Senate HELP debates cybersecurity, data privacy policy in hearing as Medicaid cuts loom

By Emma Beavins - The Senate Health, Education, Labor and Pensions committee held a hearing on Wednesday to address consumer health data privacy and cybersecurity vulnerabilities for healthcare organizations. The hearing was led by Republican senator Bill Cassidy, a physician from Louisiana. While Cassidy attempted to keep the hearing focused on the issues of data privacy and cybersecurity, Senator Bernie Sanders, I-Vt., kept his remarks and questioning focused on the impacts of Trump’s domestic policy agenda, signed into law last week. Read Full Article…

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1. Healthcare Funding and Access Debate: Senator Bernie Sanders and several expert witnesses expressed serious concern over the reconciliation bill, citing Congressional Budget Office projections that 17 million people could lose health insurance due to the expiration of Affordable Care Act premium subsidies. Studies from Yale and the University of Pennsylvania estimate 51,000 additional deaths annually from reduced healthcare access. Republicans, including Sen. Jon Husted, countered by pointing to a $50 billion rural hospital fund included in the bill and claimed some rural facilities will see a 24% funding increase, though critics argued Medicaid cuts would outweigh these benefits.

2. Focus on Cybersecurity Legislation: Chairman Bill Cassidy and other senators redirected attention toward healthcare cybersecurity, emphasizing the urgency of protecting hospitals from rising cyber threats. Cassidy promoted the Health Care Cybersecurity and Resiliency Act, which would provide federal support for cyberattack victims, boost education, and enhance interagency coordination. Sen. Josh Hawley also introduced the Rural Hospital Cybersecurity Enhancement Act to expand the cybersecurity workforce and ensure rural healthcare systems are better protected.

3. Call for Modernized Privacy Laws: Industry leaders and experts advocated for a comprehensive update to U.S. health data privacy regulations, arguing that HIPAA is outdated in the face of modern technologies like wearables. Rene Quashie from the Consumer Technology Association criticized the current patchwork of state privacy laws, stating it creates confusion for consumers and operational burdens for businesses. Witnesses urged Congress to pass a federal privacy law to streamline compliance, reduce costs, and improve innovation across the healthcare sector.

Aetna, CVS health hit with class-action lawsuit over prepaid debit cards

By Lucy Peterson - Last week, Aetna and its parent company, CVS Health, were hit with a consumer, class-action lawsuit on behalf of health care providers. The defendants, West Loop Chiropractic & Sports Injury Center, performs services for Aetna-insured patients, and Aetna compensates them using a prepaid card. Read Full Article… ^{_{(Subscription required)}}

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1. Alleged Use of Prepaid Debit Cards: The lawsuit claims that Aetna required health care providers to accept payments through prepaid debit cards, which come with merchant processing fees ranging from 3.5% to 4.5%. It also alleges that Aetna rejected provider requests for alternative forms of payment, potentially limiting providers' ability to avoid these additional costs.

2. Shift of Costs to Providers: According to the complaint, Aetna’s insistence on using prepaid debit cards unfairly shifted its own operational expenses onto health care providers. The lawsuit seeks declaratory and injunctive relief, as well as monetary damages for alleged unfair business practices, unjust enrichment, and the associated legal costs.

3. Broader Legal Scrutiny: This lawsuit is part of a growing list of legal challenges Aetna is facing. It follows another recent antitrust case in which Aetna and other insurers were accused of conspiring to suppress payments to out-of-network providers, allegedly allowing insurers to boost their profits at the expense of medical professionals.

Hospital margins again hold steady at 1% as cost pressures grow

By Alan Goforth - Hospital and health system operating margins remained steady at around 1% for the fifth consecutive month in May, according to the latest health care industry financial benchmarks report from Strata Decision Technology. The South saw the largest increase in the metric at 3.6 percentage points, followed by the Northeast with a 1.3 percentage point gain. The West and Midwest experienced slight declines, with decreases of 0.6 and 0.4 percentage points, respectively. Read Full Article… ^{_{(Subscription required)}}

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1. Hospital Financial Performance Varied by Size: Mid-sized hospitals (300–499 beds) recorded the strongest improvement in operating margin with a 2.6% increase, suggesting relative financial stability in this category. In contrast, the largest hospitals (500+ beds) saw a 2.6 percentage point decline, and the smallest hospitals (0–25 beds) experienced the steepest drop at 3.3 percentage points, highlighting financial pressure at both ends of the size spectrum.

2. Expenses Rose Across the Board, Especially for Drugs and Labor: Hospitals nationwide faced rising costs, with drug expenses leading the surge at 8.7% year over year. Total non-labor expenses grew 5.1%, while labor costs climbed 5%. The South experienced the highest increases in both drug (9.1%) and non-labor (6.2%) expenses, reflecting regional disparities in cost growth.

3. Revenue Continued to Grow Year Over Year Despite Some Monthly Declines: For the 25th straight month, hospitals reported year-over-year revenue growth across gross operating, inpatient, and outpatient categories, with outpatient revenue up 5.9%. However, monthly data showed mixed results, including a 1.3% decline in outpatient revenue. Additionally, patient-adjusted revenue metrics saw modest annual gains but dipped month over month, and bad debt and charity care grew significantly, rising 8.1% year over year.

From Telehealth to Trump Accounts: Breaking Down the One Big Beautiful Bill’s Impact on Employee Benefits

By Seyfarth Shaw LLP - On July 4, 2025, Donald Trump signed the One Big Beautiful Bill (OBBB) into law. Although most have focused on the sweeping tax reform included in the OBBB, a number of key employee benefits provisions are included in the OBBB as well. Most significantly, the OBBB expands access to and eligible expenses payable from Health Savings Accounts (HSAs), solidifies first dollar coverage for telehealth under high-deductible health plans (HDHPs), and permanently increases the annual contribution limit for dependent care flexible spending accounts (FSAs) for the first time since 1986. Read Full Article…

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1. Expanded Access and Permanency for Health and Savings Benefits (Effective 2025–2026): The OBBB permanently reinstates first-dollar telehealth coverage for High Deductible Health Plans (HDHPs) starting in 2025, allowing but not requiring coverage of telehealth services before the deductible is met. In 2026, the law also expands Health Savings Account (HSA) eligibility to individuals enrolled in Bronze and Catastrophic Exchange plans and certain direct primary care arrangements, removing previous barriers and broadening access to tax-advantaged healthcare savings options.

2. Significant Enhancements to Family Support and Education-Related Tax Benefits (Effective 2026): Beginning in 2026, the OBBB increases the Dependent Care FSA contribution limit for the first time in decades and raises the cap and reimbursement percentage on employer-provided child care tax credits. It also permanently allows employers to offer tax-free student loan repayment assistance and expands the use of 529 plans to cover a broader range of K–12 and post-secondary educational expenses, offering greater flexibility and support for working families and students.

3. Introduction of New Child Savings Accounts and Changes to Fringe and Executive Compensation Rules (Effective 2026): The OBBB establishes new tax-advantaged “Trump Accounts” for minors, allowing annual contributions and optional employer funding, with a one-time federal credit for eligible newborns. It also eliminates certain fringe benefits, such as the tax-free bicycle commuter benefit, and tightens rules around executive compensation and ACA premium tax credit eligibility, including full repayment of excess credits and stricter verification requirements, signaling broader structural changes in benefits and compliance expectations.

Anthem sued over alleged Mental Health Parity violations and underpaid claims

By Kristen Smithberg - The Mental Health Parity and Addiction Equity Act is at the center of a lawsuit brought against Anthem Blue Cross Blue Shield and several self-funded benefit plans that alleges they underpaid mental health and substance abuse treatment claims to an out-of-network provider. Read Full Article… ^{_{(Subscription required)}}

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1. Mental Health Parity Law at Issue: The lawsuit invokes the Mental Health Parity and Addiction Equity Act, which mandates that health plans must not offer less favorable coverage for mental health and substance use disorder treatment than for medical or surgical services. This applies to both ERISA and non-ERISA plans, though legal remedies in this area remain unsettled.

2. Provider vs. Insurer Dispute: All Points North, a Colorado-based mental health and substance use treatment provider, has sued Anthem and several self-funded employer health plans, alleging systematic underpayment and unfair reimbursement practices. The dispute includes claims of being denied fair in-network contracts and concerns over direct payments to patients rather than providers.

3. Impacts on Care Access and Provider Stability: The provider argues that Anthem's reimbursement rates are below the cost of care, threatening the financial viability of essential mental health services in underserved areas. The lawsuit claims this underpayment practice limits access to care and has allegedly contributed to negative outcomes, including patient harm.

The evolving role of TPAs in building health plans

By Lorene Barulich and Stefanie Watt - As employers struggle to keep up with rising health care costs and growing benefit complexity, third-party administrators are emerging as partners for building smarter, data-driven health strategies. Through deeper data access, flexible plan design and a focus on member education, TPAs help employers strike a more sustainable balance between cost and care. Read Full Article…

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1. TPAs Enable Cost Control Without Sacrificing Quality: As employer-sponsored healthcare costs continue to climb, TPAs (Third-Party Administrators) offer a more adaptable and cost-effective alternative to traditional insurance carriers. Their ability to customize plans, access real-time claims data, and tailor benefits to the unique needs of each workforce allows for smarter, more strategic cost containment—without resorting to blanket benefit cuts or compromising care quality.

2. Actionable Data and Member Education Drive Better Outcomes: TPAs provide deep insights into claims and utilization patterns, enabling targeted strategies to address chronic conditions, reduce unnecessary ER visits, and manage high-cost cases. At the same time, they enhance health literacy through member education, care navigation, and communication efforts—helping individuals make more informed choices, improve medication adherence, and engage more actively in their care to avoid preventable complications.

3. Strategic Collaboration Over Traditional Administration: Moving beyond their traditional administrative roles, TPAs now serve as strategic partners in designing sustainable benefits programs. By working collaboratively with brokers, employers, providers, and vendors, they align plan design with real-world population health goals. This holistic approach not only improves healthcare outcomes but also delivers long-term value by integrating cost management with meaningful, accessible employee benefits.

How Common Meds Secretly Wreck Your Patients’ Microbiome?

By Eli Paes - Effective ways to combat harmful viruses, bacteria, fungi, and parasitic worms have driven major advances in medicine and contributed to a significant increase in human life expectancy over the past century. However, as knowledge about the role of these microorganisms in promoting and maintaining health deepens, there is a need for a new look at the impact of these treatments. Read Full Article…

HVBA Article Summary

1. Many Common Medications Disrupt Gut Microbiota: A wide range of drug classes — including antibiotics, NSAIDs, proton pump inhibitors, antidepressants, chemotherapeutics, and more — have been shown to directly or indirectly alter the gut microbiome. A 2020 study found that 19 out of 41 drug classes significantly impacted microbiome composition and function, often leading to dysbiosis and associated health issues.

2. Dysbiosis Can Affect Health and Treatment Outcomes: Disruption of the gut microbiota can reduce microbial diversity, weaken the intestinal barrier, and impair immune function. This can contribute to infections, inflammation, and reduced treatment efficacy, particularly in contexts like chemotherapy, immunosuppression, and antipsychotic use. While some medications like metformin and GLP-1 agonists may have beneficial effects on the microbiota, others can promote pathogenic overgrowth or metabolic complications.

3. Clinical Management Is Still Evolving: There are currently no standardized protocols to protect or restore the microbiota during pharmacological treatments. Although probiotics, prebiotics, and lifestyle changes may support gut health, their use remains case-dependent. Experts caution against overreliance on microbiome tests and unproven treatments, emphasizing the need for more clinical research and a balanced, evidence-based approach across medical disciplines.