While health AI legislation remains distant, Senate wants to appropriate funds, spur action in committees and agencies

By Emma Beavins - Passing comprehensive artificial intelligence legislation for healthcare is likely still a far-off dream for lawmakers, multiple sources told Fierce Healthcare. But documents that have emerged from the top offices of the Senate and comments from staffers working on the ground show Congress will play a role in AI regulation. Read Full Article…

HVBA Article Summary

1. Current Legislative Landscape: Senators have introduced multiple AI-related bills, highlighting healthcare as a significant area for regulation. However, the likelihood of immediate congressional action is low due to uncertainties surrounding specific proposals and the impending election season.

2. Lack of Mature Proposals: Capitol Hill sources suggest that there's a dearth of sufficiently developed AI legislation for lawmakers to engage with, unlike the robust discussions surrounding data privacy. Despite the presence of numerous bills addressing common AI concerns, there's a consensus that more comprehensive proposals are needed before significant legislative progress can be made.

3. Bipartisan Efforts and Future Directions: Although comprehensive AI bills are yet to surface, bipartisan efforts are evident in the Senate's AI roadmap, emphasizing the need for federal investments in AI research and development. While immediate passage of major bills may be unlikely, there's potential for the enactment of certain targeted measures, such as the Future of AI Innovation Act and the Algorithmic Accountability Act, which enjoy bipartisan support and address critical issues in AI regulation.

Novo Nordisk mounts legal campaign against companies marketing compounded semaglutide

By Nicole DeFeudis - Novo Nordisk is ramping up its legal campaign against medical spas, pharmacies and clinics marketing compounded versions of its popular weight loss and diabetes drugs. Read Full Article…

HVBA Article Summary

1. Deceptive Marketing Allegations: Novo Nordisk, a Danish pharmaceutical company, has initiated legal action against several entities in multiple states for allegedly deceptively marketing compounded semaglutide, the primary ingredient in Novo’s Wegovy and Ozempic drugs. Among the allegations is a case where compounded semaglutide sold by Midtown Express in Tennessee was found to contain no semaglutide at all, according to court documents.

2. Continued Legal Pursuit: Doug Langa, Novo’s executive VP of North America operations, emphasized the company's commitment to pursuing legal action against entities providing potentially unsafe and ineffective compounded semaglutide products. Langa highlighted the importance of maintaining public trust in the safety of FDA-approved medicines amidst concerns over deceptive marketing practices.

3. Expansion of Legal Actions: Novo has filed complaints against various entities including Aesthetic Maison and MediOAK Pharmacy in Texas; BOF Medical Center, MD Exam, and DoctorsRx in Florida; G2 Telemedicine in Montana; GenericOzempic.com in Illinois; Midtown Express in Tennessee; and Weight Loss MD in Colorado. These actions mark the continuation of Novo’s legal campaign, totaling 21 actions against companies marketing compounded semaglutide.

Most hospitals not in compliance with federal price transparency rules

By Scott Wooldridge - The federal Hospital Price Transparency Rule, which went into effect at the beginning of 2021, has limped out of the gate, a new report has found. After three years, only 34.5% of 2,000 U.S. hospitals reviewed were in compliance, a report from Patient Rights Advocate.org (PRA) has found. Read Full Article…

HVBA Article Summary

1. Lack of Compliance: Only 34.5% of hospitals were fully compliant with federal transparency rules, with 65.5% not in full compliance, and 4% in total noncompliance, indicating a significant gap in adhering to regulations aimed at price transparency in healthcare.

2. Limited Enforcement: The study suggests minimal enforcement by the Centers for Medicare & Medicaid Services (CMS), with only 0.8% of noncompliant hospitals receiving civil monetary penalty notices. This leniency hampers efforts to empower consumers with information necessary for informed decision-making and protection against overcharges and fraud.

3. Call for Legislative Action: With overwhelming public support (94%) for healthcare price transparency, there's a bipartisan push in the Senate for legislation like the Braun-Sanders Senate Health Care PRICE Transparency Act 2.0 (S. 3548). This bill seeks to enhance disclosure requirements and increase penalties for noncompliance, highlighting the need for legislative intervention to ensure fair and transparent healthcare pricing practices.

Time for Employers to Take the Reins on Employee Healthcare

By David Nash - Healthcare is big business in the U.S., where employers and other purchasers spend billions of dollars on it every year. Unfortunately, the national health quality/safety statistics tell us that nearly one-third of that healthcare spending is "wasted" on unnecessary or duplicative procedures, inflated administrative costs, medical mishaps, and outright fraud. Read Full Article…

HVBA Article Summary

1. Growing Employer Involvement in Healthcare Delivery: With a systemic lack of transparency and accountability in the healthcare industry, employers are increasingly taking an active role in providing high-value care to their employees. This trend has seen the emergence of regional healthcare purchaser coalitions, such as those under the National Alliance of Healthcare Purchasers Coalitions, representing over 45 million American lives with an annual spending of $400 billion on healthcare.

2. Success Story of Rosen Hotels and Resorts: Harris Rosen's transformative approach to healthcare benefits at Rosen Hotels and Resorts serves as a beacon of success in employer-sponsored healthcare. By implementing innovative strategies such as unlimited primary care visits, no copays on 90% of prescriptions, and negotiated reference-based pricing for major procedures, Rosen achieved significant cost savings (55% less than the average) while fostering a healthier, more satisfied workforce with low turnover rates.

3. Community Investment and Social Impact: Beyond internal benefits, Rosen's initiative extends to community investment, exemplified by the $11 million investment in Tangelo Park over 24 years. This investment not only improved healthcare access but also contributed to societal outcomes such as increased high school graduation rates and reduced crime rates. The success of such initiatives underscores the potential for employers to drive positive change beyond their own workforce, inspiring a broader movement towards value-based purchasing in healthcare.

New York Presbyterian's Anti-Competitive Maneuver Cost the 32BJ Health Fund $25 Million

By Chris Deacon - The recent conflict between 32BJ Health Fund and New York Presbyterian exemplifies the critical need for legislative intervention against anti-competitive contracting terms in health care. Read Full Article…

HVBA Article Summary

1. Context of Escalating Healthcare Costs: The narrative unfolds against a backdrop of soaring healthcare expenses, largely propelled by provider consolidation and market dominance. This context underscores the critical need for robust measures to address these practices, compelling state and federal policymakers towards action.

2. Importance of Prohibiting Anti-Competitive Contracting Terms: The article emphasizes that prohibiting anti-competitive contracting terms is a crucial initial step in rebalancing power dynamics within healthcare negotiations. These terms, including all-or-nothing contracting and gag clauses, enable dominant providers to manipulate market conditions, disadvantaging payers like unions and employers.

3. Urgent Call for Legislative Reform: The dispute between 32BJ Health Fund and New York Presbyterian underscores the pressing necessity for comprehensive legislative reform against anti-competitive healthcare practices. Despite proactive steps such as pushing for the Hospital Equity and Affordability Law (HEAL Act), lobbying efforts from hospital systems led to the removal of key provisions, leaving entities like 32BJ without adequate tools to combat monopolistic behaviors. The article urges policymakers to move beyond mere expressions of concern and enact decisive measures to enforce laws that curb these practices, safeguarding unions, employers, and consumers from exploitation by dominant healthcare providers.

Mental Health Inequities Could Cost $1.3 Trillion in 2040. How Can the Industry Prevent This?

By Marissa Plescia - The U.S. is spending about $477.5 billion annually in unnecessary expenses related to mental health inequities, according to a recent report from Deloitte and the Meharry School of Global Health. If left unaddressed, this could increase to $1.3 trillion in 2040. The cumulative cost from 2024 to 2040 would equal $14 trillion. Read Full Article…

HVBA Article Summary

1. Integration of Mental Health and Primary Care: To address mental health challenges effectively, there needs to be a seamless integration of mental health services into primary care. This approach not only improves access to mental health care but also facilitates the management of chronic physical conditions often exacerbated by untreated mental health issues.

2. Incentivizing Mental Health Screenings: Encouraging regular mental health screenings is essential to identify and address issues early on. By incentivizing these screenings, healthcare providers can detect mental health concerns before they escalate, ultimately reducing the burden on emergency departments and improving overall health outcomes.

3. Policy Reforms and Stakeholder Collaboration: Policymakers must prioritize mental health parity provisions to ensure equitable coverage for mental health treatments. Additionally, collaboration among academia, healthcare providers, employers, elected officials, and government agencies is crucial to address access barriers, shortage of mental health providers, and systemic inequalities in healthcare delivery. By working together, stakeholders can implement comprehensive strategies to improve mental healthcare access and outcomes in the United States.

As weight loss booms, drugmakers look for an edge with oral options

By Amy Baxter - The GLP-1 market is on fire. And as Eli Lilly and Novo Nordisk struggle to meet soaring demand, the window is open for new versions of the popular drugs. To compete with the weekly injectables, some biotechs are turning to pills for a new angle. Read Full Article…

HVBA Article Summary

1. Rybelsus Success and Market Landscape: Despite facing competition from injectable GLP-1 drugs like Ozempic and Wegovy, Novo Nordisk's Rybelsus has secured a significant share of the market, accounting for 14% of the GLP-1 market share by the end of 2023 and generating around $2.7 billion in sales in the previous year. The growing demand for GLP-1 agonists is evident, with as many as 1 in 8 American adults having taken a GLP-1 agonist according to a recent KKF poll. Analysts predict the GLP-1 market will exceed $100 billion by 2030, indicating substantial growth potential.

2. Challenges and Opportunities in Oral GLP-1 Development: Several pharmaceutical companies are actively developing oral GLP-1 drugs, aiming to capitalize on the market demand and address patient preferences for oral medication over injectables. While oral GLP-1s offer convenience and potentially lower manufacturing costs compared to injectables, they must demonstrate comparable efficacy to existing injectable options like semaglutide to gain market acceptance.

3. Noteworthy Oral GLP-1 Candidates: Several oral GLP-1 candidates are progressing through clinical trials, including Lilly’s orforglipron in Phase 3, Roche’s CT-996 in Phase 1, Viking Therapeutics’ VK2735 in Phase 2 (planned for 2024), Pfizer’s danuglipron in Phase 2, and AstraZeneca’s ECC5004 in Phase 2. These candidates represent significant investments and potential advancements in the treatment landscape for Type 2 diabetes and obesity.

Despite Some Improvements, 24 States Get D Grade in Maternal Mental Health

By David Raths - A nonprofit think tank called the Policy Center for Maternal Mental Health has collaborated with the George Washington University to create a report card that scores each state's efforts to address maternal mental health. Read Full Article…

HVBA Article Summary

1. State Grades Show Incremental Improvement: In 2024, the U.S. national grade for maternal mental health improved slightly from a D to a D+, with thirty-four states witnessing an increase in their grades. Notably, the number of states earning failing grades decreased from fifteen in 2023 to five, while the count of states achieving Bs rose from one to three.

2. Persistent Disparities in Maternal Mental Health: Maternal mental health disorders, affecting approximately 600,000 U.S. mothers annually, remain a significant concern. Vulnerabilities to disparities in rates and access to care are particularly pronounced among Black, American Indian/Alaskan Native, and other women of color. Alarmingly, up to 50% of mothers go undiagnosed by healthcare professionals, and a staggering 75% never receive the necessary treatment.

3. Call for Continued Action and Monitoring: While there have been incremental improvements in state efforts and data availability regarding maternal mental health, the overall grades remain dismally low. With 24 states receiving a D grade and five receiving failing grades, there is a recognition of both progress and the substantial distance yet to be covered. The 2024 Maternal Mental Health State Report Cards, comprising 18 measures across three key domains, serve as crucial tools for identifying areas of opportunity and tracking annual progress in addressing maternal mental health disparities.

More than a third of healthcare organizations aren’t prepared for cyberattacks: report

By Sydney Halleman - Cyberattacks and data breaches in healthcare are on the rise. Over 30% of healthcare organizations experienced a cyberattack in the last three years, according to the survey. Over the past five years, there has been a 256% increase in large breaches reported to the HHS Office for Civil Rights involving hacking. Read Full Article…

HVBA Article Summary

1. Impact on Patient Care: More than 25% of ransomware attacks in the healthcare sector directly affect patient care, highlighting the critical vulnerability of healthcare systems to cyber threats.

2. Data Recovery Challenges: Around 34% of healthcare organizations fail to recover patient data post-ransomware attack, underscoring the long-term consequences and complexities associated with data breaches in the healthcare industry.

3. Lack of Preparedness: Despite the significant risks posed by cyberattacks, only 63% of healthcare companies have a cybersecurity response plan in place, indicating a concerning gap in preparedness within the industry.

Weight Loss Maintained With Slow Taper of Semaglutide

By Becky McCall - Personalized doses and slow tapering of semaglutide (Wegovy or Ozempic, Novo Nordisk) in patients who also follow a digital weight loss program can lead to maintenance of target weight up to 6 months later, show retrospective, real-world data. Read Full Article…

HVBA Article Summary

1. Efficacy of Lower Semaglutide Doses: Research suggests that lower doses of semaglutide are equally effective as higher doses for weight loss. Participants in the study achieved a median weight loss of 14.8% of body weight using only around a third of the suggested cumulative dose of semaglutide.

2. Preventing Weight Regain with Lifestyle Changes: The study implemented a digital weight loss program that focused on gradually reducing medication while emphasizing lifestyle modifications. This approach appeared successful in preventing weight regain, with participants maintaining stable body weight for up to 26 weeks after tapering off semaglutide.

3. Cost-Effectiveness and Fewer Side Effects: Lower doses of semaglutide not only result in comparable weight loss but also offer advantages such as reduced side effects and lower treatment costs. This approach makes weight loss interventions more accessible and sustainable for patients, while also optimizing the utilization of limited drug supplies.