The Weekly Ethical Roundabout

April 21-May 2

Federal:

SCOTUS Blog: In a 7-2 decision, the Supreme Court has ruled on the question of supplementary security income (SSI) benefit eligibility in regards to hospital payments. In Advocate Christ Medical Center v. Kennedy, SCOTUS ruled against the plaintiffs, over 200 hospitals, on the proper use of the formula used to determine compensation under Medicare. The plaintiff hospitals interpreted the formula to include all patients enrolled in SSI benefit programs, which was disputed by HHS, which held the formula should apply only to patients eligible to receive SSI benefits during the time of hospitalization. The Court held that the Medicare statute intended SSI benefits to be determined monthly and therefore, the formula interpretation of HHS was correct.

STAT News: President Trump has issued an executive order to address increasing pharmaceutical prices and fees. The Executive Order states the government’s policy is to optimize pharmaceutical prices to lower consumer costs. Among the sections of the expansive order are instructions to the Secretary of HHS to improve the Medicare Drug Price Negotiation Program, to the Assistant to for Domestic Policy to provide the President with recommendations to reduce Medicare Part D premiums, and commission a report on anti-competitive behavior by pharmaceutical manufacturers.

Fierce Healthcare: The chair of the Senate Health, Education, Labor, and Pensions Committee, Senator Bill Cassidy, has released a report on the use and revenue of the 340B Drug Pricing Program. The 340B Program was created in 1992 to allow specified programs serving indigent patients to purchase discounted pharmaceuticals. Senator Cassidy’s report details that healthcare facilities obtaining 340B revenue did not transfer savings to patients, pharmacies charged a number of additional fees to eligible clinics, which diverted Program resources, and drug manufacturers have found it difficult to prevent unlawful diversion of Program funds. The Cassidy report outlines several potential congressional reforms to the program to address these shortfalls and clarify program utilization.

State:

Michigan Advance: The Michigan Senate has passed a package of three healthcare-related bills intended to address rising prescription drug costs. Senate Bills 3, 4, and 5 will create a drug pricing board and a drug affordability council, and compel insurers and medical assistance programs to comply with the boards’ analysis. As the House is controlled by the opposition party, passage of the bill package is not assured.

Statesman Journal: An Oregon medical debt bill has been read in the House after passing through the Senate this week. Senate Bill 605 will prohibit medical providers from referring medical debt to consumer reporting agencies. If passed, Oregon will become the third state, after New York and Colorado, to ban the reporting of medical debt.

Texas Tribune: A bill to provide clarity on a Texas abortion law has been passed by the Senate committee on state affairs. Senate Bill 31 will maintain the state’s prohibition on elective abortion procedures, but provides a refined definition of physician medical judgment and exceptions to the current law’s prohibition.

VT Digger: A Vermont bill to exclude medical debt from credit reports has passed the State House and will now be reviewed by the Senate. Senate Bill 27 will permit the State Treasurer to acquire the medical debt of residents with income at or below 400% of the federal poverty line or with debt equal to 5% of their income. In addition, the bill will prohibit credit agencies from reporting on medical debt held by state residents.

PR Newswire: A bill to create a diversion program for physicians under investigation by the Medical Board of California has moved to the Judiciary Committee. Assembly Bill 408 would allow for the creation of a Physician and Surgeon Health and Wellness Program to assist physicians struggling with physical or mental impairments, including substance use disorders. A previous diversion program was shuttered after failing five state-led audits.

Glances Abroad:

IOL: South Africa’s National Health Insurance (NHI) Act is facing legal challenges from the South African Medical Association (SAMA) over concerns of its impact on the stability of the nation’s healthcare system. The SAMA is concerned that passing the NHI Act will diminish healthcare access and quality due to increased bureaucracy and the replacement of private clinics.

WeAreTech.Africa: The Senegal Health and Social Action Minister has announced the adoption of a health policy to optimize digitalization of the nation’s medical industry. This policy comes ahead of draft legislation that will institute guidelines on the collection and storage of digital health information.