Hazen and other senior leaders at Nashville-based HCA were handsomely rewarded for the company's strong financial performance in 2019.
HCA Healthcare CEO Samuel N. Hazen received $26.7 million in total compensation in his first year at the helm of the nation's largest for-profit hospital system.
Hazen and other senior leaders at Nashville-based HCA were handsomely rewarded for the company's strong financial performance in 2019, which saw total revenues of nearly $12.3 billion, a 6.2% increase year-over-year.
Hazen's compensation came in the form of $1.4 million in salary, $5.9 million in stock, $5.6 million in SAR awards, $4 million in non-equity incentives, $9.5 million in pension value and deferred earnings, and $126,000 in "all other compensation."
William Rutherford, HCA's CFO, received total compensation of $6.3 million; Jon M. Foster, president of HCA's American Group, received $7.7 million; Charles J. Hall, president of HCA's National Group, received $6.5 million; Jonathan B. Perlin, MD, CMO, received $5.9 million; and former CEO R. Milton Johnson received $4.3 million.
HCA ended 2019 with total revenues of more than $46.7 billion, up from $43.6 billion in 2018, and a net income of $3.8 billion, well exceeding its $2.2 billion during the prior year.
A whistleblower complaint alleged that Millennium Physicians Association PLLC billed Medicare for sleep studies conducted by uncredentialed technicians.
A Houston area physician group will pay $1.2 million to settle whistleblower allegations that it improperly billed Medicare for sleep studies,the Department of Justice said.
A whistleblower complaint alleged that, from January 2015 through March 2019, Millennium Physicians Association PLLC, operating as Millennium Respiratory & Sleep Disorder Specialists, and based in The Woodlands, conducted sleep studies at two clinics without properly credentialed technicians, and improperly billed Medicare for the services.
Medicare requires sleep centers to be accredited or certified by the America Academy of Sleep Medicine, Joint Commission or Accreditation Commission for Health Care Inc.
Millennium self-reported that from 2011 through 2019, two of its sleep centers were unaccredited.
"Providers using improperly credentialed technicians are cheating the taxpayers and may put beneficiaries at risk," said Joseph Martin, Acting Special Agent In Charge for the Office of Inspector General of the U.S. Department of Health and Human Services.
The whistleblower will receive $187,000 from the settlement.
MA, Part D plans given option to waive cost-sharing and prior authorizations.
Medicare Advantage and Part D plans have been given the option to waive prior authorization, cost-sharing, and other potential barriers that could delay testing and treatment for the COVID-19 virus, the Centers for Medicare & Medicaid Services said.
"Medicare beneficiaries are at the greatest risk of serious illness due to COVID-19 and CMS will continue doing everything in our power to protect them," CMS Administrator Seema Verma said in a media release.
Waiving cost-sharing for COVID-19 treatments in doctor’s offices or emergency rooms and services delivered via telehealth;
Removing prior authorizations requirements;
Waiving prescription refill limits;
Relaxing restrictions on home or mail delivery of prescription drugs;
Expanding access to certain telehealth services.
Verma said the waivers allow plans to work with pharmacies and providers to treat patients without burdensome requirements limiting their options during this outbreak.
ACP says its decision to cancel its conference next month was based on "rapidly escalating concerns about the Coronavirus Disease 2019."
The American College of Physicians on Tuesday cancelled its annual Internal Medicine Meeting 2020 next month in Los Angeles over concerns about the spread of the coronavirus.
Philadelphia-based ACP said the decision was "based on recent reports from the World Health Organization and the Centers for Disease Control and Prevention of rapidly escalating concerns about the Coronavirus Disease 2019 (COVID-19), and in recognition of the vital role of internal medicine physicians in diagnosing, managing and caring for their patients and communities on the front lines."
"ACP also recognizes its professional responsibility to consider the safety of its meeting participants by modeling social distancing and not contributing to the spread of the virus through a large public gathering such as its annual scientific meeting," ACP said in a media release.
ACP, the nation's largest specialty organization, with 159,000 members in more than 145 countries, was scheduled to meet on April 23-25 in Los Angeles. The cancellation joins a growing list of associations opting out of conferences because of fears of the coronavirus.
Last week, the Healthcare Information and Management Systems Society, American College of Healthcare Executives, America's Health Insurance Plans, and the American Organization for Nurse Leadership all cancelled upcoming meetings for later this month.
The actions follow that of HIMSS, which last week issued a last-minute cancellation of this week's annual conference in Florida.
The American College of Healthcare Executives, America's Health Insurance Plans, and the American Organization for Nursing Leadership have cancelled upcoming annual conferences this month amid concerns about the coronavirus.
The actions follow those of Healthcare Information and Management Systems Society, which last week issued a last-minute cancellation of this week's annual conference in Orlando, at which 45,000 people from across the globe were expected to attend.
ACHE's board of governors issued a statement saying it cancelled its 2020 Congress on Healthcare Leadership, scheduled for March 23-26, 2020 in Chicago, because many of the 4,200 executives who were expected to attend "are actively managing the response to coronavirus (COVID-19) in their communities."
"We understand and support our members and other leaders—and the need to respond effectively to patient and community concerns," ACHE said."The decision to cancel this event was not made lightly. Out of respect for our attendees and faculty, we wanted to announce this news as soon as the decision was made and prior to our cancellation deadline."
AHIP's board of directors said it cancelled its National Health Policy Conference and National Conference on the Individual and Small Group Market in Washington, D.C., scheduled for March 18-20, "to help prevent the spread of this disease, to ensure that people have coverage for and access to needed testing, and to help patients who are infected receive the care and treatment they need."
"As our country prepares for the possibility of widespread infections and takes action to mitigate the impact, our priority is the health and well-being of the people we serve," AHIP said in a media release. "There are three critical areas health insurance providers are proactively addressing right now: Prevention, testing, and treatment."
As of now, AHIP's Institute & Expo on June 17-18 in Miami remains scheduled.
AONL said it decided to cancel its 2020 Conference, scheduled for March 18-21 in Nashville, "in light of the latest COVID-19 developments and the unprecedented and still growing demand for nursing leadership at this time," AONL announced on its webpage. "Our nursing leaders must remain on site in their roles. We are confident this is not only in the best interest of our attendees and exhibitors but also the patients and families they serve."
(Correction: In an earlier report HealthLeaders incorrectly reported that AHIP had cancelled its June conference in Miami.)
AHIP says its members are committed to keeping out-of-pocket expenses low so that cost is not a barrier for people seeking treatment for COVID-19.
The nation's health insurance companies pledged this week to coordinate and intensify prevention, testing and treatment efforts to mitigate the spread of the coronavirus, including waiving patient copays for physician-ordered tests and treatments.
"We are taking decisive action to help prevent the spread of this disease, to ensure that people have coverage for and access to needed testing, and to help patients who are infected receive the care and treatment they need," America's Health Insurance Plans announced on Thursday.
AHIP says its members are committed to keeping out-of-pocket expenses low so that cost is not a barrier for people seeking treatment for COVID-19. That will include payers covering the costs for physician-ordered testing, and reducing red tape around provider networks, referrals and prior authorization, and waiving patient cost-sharing.
The payers said they would share data with clinicians and coordinate care management to ensure providers have the tools to quickly diagnose and treat infections, and that patients have access to effective treatment. This includes encouraging the use of telehealth and other technology-enabled remote health options to expand access and avoid infection risks.
The payers also pledged to work with the Centers for Disease Control and Prevention and other government agencies to coordinate efforts, share information, mitigate health risks, and keep the public informed. That includes identifying people who are most at-risk of acquiring the infection, such as seniors and people with chronic diseases.
Centers for Medicare & Medicaid Services Administrator Seema Verma applauded the stepped-up response from payers, saying it meshes with the Trump administration's "whole-of-America approach, including working with our private partners, so that our entire healthcare system and our communities are activated and coordinated in our efforts to protect the American people."
Separately, Cigna announced that it would waive all copays and cost-shares for coronavirus testing and treatment prescribed by providers.
"During this time of heightened concern, Cigna's role is clear," CEO David M. Cordani said in a media release. "We will do everything we can to help contain this virus, remove barriers to testing and treatment, especially for seniors and people who are chronically ill, and give peace of mind to those we serve."
CMS also ordered state regulators and accrediting organizations to immediately inspect thousands of Medicare-participating healthcare facilities and focus on infection control.
The Centers for Medicare & Medicaid Services has ordered hospitals and nursing homes to ensure that infection control procedures are in place to address the spread of the Coronavirus.
In a series of three memoranda issued Wednesday, CMS also ordered state regulators and accrediting organizations to immediately inspect thousands of Medicare-participating healthcare facilities and focus exclusively on infection control and other serious health and safety threats, such as patient abuse.
Healthcare facilities participating in Medicare and Medicaid already are already required by statute to ensure they have in place infection control procedures. Nonetheless, CMS Administrator Seema Verma said the memoranda issued this week "represent a call to action across the healthcare system."
"All healthcare providers must immediately review their procedures to ensure compliance with CMS' infection control requirements, as well as the guidelines from the Centers for Disease Control and Prevention ," she said.
"We sincerely appreciate the proactive efforts of the nursing home and hospital associations that have already galvanized to provide up-to-the-minute information to their members. We must continue working together to keep American patients and residents safe and healthy and prevent the spread of COVID-19."
Under the inspection memorandum, state survey agencies will look for:
All immediate jeopardy complaints (a situation in which entity noncompliance has placed the health and safety of recipients in its care at risk for serious injury, serious harm, serious impairment or death or harm) and allegations of abuse and neglect;
Complaints alleging infection control concerns, including facilities with potential COVID-19 or other respiratory illnesses;
Statutorily required recertification surveys (Nursing Home, Home Health, Hospice, and ICF/IID facilities);
Any re-visits necessary to resolve current enforcement actions;
Initial certifications;
Surveys of facilities/hospitals that have a history of infection control deficiencies at the immediate jeopardy level in the last three years;
Surveys of facilities/hospitals/dialysis centers that have a history of infection control deficiencies at lower levels than immediate jeopardy.
The memorandum also includes protocols providers must take when COVID-19 is identified or suspected that include working with CMS and CDC.
The other two memoranda answer procedural questions that nursing homes and hospitalsmay have, such as how to screen patients and staff for the virus, and how to transfer patients diagnosed with the virus between nursing homes and hospitals.
Net drug prices began leveling off in 2015, but the researchers said that doesn't mean that drugs are affordable for many consumers.
The net cost of prescription drugs — defined as sticker price minus manufacturer discounts — grew more than three times faster than the rate of inflation over the past decade, according to new research published this week in JAMA.
"Previously, we were limited to studying list prices, which do not account for manufacturer discounts. List prices are very important, but they are not the full story," said study lead author Inmaculada Hernandez, assistant professor of pharmacy at Pitt. "This is the first time we've been able to account for discounts and report trends in net prices for most brand name drugs in the U.S."
The researchers used revenue and usage data for 602 brand-name drugs to track list and net prices from 2007 to 2018. They found that inflation-adjusted list prices increased by 159%, while net prices, which account for rising manufacturer discounts, including rebates, coupon cards and 340B discounts, increased by 60%, which is 3.5 times the rate of general inflation.
Net drug prices began leveling off in 2015, but the researchers said doesn't mean that the drugs are affordable for many consumers.
"Net prices are not necessarily what patients pay," said senior author Walid Gellad, MD, associate professor of medicine and health policy at Pitt and director of the CP3. "A lot of the discount is not going to the patient."
The lion's share of the discounts is made up by rebates that are paid directly to insurers. In addition, the rebates have little affect on the price consumers pay through copays, which are based on list price, not net price.
Depending on the drug, the gap between list and net prices is either widening for drugs such as insulin and TNF inhibitors, or rising at the same level, which is what's happening with cancer drugs. Multiple sclerosis drug net prices more than doubled over the past decade in inflation-adjusted dollars, even after discounts were applied.
"We're seeing a lot of discussion that net prices have stabilized over the last few years, and that does appear to be the case," said Gellad. "But the stabilization of net price comes on top of large increases over the last decade, many times faster than inflation, for products that have not changed over this time period. In addition, this net price is an average, with substantial variability across payers and drugs."
Medicaid enjoys much larger discounts than for other payers, reflecting the mandatory Medicaid rebate based on price increases over inflation. Discounts for other payers are based on negotiations.
Hernandez disclosed fees paid to her personally by Pfizer, for services unrelated to the scope of this work.
With the increased likelihood of a recession this year, S&P says lower credit ratings for private equity-backed issuers may increase, making the sector vulnerable to downgrades and defaults.
Private equity firms' increasing ventures into the healthcare sector may be harming the credit ratings of their newly acquired, highly leveraged assets, according to a report published by S&P Global Ratings.
"The influx of private equity-backed healthcare companies, as well as continued high valuations has led to significantly higher debt levels," said S&P Global Ratings credit analyst Alice Kedem.
Because of this increased debt burden, Kedem said, credit ratings continue to fall into the 'B' category, with the proportion of "B-" rated companies in the healthcare sector doubling in past few years.
Higher risk of the private equity-backed issuers is also reflected through a high ratio of downgrades to upgrades, with private equity-backed issuers having limited to no upside, according to the report.
The report identified a combination of factors that prompted the negative rating actions in private equity-backed ratings originated from transactions from 2014 through 2019, including "lower demand or negative reimbursement changes for service-oriented issuers with higher-than-estimated operating costs, integration challenges, or disruption stemming from a transition of the enterprise resource planning."
Kedem said there are no signs that private equity interest in healthcare is abating, and that the highly leveraged arrangements will persist.
"As many transactions are in services-oriented subsectors that are highly fragmented and where size and scale can bring operational leverage, we expect that private equity-owned issuers will continue to pursue merger and acquisition strategies, maintaining leverage at high levels," she said.
With the increased likelihood of a recession this year, S&P forecasts that downward bias for private equity-backed issuers may increase, making the sector more vulnerable to downgrades and eventually to defaults.
It's the seventh such settlement reached by DOJ's Antitrust Division in its ongoing probe of the generic pharmaceutical industry.
Generic drug maker Sandoz Inc. will pay the federal government $195 million to avoid felony charges for price fixing, bid rigging, and customer allocation under a deferred prosecution agreement announced this week by the Department of Justice.
The DPA is the seventh such settlement reached by DOJ's Antitrust Division in its ongoing probe of the generic pharmaceutical industry. Sandoz is the third company to be charged and entered into a DPA.
Three executives have pleaded guilty, including former Sandoz executive Hector Armando Kellum. Ara Aprahamian, a former executive at Taro Pharmaceutical USA, was indicted last month on price fixing charges and is awaiting trial.
DOJ accused Sandoz of participating in four criminal antitrust conspiracies, each with a competing generic drug maker, between 2013 and 2015.
Under the DPA, Sandoz admitted that its sales from the various schemes exceeded $500 million. The company has agreed to cooperate with federal prosecutors in the ongoing conspiracy.
"Today’s resolution, with one of the largest manufacturers of generic drugs, is a significant step toward ensuring that prices for generic drugs are set by competition, not collusion, and rooting out antitrust crimes that cheated American purchasers of vital medicines," Assistant Attorney General Makan Delrahim of DOJ's Antitrust Division said in a media release.
"Sandoz conspired for years with other manufacturers and their executives to raise prices for critical medications, and the Antitrust Division will continue its ongoing investigation to hold both individuals and corporations accountable for these crimes," Delrahim said.
Sandoz has also set aside $185 million while it negotiates a separate settlement with DOJ's Civil Division to resolve related claims.
"In reaching today’s resolution, we are not only resolving historical issues but also underscoring our commitment to continually improving our compliance and training programs and evolving our controls," she said. "We are disappointed that this misconduct occurred in the face of our clear antitrust compliance policies and multiple trainings – and in full contravention of the company’s values."
Specifically, Sandoz admitted to the following four felony charges:
Count One charged Sandoz for conspiring with Taro Pharmaceuticals USA to fix prices for drugs that included clobetasol (cream, emollient cream, gel, ointment, and solution), desonide ointment, and nystatin triamcinolone cream.
Count Two charged Sandoz for conspiring with Kavod Pharmaceuticals LLC to allocate customers and fix prices of benazepril HCTZ. Kavod was charged and entered into a DPA last year for its participation.
Count Three charged Sandoz for conspiring with a generic drug company based in Michigan for drugs that included desonide ointment.
Count Four charged Sandoz for conspiring with a generic drug company based in Pennsylvania for drugs that included tobramycin inhalation solution.
By accepting the DPA, Sandoz avoided minimum fines of $100 million for each count, which could have been increased to twice the gain derived from the crime or twice the loss suffered by victims if either amount is greater than $100 million.
