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Morning Briefing

Summaries of health policy coverage from major news organizations

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Monday, Jul 13 2020

Full Issue

Come Back For Routine Health Care, Patients Urged

Hospital systems warn against a "second health crisis" if people don't return. In other industry news: Who's paying for COVID tests?; grandfathered plans in the ACA; Sutter's antitrust deal; and more.

Even as Los Angeles health systems face surging COVID-19 cases this summer, they have a consistent message to the community: Don’t delay routine or emergent medical care. The city’s six major health systems launched a campaign in early May—before Los Angeles became a COVID-19 hot spot again—letting the community know their doors are open and urging patients to keep up with their health during the pandemic. The systems—Cedars-Sinai, Dignity Health, Kaiser Permanente, Keck Medicine of USC, Providence and UCLA Health—are usually fierce competitors that don’t collaborate, but lower patient volumes had them all worried. (Castellucci, 7/11)

HHS said it will refuse to change its guidance letting insurers off the hook for paying for COVID-19 tests that employers may mandate for employees to return to work, and lawmakers appear unlikely to force a legislative change. If Congress doesn't address the issue, who gets stuck with the potentially big bill for COVID-19 tests for occupational and public health purposes could remain a gray area. The Trump administration issued guidance on June 23 that exempted health insurers from covering COVID-19 tests that aren't deemed medically necessary by a healthcare provider. The interpretation creates a loophole though which individuals could be charged. (Cohrs, 7/10)

Numerous federal agencies on Friday said they want new flexibilities for group health plans grandfathered in under the Affordable Care Act. Under the proposed rule, those plans could change cost-sharing requirements without losing their grandfathered status. The regulation also allows the health plans to meet minimum cost-sharing requirements for high-deductible health plans to enable enrollees to contribute to health savings accounts. The proposed changes wouldn't apply to grandfathered individual plans. If finalized as is, the changes would increase out-of-pocket costs for beneficiaries. (Brady, 7/10)

Universal Health Services and the Department of Justice announced a final settlement Friday to resolve claims stemming from 19 whistleblower lawsuits accusing the for-profit chain of providing unnecessary care and improperly luring patients to use its programs, among other allegations. The for-profit hospital chain said the $122 million agreement, which follows years of investigation by the government, is largely consistent with the preliminary settlement announced one year ago. (Bannow, 7/10)

San Francisco Superior Court Judge Anne-Christine Massullo denied Sutter Health’s motion to delay finalizing its $575 million settlement with the state of California in a case that alleged anti-competitive practices. The benefits arm of the United Food & Commercial Workers began pursuing this civil lawsuit in 2014, but four years later, California Attorney General Xavier Becerra said that, because Sutter’s actions were driving up prices all around Northern California, he was filing a lawsuit that would consolidate the grocery worker’s lawsuit. (Anderson, 7/10)

Some of the physician practices that received millions of dollars' worth of small-business COVID-19 relief loans are affiliates of major health systems like Sutter Health, Adventist Health and CommonSpirit Health. But just because the medical groups' websites feature the health systems' logos and branding doesn't mean they get financial support. The health systems, which themselves got hundreds of millions in aid under the CARES Act, explained that their finances are separate from that of their affiliate medical groups, making those practices eligible for the Paycheck Protection Program loans for small businesses with 500 employees or less. (Bannow, 7/10)

In other health industry news —

Oklahoma public health officials are finalizing new contracts for hospital surge plans as the number of positive cases and hospitalizations of coronavirus patients have spiked in recent weeks. The contracts expand the number of hospitals for COVID-19-only treatment for the Oklahoma City metropolitan area and keep an existing contract in place at Oklahoma State University Medical Center-Tulsa. In all, 335 beds will be available under the contracts to treat COVID-19 patients. (Monies, 7/13)

Leaders of a southwest Georgia county say the region’s largest hospital system has tried to obstruct plans for a new competitor hospital in their county, but Phoebe Putney Memorial Hospital in Albany denies doing anything wrong. (7/12)

Arizona hospitals are now reaching capacity — some have to send patients to other states. Many experts are concerned the health care system could soon crumble under pressure. (Stone, 7/10)

HHS on Friday announced plans to send an additional $3 billion in provider COVID-19 relief grants to safety-net hospitals that were left out of a prior funding tranche, and will give $1 billion to an assortment of rural and smaller hospitals. HHS officials said the new distribution is being made because they realized some safety-net hospitals didn't meet the criteria for a prior $10 billion distribution. America's Essential Hospitals, a trade group that represents safety-net hospitals, said less than half of its members qualified for the first round of safety-net funding. (Cohrs, 7/10)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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