HIDA and scores business organizations are raising concerns about the disruptions that would occur in a walk-out.
The Aug. 1 strike threatened by 340,000 United Parcel Services workers would quickly and adversely affect medical supply chains, the Health Industry Distributors Association is warning.
HIDA was one of scores business organizations from across the nation that signed a letter sent Friday to President Joe Biden, raising concerns about the disruptions to the economy that would occur if the rank-and-file workers leave the job.
"UPS is a vital lifeline for America, moving between 5% and 6% of U.S. GDP, or $3.8 billion in goods, per day," the letter states. "America also relies on critical medical deliveries enabled by the predictability and reliability of the UPS network, such as vaccines, medical devices, and life-saving medication."
"A strike would lead to months-long backlogs in the supply chain and the interruption of deliveries of critical medical supplies and other essential items."
The letter cites a study estimating that a 15-day UPS strike would harm the health and safety of U.S. consumers by $55.5 billion; even a 5-day strike at UPS, by this account, would harm the country by $15.8 billion – or $3.7 billion per day.
HIDA President / CEO Matthew J. Rowan says in a media release that "the potential impact on healthcare is very real,"
"The supply chain relies on small parcel delivery to get supplies to patients in their homes, doctors' offices, first responders, and clinics," he says. "We strongly urge the parties and the Biden administration to avoid a work stoppage at all costs."
UPS and the International Brotherhood of Teamsters severed negotiations on July 5, at loggerheads over issues that include wage hikes for experienced part-time workers who make up about half of UPS' unionized workforce.
The two sides said this week that they would resume talks on July 25 after UPS announced that it was "prepared to increase our industry-leading pay and benefits, but need to work quickly to finalize a fair deal that provides certainty for our customers, our employees and businesses across the country."
Bloomberg cites estimates that a strike would cost UPS about $170 million a day. Reuters reports that 28 U.S. senators and 178 U.S. representatives have said they will not to intervene if a strike takes place.
Letters to providers highlight concerns stemming from use of technologies that may share a user's sensitive health data.
Federal regulators are warning hospitals and telehealth providers about the risks that patients' health data could be "impermissibly disclosed" by online tracking technology wired into providers' websites and mobile apps.
The Federal Trade Commission and the Department of Health and Human Services' Office for Civil Rights cited potential violations of the Health Insurance Portability and Accountability Act (HIPAA) in a joint letter sent this week to 130 hospital systems and telehealth providers.
The watchdogs raised concerns about the privacy risks linked to online tracking platforms such as the Meta/Facebook pixel and Google Analytics that gather user personal data, often without their knowledge and in ways that are hard to avoid when users visit a website or mobile app.
"If you are a covered entity or business associate ("regulated entities") under HIPAA, you must comply with the HIPAA Privacy, Security, and Breach Notification Rules (HIPAA Rules), with regard to protected health information (PHI) that is transmitted or maintained in electronic or any other form or medium," the letter says.
"Even if you are not covered by HIPAA, you still have an obligation to protect against impermissible disclosures of personal health information under the FTC Act and the FTC Health Breach Notification Rule," the letter continues. "This is true even if you relied upon a third party to develop your website or mobile app and even if you do not use the information obtained through use of a tracking technology for any marketing purposes."
HHS highlighted these concerns in a bulletin late last year that reminded HIPAA entities of their responsibilities to protect health data from unauthorized disclosures.
The commission has backed up its warnings to third-party players with recent multimillion-dollar fines and legal actions against BetterHelp, GoodRx and Premom.
Samuel Levine, director of the FTC's Bureau of Consumer Protection, says "the FTC is again serving notice that companies need to exercise extreme caution when using online tracking technologies and that we will continue doing everything in our powers to protect consumers' health information from potential misuse and exploitation."
The collaborative hopes to minimize administrative burdens by automating clinical documentation during virtual and in-patient care.
Teladoc Health and Microsoft are expanding their collaboration to include Microsoft Azure OpenAI Service, Azure Cognitive Services, and the Nuance Dragon Ambient eXperience (DAX) into the Teladoc Health Solo platform, the two companies announced this week.
The goal of the expanded collaboration is to automate clinical documentation during virtual exams to help ease the burden on clinicians while improving the quality of shared medical information and the care it supports.
Teladoc Health Medical Group also plans to use Nuance DAX Express for care visits provided directly by Teladoc Health, the Purchase, NY-based virtual provider says.
“Administrative burden and staff shortages are major reasons why clinicians are leaving the profession,” says Teledoc Health CMO Vidya Raman-Tangella, MD. “We are focused on using AI to reassert and build the doctor-patient relationship at a time when technology frequently does the opposite.”
Rama-Tangella says the expanded collaborative addresses the worsening burnout crisis among physicians that has been the result of increased electronic paperwork.
Tom McGuinness, corporate vice president, Global Health & Life Sciences, Microsoft, says Teledoc’s integration of Azure OpenAI Service and Nuance DAX “gives clinicians the tools they need to deliver quality, coordinated care, easing administrative burdens and allowing them to spend more focused time with their patients.”
When used with the Teladoc Health Solo platform, Nuance DAX, an ambient clinical documentation solution, will automatically document patient encounters at the point of care for clinician review and signoff, which gives clinicians more facetime with patients.
The Teladoc Health Medical Group will also use Nuance DAX Express, a workflow-integrated, AI powered clinical documentation application that combines Nuance’s conversational and ambient AI with the new AI model, GPT4, in the Azure OpenAI Service.
The use of Nuance DAX Express will report encounters to other virtual and community-based clinicians to better coordinate care.
Diana Nole, executive vice president and general manager of healthcare at Nuance, says DAC Express “addresses the pressing challenge of reducing clinicians’ administrative workloads in some of the most demanding and dynamic care environments in healthcare.”
Teladoc Health first collaborated with Microsoft in 2021 to streamline the technology and administrative processes associated with providing virtual care, integrating the company’s Solo platform within Microsoft Teams and as a strategic partner expanding virtual health for Microsoft Cloud for Healthcare.
"Patient portals offer a wide range of benefits, including decreasing unnecessary hassles for providers and patients and improving access to both the medical staff and a child's medical information," Mott Poll co-director Sarah Clark, MPH, says in a media release.
"Given all the conveniences portals offer, it's surprising that over half of parents have not set one up for their child, most commonly because they don't see a need for it. This report suggests many parents may not be aware of all the potential benefits of using a patient portal for children."
Nearly one-third of parents who did not have a patient portal for their child say they do not see the need, a quarter say they don't know how to access it, and 20% say they prefer other ways to communicate.
Few parents cite privacy concerns or technical problems, but some don't know if their provider offers a portal option.
Parents who use a portal enjoy the benefits. One-third say they've received advice about their child's illness, injury or symptoms through the platform. Nearly all of these parents say they got the level of guidance they anticipated within a reasonable amount of time and usually from the person they expected.
The majority of portal users have tapped it to make appointments, view tests, complete forms, get prescription refills, request immunization records or get referrals.
"Our poll suggests that pediatric health providers should continue efforts to inform families about the benefits of patient portals, and parents who haven't set one up should take steps to learn more about portal advantages and how to establish one for their child," Clark says.
Some providers have expressed concerns about parents' unrealistic expectations for portal queries, especially for urgent care. Clark says providers can help manage those expectations, and that parents who get instructions from their provider on how to use portals are more enthusiastic.
More than third of parents who did not receive portal training guidance also had the lowest satisfaction ratings on communication with their child's provider.
"Instructions from the practice on how to optimize portal benefits appear to be the key to helping parents use it effectively and appropriately and increase families' satisfaction with the experience," Clark said.
DOJ says the EHR vendor 'falsely obtained certification for its software.'
NextGen Healthcare Inc. will pay $31 million to resolve whistleblower allegations that the electronic health records (EHR) vendor lied about its software's capabilities and paid kickbacks to users who shilled their product, the Department of Justice announced.
NextGen has denied the allegations, which occured nearly a decade ago, and says it settled with DOJ to avoid lengthy and costly litigation.
In a civil complaint filed with the settlement, DOJ says NextGen "falsely obtained certification for its software in connection with the 2014 Edition certification criteria published by the Department of Health and Human Service's Office of the National Coordinator."
Specifically, DOJ alleges that NextGen "relied on an auxiliary product designed only to perform the certification test scripts, which concealed from the certifying entity that NextGen's EHR lacked critical functionality."
Because of that, DOJ says the EHR that NextGen sold to providers lacked mandated functions, including the ability to record vital sign data, translate data into required medical vocabularies, and create complete clinical summaries.
DOJ also alleges that NextGen violated the Anti-Kickback Statute when it gave credits worth as much as $10,000 to existing customers whose recommendation of NextGen's EHR software led to a new sale. The kickbacks also included tickets to sporting events and other entertainment.
"Electronic health records play a pivotal role in the provision of safe, effective healthcare, and the testing and certification process of the EHR Incentive Program was intended to provide assurances to providers that their EHR can perform certain important functions," U.S. Attorney Nikolas P. Kerest for the District of Vermont, the lead prosecutor of the case, says in a media release. "With this settlement, our office has now resolved five investigations into misconduct by EHR companies, demonstrating our commitment to ensuring that EHR companies are held responsible for their misrepresentations."
The settlement resolves claims brought under whistleblower provisions of the False Claims Act by Toby Markowitz and Elizabeth Ringold, healthcare professionals at a facility that used NextGen's software, who will receive $5.6 million.
NextGen Responds
NextGen issued the following statement in response to the settlement.
"The company denies that any of its conduct violated the law, and the settlement agreement does not include any admissions of wrongdoing. This agreement relates to claims from more than a decade ago. The settlement resolves the matter without monitoring or changes to NextGen Healthcare's products or compliance policies. To avoid the distraction and expense of litigation, we believe it is in the best interest of the company to put this historical matter behind us and keep our attention focused on innovating solutions that enable better healthcare outcomes for all."
Caremark Cost Saver will be a free service for CVS Caremark enrollees in 2024.
CVS Caremark and GoodRx announced this week the launch of a new collaborative to help lower out-of-pocket drug costs for CVS Caremark members.
Under the Caremark Cost Saver program, set to launch on January 1, 2024, commercially insured plan members will automatically access GoodRx's prescription pricing for lower prices on generic medications.
The amount paid will be applied to plan members' deductible and out-of-pocket thresholds. No action is required by plan members, who can use their existing benefit card at their in-network pharmacy.
"This collaborative prescription discount solution enables us to dynamically shop for the best price on (consumers') behalf," David Joyner, executive vice president, CVS Health and president, CVS Caremark says in a media release. "By lowering out-of-pocket costs for our clients' members, Caremark Cost Saver will help patients afford to take their medicine as directed."
Scott Wagner, Interim CEO of Santa Monica, CA-based GoodRx, says the new programs means that "patients don't have to choose between using their pharmacy benefit or using GoodRx to save on their prescriptions."
"Now they can do both right at the counter so they have confidence they are always paying the lowest available price," he says. "This collaboration can make a meaningful difference for the tens of millions of Americans that CVS Caremark serves."
The collaborative provided no estimates on the potential dollar savings it could generate for consumers.
Drug shortages affect consumer costs in several ways, including higher out-of-pocket costs, higher insurance premiums, and adverse health.
The chronic and worsening wave of drug shortages in the United States not only imperils patient health, it also costs them more money, a new study shows.
The study released this week by RAND Corporation finds that drug shortages affect consumer costs in several ways, including higher out-of-pocket costs, higher insurance premiums, and adverse health outcomes when the drug is unavailable or unaffordable. In addition, providers paying more for drugs are passing that cost on to patients.
Premier Inc. reported way back in 2011 that drug shortages cost providers at least $200 million a year. The Food and Drug Administration in 2020 identified 43 new and 86 unresolved shortages of active ingredients.
The shortages have worsened since then. The New York Times reported in May that “hundreds of drugs are on the list of medications in short supply in the United States, as officials grapple with an opaque and sometimes interrupted supply chain, quality and financial issues that are leading to manufacturing shutdowns.”
NBC News reported in May that “widespread shortages of cancer drugs are forcing doctors to make difficult decisions about how to treat their patients, including rationing doses and turning to other treatment options with potentially more side effects.”
The RAND study, commissioned by the Department of Health and Human Services, also found that:
Drug shortages affect consumers with reduced sales and/or increased prices.
The average drug shortage affects at least a half a million consumers, more than two thirds of whom are ages 65 to 85 (32%), 55 to 64 (24%) and 45 to 54 (17%).
After a drug shortage, sales volumes declined between 28% and 35% compared to the year before the drug entered a shortage. The reduction in volume of generic drug fills was larger (median of 37.6%) compared to brand-name drugs experiencing a shortage (median of 30.4%).
Drug shortages lead to a 16.6% increase in the price of drugs, driven mostly by an increase in the price of generics (14.6%). In some cases the price of generic substitutes was at least three times higher than the price increase of the drug in shortage.
The report highlights potential policies that could be pursued to address cost increases when there are shortages and to ensure sufficient supply of generic drugs.
To address the shortage, the report recommends that federal regulators tap into existing laws and policies that include requiring:
Drugmakers to notify FDA about drug making discontinuations or delays that are likely to lead to supply disruptions;
FDA to prioritize reviews of applications and inspections, as needed;
Manufacturers of flagged drugs or of any API used for preparation included in those drugs to develop, maintain, and implement, as appropriate, a redundancy risk management plan;
Registrants of drug establishments to report annually on the amount of each listed drug that they manufactured, propagated, compounded, or processed for commercial distribution.
In addition, FDA has already taken steps to prevent or mitigate shortages, including;
:
Working with manufacturers to increase production of certain drugs in shortage;
Expediting reviews of submissions to increase supply of products in shortage;
Working with manufacturers to determine if data support extending expiration dates of certain drugs in shortage;
Exercising temporary regulatory flexibility for sources of medically necessary drugs,
Issuing emergency use authorizations, under a public health emergency, for certain therapeutic treatments and patients.
FAIR Health reports that declines in telehealth claims were seen in all four U.S. census regions.
Overall private insurance telehealth claims fell 5.4% nationally in April, representing 5.3% of all medical claims, compared with 5.6% of claims in March, according to FAIR Health's Monthly Telehealth Regional Tracker.
The drop in telehealth claims was seen in all four U.S. census regions—the Midwest (4.7%), Northeast (6.3%), South (6.8%) and West (6.4%). The average patient visit lasted between 20 and 29 minutes, the median charge was $167.77, and the median allowed amount was $89.70.
Audio-only telehealth fell in both rural and urban areas nationally and in every region except the West, where it fell in rural areas but rose in urban areas.
The data was taken from privately insured population, including Medicare Advantage and excluding Medicare fee-for-service and Medicaid.
Mental health conditions continued to be the top-ranking telehealth diagnosis nationally and in every region, rinsing from 67.4% of telehealth claim lines nationally in March to 68.4% in April—the fourth straight month of national increases.
Claims for acute respiratory diseases and infections, the second most-common telehealth consultation, fell nationally in April from 3.2% in March to 2.7% in April, the fourth straight national monthly decrease for this diagnosis.
Developmental disorders rose to third place while joint/soft tissue diseases and issues fell to fourth place.
Among the top five diagnoses nationally via asynchronous telehealth places with urinary tract infections, rising to third place while UTI fell to fourth.
Asynchronous telehealth claims for hypertension increased to 12.5% nationally in April, up from 9.7% in March, and in every region. Hypertension rose from second to first place in the West and from fourth to second place in the South. It maintained its position nationally (second place) and in the other regions—second place in the Northeast and first in the Midwest.
Sleep disorders climbed in the rankings of asynchronous telehealth diagnoses from fifth to fourth place in the Northeast and from fourth to second place in the West. Diabetes mellitus rose in the rankings in three regions: from fifth to third place in the Midwest, from fourth to third place in the Northeast and from fifth to fourth place in the West.
The for-profit, megasystem has launched a webpage to keep patients informed.
HCA Healthcare Inc. announced Monday that it has discovered a data breach that could make vulnerable the personal information of many as 11 million patients at scores of care venues in 20 states.
In a media release, the Nashville-based for-profit health system says the information was "made available by an unknown and unauthorized party on an online forum."
The exposed data includes patients’ names addresses, emails, phone numbers, dates of birth, gender, service dates, locations and next appointment dates.
No clinical or payment data was exposed, nor were passwords or drivers’ license or Social Security numbers.
"This appears to be a theft from an external storage location exclusively used to automate the formatting of email messages," HCA says.
"There has been no disruption to the care and services HCA Healthcare provides to patients and communities. This incident has not caused any disruption to the day-to-day operations of HCA Healthcare. Based on the information known at this time, the company does not believe the incident will materially impact its business, operations or financial results."
HCA says it has reported the breach to law enforcement and has hired a third-party forensics investigator and "threat intelligence advisors." The investigation is ongoing but HCA says it has uncovered no evidence of "malicious activity" on its networks.
HCA shutdown user access to the storage location and will contact potentially affected patients and has launched a webpage to keep patients informed.
The legislation gives the executive enhanced powers to cut red tape and reduce trade barriers with 'trusted allies.'
A bipartisan bill introduced in the U.S. Senate aims to correct the nation's medical supply chain weaknesses that were exposed during the COVID-19 pandemic.
The Medical Supply Chain Resiliency Act, sponsored by U.S. Senators Thom Tillis (R-NC) and Tom Carper (D-DE) would strengthen the government's hand in trade negotiations that ensure that safe and timely delivery of critical medical goods.
A key component of the bill gives the president – through his appointed U.S. Trade Representative -- the authority to negotiate with "trusted allies" to eliminate tariffs and other barriers that weaken the medical goods manufacturing sector in the United States and allied nations. These agreements also would protect intellectual property rights and strengthen regulatory cooperation and collaboration on R&D efforts. Congress would be looped in on the status of these new trade agreements and would reserve the right to reject them.
"The pandemic caused major disruptions across nearly all supply chains, and these challenges disproportionately impacted our healthcare supply chain – from medical devices to life-saving medicines to personal protective equipment (PPE)," Tillis says in a media release.
"Now is the time to address the long-standing shortcomings in our supply chains that were highlighted over the pandemic, repair the damage done, and ensure America is adequately prepared for future national security and public health threats," he says.
Carper says the bill "will help mitigate trade challenges by authorizing the president to work more closely with our global partners and take action to ensure that healthcare providers and patients can access life-saving medical products when they need them the most."
"The pandemic wreaked havoc on our communities and caused our medical supply chains to break down during the worst possible time. We must prevent these same horrible losses from happening again by working together to fix our broken supply chains and better prepare for future public health emergencies," Carper says.
The bill has the support of key stakeholders, including the U.S. Chamber of Commerce, the National Foreign Trade Council, the Trade Alliance for Health, the National Foreign Trade Council, and the National Association of Manufacturers.
"This is practical legislation that, if enacted, will apply lessons learned in the COVID-19 pandemic to strengthen America's health preparedness," says John Murphy, senior vice president for international policy at the U.S. Chamber of Commerce.
