who sell new Medicare Part D prescription drug plans. The insurer, which has had a rough week that's included a new CEO and reports of a federal investigation, on Thursday notified companies that market its plans of the change. (Tepper, 5/15)
Modern Healthcare:
Leapfrog Group Sends Cease-And-Desist Letter To Tenet Hospitals
The Leapfrog Group has sent a cease-and-desist letter to five Tenet Healthcare Corp. facilities in Florida, demanding the hospitals and a law firm stop spreading what it said were "false statements" about the group and its safety grades process. The letter follows the filing of a federal lawsuit against the nonprofit healthcare watchdog group late last month, in which the five facilities allege that hospitals who receive the highest grades from Leapfrog are paying for them through membership fees. (DeSilva, 5/15)
Becker's Hospital Review:
Care New England Hospital Workers Launch Open-Ended Strike: 5 Things To Know
Members of Service Employees International Union1199 New England began an open-ended strike May 15 at Care New England’s Butler Hospital in Providence, R.I. Five things to know: 1. The strike involves more than 800 staff at the hospital, including registered nurses, mental health workers, clerical, environmental service and dietary staff, according to a May 15 union news release. Care New England employs more than 8,000 workers total. (Gooch, 5/15)
Modern Healthcare:
Montana Hospitals Launch Clinically Integrated Network
Two dozen critical access hospitals in Montana have created a clinically integrated network, following similar rural provider-led coalitions in other states. The Yellowstone High Value Network, announced Thursday, looks to improve independent rural hospitals’ care models while also lowering their costs. (Kacik, 5/15)
KFF Health News:
Pain Clinic CEO Faced 20 Years For Making Patients 'Human Pin Cushions.' He Got 18 Months
Federal prosecutors sought a maximum prison sentence of nearly 20 years for the CEO of Pain MD, a company found to have given hundreds of thousands of questionable injections to patients, many reliant on opioids. It would have been among the longest sentences for a health care executive convicted of fraud in recent years. Instead, he got 18 months. (Kelman, 5/15)
Fierce Healthcare:
Study Suggests Upcoding Practices Are Fairly Common Across Outpatient Care
A new study suggests "upcoding" practices are growing across outpatient service lines. The report, compiled by researchers at Trilliant Health, found that the share of visits that were coded at higher intensities grew in emergency care, urgent care and physician office visits between 2018 and 2023. For example, the number of emergency department visits coded as 99284, or level four of five total, grew from 32.5% to 39.6% in the study window. (Minemyer, 5/15)
In pharmaceutical news —
MedPage Today:
FDA Grants First Approval To First-Line Therapy For Advanced Anal Cancer
The FDA granted a first-ever approval for a first-line therapy for anal cancer to the PD-1 inhibitor retifanlimab (Zynyz), the agency announced Thursday. ... "Patients with inoperable, locally recurrent, or metastatic anal cancer have historically faced poor 5-year survival rates and limited treatment options," said Marwan Fakih, MD, of City of Hope in Duarte, California, in a statement from drugmaker Incyte. "This approval marks an important advancement as it makes a new treatment approach available for this challenging disease." (Bankhead, 5/15)
CIDRAP:
Industry Group Updates Standards For Responsible Antibiotic Manufacturing
The AMR Industry Alliance announced this week that it has updated its Antibiotic Manufacturing Standard to be more aligned with World Health Organization (WHO) antibiotic manufacturing guidelines. The Standard, developed in 2022 in collaboration with the British Standards Institute (BSI), provides guidance to antibiotic manufacturers to help ensure that their products are made responsibly and don't contribute to the development of antimicrobial resistance (AMR) in environmental bacteria. (Dall, 5/15)
MedPage Today:
Alzheimer's Drug Used Mainly By Relatively Affluent, Urban White Men
Uptake of lecanemab (Leqembi), a monoclonal antibody approved to treat early Alzheimer's disease, appeared to be marked by racial, ethnic, and socioeconomic disparities, an analysis of Medicare data suggested. Of all Medicare fee-for-service beneficiaries during the study timeframe, 1,725 beneficiaries used lecanemab, reported John Mafi, MD, MPH, of the David Geffen School of Medicine at the University of California Los Angeles, and co-authors in a JAMA Network Open research letter. (George, 5/15)
Bloomberg:
CVS Bids For Rite Aid Stores, Patient Files In Pacific Northwest
CVS Health Corp. is trying to buy stores and patient data from Rite Aid Corp., the beleaguered pharmacy chain that is going out of business after filing for bankruptcy a second time earlier this month. CVS, which already owns the largest chain of retail pharmacies in the US, put in a bid for a significant number of stores in Washington, Oregon, and Idaho, as well as patient prescription information, Rite Aid Chief Executive Officer Matthew Schroeder told employees Thursday, according to a recording of the meeting reviewed by Bloomberg News. (Swetlitz, 5/15)
