Welcome to Wednesday, or as I’m choosing to think of it, the day after Rachana Pradhan guest-authored The Health 202. I’m a health reporter for The Post who has fond memories of his fabled partnership with Rachana … but now we're competitors, so I must deliver a better newsletter. Tell me if I succeeded: dan.diamond@washpost.com. Not a subscriber? Sign up here.
Today’s edition: House Republicans are subpoenaing former New York governor Andrew M. Cuomo (D) over his pandemic-era nursing home policies. Federal regulators launched a probe into the role of private equity in the health-care industry. But first …
Feds unveil response to health-care hack as medical practices reel
The nation’s health-care system continues to reel from a cyberattack that has crippled payments for tens of thousands of organizations, my colleague Daniel Gilbert and I write in The Post.
It’s been two weeks since hackers took down Change Healthcare — a unit of UnitedHealth Group that is the country’s largest processor of medical claims. Hospitals, doctors and other providers are warning that unpaid bills are piling up and threatening their ability to stay open, with some going to extraordinary lengths just to meet payroll.
As many as 25 percent of physician practices across the country are in severe financial distress, Farzad Mostashari, the CEO of Aledade, the nation’s largest network of independent physician practices, estimated in an interview with The Post on Tuesday. Mostashari and others said the crisis evoked the early days of the coronavirus pandemic, when health-care revenue suddenly dried up as elective procedures were abruptly canceled.
Federal officials unveiled their response to the spiraling crisis yesterday, with the Department of Health and Human Services encouraging hospitals to seek out accelerated payments and private insurers to offer new flexibilities. But health-care advocacy groups — including the American Hospital Association, Federation of American Hospitals, the American Medical Association and others — deemed it insufficient, especially for doctors, whose payment needs weren't covered in Tuesday's announcement.
“The AMA urges federal officials to go above and beyond what has been put in place and include financial assistance such as advanced payments for physicians,” Jesse M. Ehrenfeld said in a statement.
Making matters worse: The emergency loans offered by UnitedHealth also have been widely panned, with physicians saying they're equivalent to pennies on the dollar.
Doctors say they’ve been left in the lurch and are growing frightened.
Christine Meyer, who owns a primary care practice outside Philadelphia that serves 20,000 patients, has watched payments from insurance companies dwindle by the day. Typically, her practice gets between $20,000 and $70,000 a day in deposits, but on Tuesday, it received barely $1,600 — the lowest in 20 years, Meyer told Daniel.
“I’m terrified our cash will only last so long,” said Meyer, who has applied for a loan to buy time.
A plea for help: Mostashari, whose organization is fronting up to $100 million in advance payments to help stabilize physician practices, said the federal government must do must more to help at-risk medical organizations.
“We have accumulated a backlog of unsubmitted claims,” Mostashari said, adding that even if the Change Healthcare crisis is abruptly resolved, there will be weeks of an “air bubble” plaguing physician practices’ finances. “It seems like a very low-regret move to push up the advance payments, which will be fully recouped. It won't cost the government a penny to push those payments.”
The federal government so far has been hesitant to lay out too much of its own cash, leaning instead on UnitedHealth and other private health plans.
“Deeply concerning how long it is taking to recover,” Ceci Connolly, the president and CEO of the Alliance of Community Health Plans (and a former Post reporter) wrote on social media Tuesday. “Our nonprofit health plans are being asked to advance payment to physicians because billing systems are not back.”
Not on the table so far: Some industry experts have invoked the idea of a new provider relief fund, akin to the initiative that distributed billions of dollars in emergency payments that helped keep hospitals and other providers afloat during the coronavirus pandemic.
But Jim Parker, who helped oversee the fund as a senior HHS official during the Trump administration, cautioned against trying to set up such a fund, noting the difficulties in running the earlier initiative.
“It was really a challenge to implement and, candidly, to implement in a way that was both comprehensive and equitable,” Parker told me.
Expect this crisis to keep gaining steam on Capitol Hill, as hospitals and doctors stay in the ears of their representatives. A growing number of bipartisan lawmakers, ranging from Senate Majority Leader Charles E. Schumer (D-N.Y.) to Rep. Gus M. Bilirakis (R-Fla.), who chairs a key House panel overseeing health-care data, have already demanded answers, saying their communities are being affected and it's putting patient care at risk.
“I am deeply concerned that the negative impacts on Arizona’s health infrastructure and access to care for Arizonans may become irreversible,” Rep. Ruben Gallego (D-Ariz.) wrote on Tuesday to HHS Secretary Xavier Becerra and Jen Easterly, the nation's cybersecurity chief. “I request you use all available resources and authorities to provide relief.”
On the Hill
House panel subpoenas Cuomo over nursing home policies
The House panel probing the coronavirus response has subpoenaed former New York governor Andrew M. Cuomo (D) to testify on his administration’s nursing home policies during the pandemic.
The subpoena compels Cuomo to sit for a closed-door deposition May 24. Rep. Brad Wenstrup (R-Ohio), the subcommittee's chairman, cited the former governor’s alleged stonewalling of the investigation as grounds for the order.
A closer look: The probe focuses on a directive Cuomo issued in March 2020 that ordered long-term care facilities to admit recovering covid patients ― a policy that the state’s attorney general later concluded “may have put residents at increased risk of harm.” Lawmakers are also investigating allegations that his administration downplayed nursing home deaths during the outbreak.
Rich Azzopardi, a spokesperson for Cuomo, called the subpoena as “an obvious press charade.” He denied accusations of noncooperation, saying Cuomo’s lawyer had provided interview dates two weeks prior.
In other news from Capitol Hill …
The lower chamber approved a handful of health-care-related bills last night under suspension of the rules, requiring a two-thirds majority vote for passage. If signed into law, the legislation would:
- Reauthorize federal funding through 2028 for state-based maternal mortality review committees and a pediatric disease research initiative at the National Institutes of Health.
- Require the Substance Abuse and Mental Health Services Administration to bolster the defenses of the federal 988 mental crisis hotline against cybersecurity threats.
Agency alert
Federal agencies probe private equity's grip on health care
Three federal agencies are teaming up to investigate the growing influence of private equity firms and other corporations on the health-care industry.
The Federal Trade Commission, Justice Department and the Department of Health and Human Services jointly issued a request for information yesterday seeking public feedback on health-care transactions, including smaller deals that might have slipped under the radar of antitrust authorities. Comments will be accepted until May 6.
Key context: The number of private equity firms in health care has exploded in recent years, sparking criticism from politicians and watchdogs who say the financiers enrich investors by monopolizing markets, raising prices and compromising patient care.
The view from the industry: “Washington regulators should stop playing election year politics with health care investments,” Drew Maloney, CEO of American Investment Council, said in a statement to The Health 202. “Private equity investments fuel lifesaving innovation and high quality care facilities that benefit patients and providers.”
Meanwhile, at the Food and Drug Administration …
- Independent advisers voted unanimously to recommend that the agency approve three-strain flu vaccines for the 2024-2025 season, shifting away from the four-in-one shots that have been the industry standard in recent years, according to Stat’s Helen Branswell.
- Federal regulators greenlit the nation’s first over-the-counter continuous blood sugar monitor, a move that is expected to increase access for individuals who face barriers obtaining a prescription.
In other health news
- A federal appeals court ruled yesterday that South Carolina cannot cut off Medicaid funding to Planned Parenthood, finding that doing so would deprive beneficiaries of the right to choose their provider, Brendan Pierson reports for Reuters.
- Novo Nordisk’s blockbuster diabetes drug Ozempic helped delay kidney disease and prevent cardiovascular events in a clinical trial, bolstering the company’s case as it looks to expand the medication’s label.
- The Centers for Medicare and Medicaid Services approved Louisiana’s request to provide community-based mobile crisis services to individuals with Medicaid, making it the 16th state to implement the policy.
Health reads
Sugar rush
Thanks for reading! See you tomorrow.
