Morning Briefing
Summaries of health policy coverage from major news organizations
States Crack Down On Facility Fees As Part Of Hospital Pricing Push
More states are cracking down on hospital prices, despite a lag in federal policy reform. Last year, Indiana, Colorado, Connecticut and Maine passed laws restricting facility fees, which are additional charges hospitals bill to patients who receive care at hospital-owned clinics and outpatient facilities. About a dozen states, including those four, have or are considering passing such laws, which range from prohibiting facility fees for certain services to disclosure requirements. (Kacik, 3/25)
Labor shortages, tighter access to capital and low reimbursements from some payers could force more healthcare providers to shed non-core operations, such as personal care and post-acute care, according to analysts. The trend to refocus on core businesses is occurring across the healthcare industry, from hospitals to home health companies. (Eastabrook, 3/25)
Tim Ebel’s visit with an ear, nose and throat specialist at an Ohio clinic last October came to $348. At the same time, he got a second bill for $645. The hospital system that owns the Avon, Ohio, clinic had charged him separately for use of the office where he met his physician. It is what is known as a facility fee, which included overhead for the system’s hospitals though Ebel hadn’t set foot in one. (Evans, 3/25)
Nonprofit health system Ascension is terminating more than 110 doctors and other providers at all 10 of its Chicago-area hospitals, turning them over to a private equity-backed staffing firm while they continue to work in Ascension facilities. The move is intended to cut costs for St. Louis-based Ascension, but in the process it is leaving affected employees concerned about working conditions and patient safety, complaints that echo those at Ascension facilities nationwide. (Davis, 3/25)
Also —
AbbVie (ABBV.N) will buy drug developer Landos Biopharma (LABP.O) for up to $212 million as the Humira-maker aims to expand its pipeline of medicines to treat immune system-related illnesses, the companies said on Monday. Landos is currently conducting a mid-stage study of its lead experimental drug NX-13 in a type of an inflammatory bowel disease called ulcerative colitis. AbbVie's blockbuster drug Rinvoq is approved to treat the disease. (3/25)
BioNTech (22UAy.DE) said on Monday the U.S. National Institutes of Health has sent a notice to the German company regarding default on the payment of royalties and other amounts related to its COVID-19 vaccine. BioNTech, which partnered with U.S. pharma giant Pfizer (PFE.N) for its COVID-19 vaccine, however, said it disagreed with the positions being taken by the NIH and intends to defend against all allegations of breach. (3/25)
The vast majority of nonprofit hospitals aren't providing a level of community support equal to the value of what they are receiving in tax breaks, according to a study published Tuesday. The study by the nonpartisan think tank Lown Institute reignites a contentious debate on whether nonprofit hospitals should qualify for tax breaks — and whether those hospitals hold up their end of the bargain. (Hudson, 3/26)
Humana has filed a motion to dismiss a class action lawsuit filed by two Medicare members who alleged the company used artificial intelligence to process post acute care claims determinations and were wrongfully denied coverage. The insurer said in the motion it did not make the determinations through the use of AI. It also contends the enrollees did not complete all the required steps in the appeal process through the Medicare Advantage plan, a four-step process that ends with a potential review by the Medicare Appeals Council. (DeSilva, 3/25)
Novo Nordisk is buying Cardior Pharmaceuticals for up to 1.03 billion euros ($1.11 billion) as the Wegovy maker moves to strengthen its pipeline of drugs to treat cardiovascular disease and expand into areas outside of its core diabetes and weight-loss market. (Chopping, 3/25)
Wipro GE Healthcare, a joint venture of India's Wipro Enterprises and a wholly owned entity of U.S.-based GE Healthcare (GEHC.O) said it would invest 80 billion rupees ($960 million) in the country in its manufacturing and research and development facilities. Bengaluru-based medical technology company Wipro GE Healthcare said on Tuesday the investment would be done over the next five years to boost local manufacturing as it focuses on growing its footprint in the country in line with the government's "Make in India" initiative. (3/26)
Using a swab inside the cheek and a sophisticated computer algorithm, a DNA test recently approved by federal regulators promises to assess genetic risk of opioid addiction. The test’s maker says results give doctors and patients a crucial tool when considering use of the very pain pills that ignited the nation’s opioid crisis. But as the company, SOLVD Health, prepares to roll out AvertD in coming months, skeptics remain unconvinced. (Ovalle, 3/25)