Wall Street Yawned as Congress Grilled UnitedHealth’s CEO but Went Ballistic on CVS/Aetna Over Medicare Advantage Claims

By Wendell Potter - After UnitedHealth Group CEO Andrew Witty’s appearances at two congressional committee hearings last week, I had planned to write a story about what the lawmakers had to say. One idea I considered was to publish a compilation of some of the best zingers, and there were plenty, from Democrats and Republicans alike. Read Full Article…

VBA Article Summary

1. Decades of Experience: The author reflects on their extensive experience around Capitol Hill, detailing how crafted talking points by staffers often influence media coverage. With a career spanning almost half a century, including roles as a Washington correspondent and a writer for political and corporate talking points, the author offers a seasoned perspective on the strategic communications used in politics and business.

2. Ineffectual Congressional Actions: Despite vigorous questioning of UnitedHealth's CEO, Sir Witty, by Congress, the author is skeptical about any significant regulatory changes affecting major insurers. The narrative suggests that while some transparency and fee-related reforms might be proposed, substantial changes to the business practices of large insurance companies like UnitedHealth are unlikely due to their substantial lobbying efforts.

3. Impact of Money in Politics: Highlighting the pervasive influence of money, the author critiques the political system's inability to provide relief from rising healthcare costs, citing corporate and investor pressures on healthcare providers. This critique is exemplified by a satirical cartoon in "Pearls Before Swine" where a "magic translation box" humorously translates political rhetoric into blunt truths about the influence of wealthy donors, encapsulating the disillusionment with political promises.

Greg Lindberg back on trial for alleged bribery of insurance commissioner

By John Hilton - Troubled financier Greg Lindberg faces a second trial on high-profile bribery allegations starting Tuesday. Lindberg was convicted in 2020 on bribery and fraud charges, along with consultant John Gray. Read Full Article…

VBA Article Summary

1. Judicial Reversal: The Fourth Circuit Court of Appeals overturned the conviction of Greg Lindberg and his associates due to a crucial error in jury instruction. The court ruled that the trial judge's assertion that a staffing change constituted an "official act" improperly influenced the jury's understanding of the fraud conspiracy charge.

2. Legal Fallout and Retrial: Following the reversal, Lindberg faces a retrial on both fraud and bribery charges. The appellate court found that the error significantly impacted the fraud count and could have influenced the bribery charge. Despite objections from federal prosecutors, District Judge Max Cogburn denied a motion to separate Lindberg's retrial from his co-defendant's, highlighting the ongoing legal complexities.

3. Continued Legal Battles: Lindberg, the founder of Eli Global, is embroiled in additional legal challenges, including allegations of siphoning funds from his insurance companies for personal gain. Indicted on federal fraud charges, Lindberg faces a litany of accusations, from conspiracy to defraud the United States to money laundering and wire fraud. However, his trial on these new charges is delayed until after the retrial on bribery charges.

Medicare hospital trust fund extended by 5 years to 2036

By Noah Tong - The Hospital Insurance Trust Fund will be fully solvent for longer than previously projected, according to an annual Medicare Trustee report. Read Full Article…

VBA Article Summary

1. Extended Solvency: The latest report on Medicare's financial status reveals a positive trend, with projected benefits payable until 2036, seven years later than previously anticipated. This extension is attributed to improved economic performance and policy changes, including the Inflation Reduction Act, reflecting the Biden administration's healthcare policies.

2. Challenges and Reforms: Despite the extended solvency, significant challenges persist, notably in physician payments not keeping pace with requirements. Lawmakers and experts emphasize the urgency of addressing this issue to ensure continued access to care for Medicare beneficiaries. Suggestions include increasing physician payments linked to the Medicare Economic Index.

3. Future Sustainability: While the report highlights improvements, it underscores the need for further action to ensure long-term stability. Recommendations include potential payroll tax increases or expense reductions. Additionally, rising costs associated with certain drugs and increased enrollment pose future financial challenges, necessitating ongoing vigilance and potential reforms.

Change Healthcare lacked safeguards even as it gave security advice

By Gopal Ratnam - In the months surrounding UnitedHealth Group Inc.’s $13 billion purchase of software company Change Healthcare Inc. in 2022, experts at Change published articles and policy papers extolling the need for cybersecurity measures in the health care industry. Read Full Article…

VBA Article Summary

1. Lax Cybersecurity Standards Exposed: Despite advocating for robust cybersecurity practices, Change Healthcare neglected basic security measures such as multi-factor authentication, leaving its systems vulnerable to cyberattacks.

2. Consequences of Oversight: The absence of multi-factor authentication facilitated a breach by the BlackCat/ALPHV group, resulting in the exfiltration of sensitive data and the deployment of ransomware, which severely disrupted Change Healthcare's operations, including payment processing for healthcare providers.

3. Failures in Response and Accountability: Despite the severity of the breach, Change Healthcare's response was criticized by lawmakers for failing to meet standard cybersecurity protocols. The delayed identification of affected individuals and notification process raises concerns about the company's compliance with data protection laws and its ability to safeguard patients' sensitive information.

Nearly half of Americans expect slow transition into retirement

By Allianz SE - Americans' view of retirement is shifting as nearly half of Americans think about retirement as a slow transition away from full-time work rather than a distinct day in the future to leave the workforce, according to the 2024 Annual Retirement Study* from Allianz Life Insurance Company of North America (Allianz Life). Read Full Article…

VBA Article Summary

1. Changing Perceptions of Retirement: While 47% of Americans view retirement as a gradual transition from full-time work, only 38% see it as a fixed date to stop working. This shift in mindset indicates a departure from the traditional abrupt retirement model, with 15% of respondents expressing no intention of slowing down or retiring at all.

2. Extended Work Expectations: A significant 68% of Americans believe that working later in life is necessary to accumulate sufficient funds for retirement. Moreover, 61% anticipate the need to continue working during retirement just to meet basic living expenses, highlighting the financial challenges many face in planning for a retirement that could span nearly three decades.

3. Financial Pragmatism and Longevity: A majority (80%) of respondents acknowledge that extending their working years or delaying retirement would enhance their ability to finance their desired lifestyle. Notably, 63% anticipate working at least part-time during retirement to supplement income, with millennials and Gen Xers showing the highest inclination. This pragmatic approach underscores the importance of adapting retirement strategies to address longevity, inflation, and market volatility risks.

Biden Administration rolls out international cybersecurity plan

By Maggie Miller - The Biden administration is rolling out a strategy Monday for how to build global cybersecurity cooperation, following years of stepped up threats from China, Russia and cybercriminals. Read Full Article…

VBA Article Summary

1. Historic Milestone: The State Department’s unveiling of the international cybersecurity strategy marks the first comprehensive U.S. global cyber strategy in over a decade, signaling a pivotal moment in elevating America's global leadership in countering cyber threats and fostering consensus on artificial intelligence (AI).

2. Strategic Focus: The strategy outlines four key areas of focus, including promoting global digital security, upholding rights-respecting digital approaches with allies, forming coalitions against cyberattacks, and enhancing cybersecurity resilience among partner nations. Notably, the establishment of the Cyberspace and Digital Connectivity fund, backed by a $50 million allocation, underscores the commitment to bolstering allied cybersecurity capabilities.

3. Diplomatic Initiatives: Beyond financial commitments, the strategy emphasizes an enhanced role in cyber diplomacy, particularly at the United Nations, aiming to steer "action-oriented conversations" and implement frameworks for responsible behavior in cyberspace. Moreover, amidst the transformative impact of AI, the strategy pledges to collaborate with allies to establish guiding principles and global norms for AI development and application, fostering cooperation beyond geopolitical tensions.

It May Be Safe to Extend Time Between Colonoscopy Screenings, Study Says

By Kate Kneisel - Patients with no family history of colorectal cancer (CRC) whose first colonoscopy was negative may be able to delay their next screening for 15 years rather than the currently recommended 10 years, a Swedish register-based cohort study showed. Read Full Article…

VBA Article Summary

1. Extended Screening Intervals and Reduced Risk: Patients with a negative initial colonoscopy for colorectal cancer (CRC) experienced significantly reduced 10-year standardized incidence and mortality ratios, with a risk reduction of 28% and 45%, respectively, compared to controls. Extending the screening interval from 10 to 15 years could lead to missing the early detection of only two CRC cases and preventing one CRC-specific death per 1,000 individuals, potentially avoiding unnecessary colonoscopies.

2. Impact of Longer Screening Intervals: Sensitivity analysis showed that significantly lower risk persisted up to 16 years for CRC and CRC-specific death, even after adjusting for additional risk factors like obesity and alcohol use disorder. However, longer screening intervals of 16 to 20 years saw a gradual increase in additional CRC diagnoses and CRC-specific deaths per 1,000 individuals, highlighting the need for balance between screening efficacy and risk of missed diagnoses.

3. Implications for Screening Guidelines: This study, based on extensive data from a Swedish nationwide register, suggests extending the historical 10-year screening interval for individuals at average risk of CRC. Leveraging large population-based registries provides valuable evidence for revising screening guidelines, with potential economic implications for comparing resources required for colonoscopy-based screening programs versus noninvasive options. However, the study's limitations, including its focus on primarily white European populations, underscore the need for validation in diverse settings to ensure global applicability.

CMS, NCQA delay health plan quality reporting following Change attack

By Jakob Emerson - CMS and the NCQA are extending the quality data submission deadline for health plans by two weeks due to "extraordinary circumstances" caused by the cyberattack on Change Healthcare in late February. Read Full Article…

VBA Article Summary

1. Extended Reporting Deadline: Payers now have until 5pm Eastern Time on June 28 to submit their performance data on Healthcare Effectiveness Data and Information Set (HEDIS) measures. This extension, announced in an April 29 memo from CMS, provides relief amidst the aftermath of the Change Healthcare cyberattack.

2. Significance of HEDIS Measures: HEDIS measures encompass vital data on preventive care services, treatment, equity, and patient experience. These metrics are pivotal for evaluating the quality of healthcare services provided by Medicare, Medicaid, and commercial health plans. They serve as the foundation for calculating star ratings by CMS and NCQA.

3. Acknowledgment of Industry Challenges: Eric Schneider, MD, EVP of the Quality Measurement and Research Group at NCQA, underscored the unprecedented challenges faced by healthcare organizations following the cyberattack. Recognizing the strain on resources and the disruption to quality reporting efforts, NCQA, in alignment with CMS, has granted the deadline extension for the submission of HEDIS Measurement Year 2023 results.

Gene Therapy Allowing Heart to Grow New Blood Vessels Supported by Early Data

By Nicole Lou - A gene therapy for therapeutic angiogenesis showed promise for people with angina who had already exhausted their options for medical therapy and coronary revascularization, according to the single-arm phase I/II EXACT trial. Read Full Article…

VBA Article Summary

1. Safety and Feasibility: The study involving XC001 gene therapy for refractory angina demonstrated promising safety profiles with no serious adverse events related to the therapy itself. Instead, expected events were related to the surgical procedure. This suggests that direct transepicardial delivery of XC001 is feasible and well-tolerated in this population.

2. Efficacy Endpoints: Exploratory efficacy endpoints of XC001 therapy showcased significant improvements in various parameters associated with angina severity and myocardial perfusion deficit. These include increased total exercise duration, reduced myocardial perfusion deficit on PET imaging, prolonged time to ST depression, and decreased angina frequency. Such improvements indicate the potential of XC001 therapy in alleviating symptoms and improving functional capacity in patients with refractory angina.

3. Future Directions and Considerations: Despite encouraging results, panelists highlighted the need for cautious optimism and further investigation. Transitioning to percutaneous delivery in upcoming trials addresses concerns about the invasiveness of the procedure. Additionally, ongoing efforts aim to address the growing population of patients with refractory angina, particularly those with microvascular involvement. Further controlled trials with larger and more diverse cohorts are necessary to validate the efficacy and safety of XC001 therapy in the long term and to address limitations of the current study, such as its uncontrolled design and demographic homogeneity.