3 Things to Know About the Cybergang That Attacked Ascension

By Katie Adams - Since first appearing two years ago, the ransomware group Black Basta has rapidly gained prominence as one of the biggest threats to healthcare organizations’ cybersecurity. Read Full Article…

HVBA Article Summary

1. Origins and Impact: Black Basta, believed to be an offshoot of the Russian group Conti, gained notoriety for a massive cyberattack on Ascension and has affected over 500 organizations globally, according to CISA.

2. Operational Tactics: Victims typically face a short window of 10-12 days to pay ransom before their data is exposed. The group uses phishing and software vulnerabilities for initial access, employing a double-extortion strategy of data encryption and exfiltration.

3. Financial Impact and Security Concerns: In its first 18 months, Black Basta extorted over $100 million in Bitcoin, averaging $1.2 million per ransom payment. Such attacks force healthcare providers and others to resort to insecure workarounds, risking patient data breaches and safety, especially when secure systems are compromised.

Federal appeals court protects Cigna from California state-law suit

By Allison Bell - A federal appeals court in California has shielded a health insurer against a state-law breach-of-contract claims and other state-law claims. A three judge panel at the 9th U.S. Circuit Court of Appeals recently found that the state-law claims had a "connection with" a benefit plan governed by the Employee Retirement Income Security Act. Read Full Article…

HVBA Article Summary

1. ERISA and Federal Preemption: Congress enacted ERISA to streamline administration of multistate benefit plans by enforcing uniform federal rules, preempting potentially conflicting state regulations. This framework aims to ensure consistency and efficiency in managing employee benefit plans across the country.

2. 9th Circuit Case Overview: In Bristol SL Holdings v. Cigna Health et al., plaintiffs argued that their state-law claims against Cigna, related to contractual disputes rather than ERISA-specific matters, should proceed independently. However, the 9th Circuit panel disagreed, emphasizing that claims interfering with plan administration or ERISA-regulated relationships fall under federal jurisdiction.

3. Preemption Decision: Circuit Judge Daniel Bress highlighted that Bristol's claims, which involved disputes over reimbursement for out-of-network medical services and allegations of fee forgiveness, directly implicated ERISA plans administered by Cigna. The court concluded that these state-law contract claims were preempted by ERISA due to their significant connection with and potential impact on the administration of federally regulated benefit plans.

Healthcare spend is big, and getting bigger. Can VBC make an impact?

By Marie Defreitas - Healthcare spending is soaring and is expected to climb even higher over the next eight years. But the impact will be felt in places other than the consumer’s wallet. Read Full Article…

HVBA Article Summary

1. Rapid Increase in Healthcare Spending: Healthcare expenditures are projected to surge by over 50% by 2032, reaching $7.705 trillion, driven significantly by rising costs in physician services, hospital spending, prescription drugs, and insurance costs.

2. Challenges with Value-Based Care: Despite optimism, value-based care models have not effectively curbed healthcare spending as anticipated. The industry faces challenges in implementing these models to achieve substantial cost reductions, highlighting ongoing tensions between payers and providers over pricing.

3. Sustainability Concerns: The expanding healthcare economy, surpassing GDP growth and inflation rates, raises sustainability concerns. Experts like Paul Keckley question whether current fiscal and policy measures can sustain these escalating costs without broader economic implications or increased taxpayer contributions.

Inside The FDA’s ‘Home As A Health Care Hub’ Initiative

By Joyce Famakinwna - In April, the U.S Food and Drug Administration (FDA) announced the launch of a new initiative, Home as a Health Care Hub. The agency views the home as a key care setting that has the potential to drive health care equity forward. Read Full Article…

HVBA Article Summary

1. Seizing the Moment for Experimentation: The FDA's new initiative focuses on home-based care as a response to lessons learned during the COVID-19 pandemic. By creating an "idea lab," the initiative aims to integrate diverse stakeholders like device developers, policymakers, and providers to explore and innovate solutions for delivering effective healthcare at home.

2. Development and Purpose of the Initiative: Initiated partly due to the COVID-19 crisis highlighting healthcare disparities, the FDA's focus on advancing health equity drives the "Home as a Health Care Hub" initiative. It involves designing virtual reality prototypes of homes to envision how medical devices can better serve diverse community needs, starting with under-resourced areas.

3. Collaborative Approach and Goals: By engaging a wide range of stakeholders including healthcare providers, community health workers, and technology developers, the FDA seeks to foster inclusive dialogue and innovation. The initiative aims to democratize healthcare access, improve health outcomes, and inspire adaptable solutions that prioritize patient-centric care and equity.

Novant Health gives up $320M hospital deal after FTC secures appeals court injunction

By Dave Muoio - Novant Health is throwing in the towel on its $320 million plan to purchase two Community Health Systems hospitals after the Federal Trade Commission (FTC) scored an injunction on the deal from an appellate court. Read Full Article…

HVBA Article Summary

1. Court Intervention: The U.S. Court of Appeals for the Fourth Circuit granted an injunction pending appeal, halting Novant Health's acquisition of Lake Norman Regional Medical Center and Davis Regional Medical Center. This decision suspends the deal until the conclusion of a potentially lengthy appeal process, which could exceed two years.

2. Novant Health's Response: Novant Health expressed frustration over the FTC's opposition, emphasizing its efforts to enhance healthcare services in the affected communities. Despite announcing the transaction in early 2023 and pursuing it for over a year, Novant Health cites regulatory roadblocks as preventing the transaction's completion, impacting patient care and community support initiatives.

3. Legal and Economic Impact: Legal arguments debated whether the acquisitions would reduce competition or sustain struggling healthcare facilities in the face of upcoming competitive pressures from Atrium Health. While a district judge initially favored allowing the acquisition to proceed, the appellate court's decision reflects ongoing concerns over competitive dynamics and the financial viability of Davis Regional Medical Center in particular.

Drug patent bill could cut the federal deficit by $3B, analysts predict

By Allison Bell - A popular, bipartisan drug patent bill could narrow federal budget deficits by a total of about $3 billion over 10 years, according to the Congressional Budget Office. Read Full Article…

HVBA Article Summary

1. Financial Impact and Scope: The revised Affordable Prescriptions for Patients Act is projected to reduce federal spending by $2.4 billion from 2024 to 2034 and increase federal revenue by $585 million over the same period. These savings reflect efforts to curb patent manipulation tactics used by drug manufacturers.

2. Legislative Background and Support: Introduced by Sen. John Cornyn and supported by four Republican co-sponsors, the bill aims to prevent drug companies from extending patent exclusivity through legal maneuvers. This bipartisan effort underscores ongoing attempts to address rising healthcare costs through legislative means.

3. Regulatory and Judicial Context: The bill empowers the Federal Trade Commission (FTC) to combat practices like "ever greening" where companies prolong patent protections by introducing minor changes. Approved by the Senate Judiciary Committee in February 2023, the legislation highlights ongoing concerns and regulatory responses regarding pharmaceutical patent practices.

U.S. House Members Press CMMI’s Fowler on Lack of Cost Savings

By David Raths - At a June 13 congressional hearing, Elizabeth Fowler, Ph.D., J.D., director of the Center for Medicare and Medicaid Innovation (CMMI), was pressed to explain why so few of CMMI’s alternative payment models have produced cost savings. Read Full Article…

HVBA Article Summary

1. CMMI's Budget and Oversight Concerns: Cathy McMorris Rodgers highlighted the concerns about CMMI's substantial budget and broad authorities with limited congressional oversight. Despite its mission to lower healthcare costs and improve outcomes, CMMI's actual impact has diverged significantly from initial projections, with increased spending rather than savings.

2. Challenges in Generating Savings: Dr. Fowler acknowledged the challenges CMMI faces in generating savings, citing voluntary participation in models that leads to risk selection among providers. Despite setbacks, CMMI emphasizes learning from each model and focuses on quality improvement and patient outcomes as integral to its mission.

3. Future Directions and Accountability: Rogers pressed on the shift in CMMI's focus away from cost reduction, questioning the prioritization of spending reductions amidst continued budget allocations. Fowler committed to rigorous evaluation of models and adjustments based on performance, indicating readiness to shut down underperforming models to correct fiscal trajectories.

Why Walgreens’ US Health President Is ‘Bullish’ on the Role of Retail in Healthcare

By Marissa Plescia - Retailers are facing several headwinds in healthcare in 2024. Walmart and Dollar General both recently ended healthcare endeavors, and CVS Health is reportedly looking for a private equity partner for Oak Street Health (which it acquired in 2023). VillageMD, which is backed by Walgreens, is shuttering numerous clinics. Read Full Article…

HVBA Article Summary

1. Consumer Demand and Convenience: Langowski emphasizes that over 80% of people desire health and wellness services in retail settings like pharmacies. Consumers prioritize ease and convenience, driving the need for retail to play a central role in healthcare delivery.

2. Strategic Partnerships: She advocates for retailers like Walgreens to collaborate extensively with multiple healthcare providers and payers across the U.S. Their widespread presence in communities and digital capabilities position them as valuable partners, offering less capital-intensive yet highly scalable healthcare models.

3. Early Intervention and Collaboration: Highlighting the frequent use of pharmacists compared to doctors, Langowski stresses the opportunity for earlier healthcare interventions through retail settings. She encourages deeper collaboration with health plans to leverage these touchpoints effectively, aiming for improved patient outcomes and a seamless healthcare experience.

PSNC 2024: Lisa Gomez Talks Cybersecurity, AI, Retirement Security Rule

By Remy Samuels - Assistant Secretary of Labor Lisa Gomez, the head of the Employee Benefit Security Administration, discussed a number of issues that are top-of-mind for plan sponsors—including concerns about cybersecurity, missing participants and the Retirement Security Rule—at the PLANSPONSOR National Conference in Chicago on Wednesday. Read Full Article…

HVBA Article Summary

1. Retirement Plan Goals and Participant Benefits

   • Plan sponsors should reassess their retirement plans to ensure they serve all participants effectively, not just higher earners.

   • Reflecting on plan objectives and participant demographics is crucial for aligning plan offerings with intended benefits.

2. Cybersecurity Measures in Retirement Planning

   • The Department of Labor emphasizes best practices in cybersecurity, including annual risk assessments and data encryption, to protect retirement plan information from increasing cyber threats.

3. Focus on AI and Lost Participant Database

   • There is growing interest in leveraging AI responsibly within retirement planning, though caution is urged due to potential risks like AI-driven deepfakes.

   • SECURE 2.0 mandates the creation of a national "lost and found" database by December 2024 to reconnect participants with lost retirement benefits, addressing challenges in data

     collection and sharing among government agencies.

Drug Enforcement Administration sends second attempt at a telehealth prescribing rule to executive budget office

By Emma Beavins - The Drug Enforcement Administration’s long-awaited second attempt at a telemedicine prescribing rule has been handed off to the Office of Management and Budget (OMB) for review. Read Full Article…

HVBA Article Summary

1. Current Regulatory Challenges: Telehealth companies face significant regulatory hurdles regarding the prescription of controlled substances like Adderall, testosterone, and buprenorphine. The absence of specific rules for buprenorphine prescribing adds complexity, contrasting with earlier attempts by the DEA to establish telehealth prescribing guidelines.

2. Impending Deadline for Regulatory Change: Pandemic-era flexibilities in telehealth prescribing will cease by December 2024. With the clock ticking, the administration must promptly release new rules to allow sufficient time for public comment, agency review, and final rule promulgation before the year's end.

3. Implementation Challenges: Organizations anticipate needing substantial time to comply with the final telehealth prescribing rule once it's established. This includes adjustments to operational practices and adherence to new regulatory requirements, reflecting the industry's readiness concerns.