Hot Topics in Health Care - November 2022
Physician Groups Voice Strong Opposition to Proposed Expanded Scope of Practice for Non-Physician Practitioners
The American Medical Association and over 80 other physician industry groups have come out in strong opposition to H.R. 8812, the “Improving Care and Access to Nurses Act,” known as the “I CAN Act.” The Act purports to remove outdated federal barriers to the nursing practice, which its supporters argue will improve patient access to quality health care. For example, the Act would allow non-physician practitioners to provide certain tasks and services without the supervision of a physician. In a November 2 letter to Congress, leading physician organizations called the Act a “broad, sweeping bill” that if passed, would “endanger the quality of care” provided to patients.
One to Watch: U.S. Supreme Court Hears Oral Arguments on Medicaid Patients’ Rights to Sue
Kaiser Health News reports that the U.S. Supreme Court heard oral arguments on November 8, 2022, regarding “whether Medicaid beneficiaries can seek relief in federal court when they believe their rights are being violated by state officials, or whether enforcement of state compliance with federal Medicaid rules should be left solely to the federal Centers for Medicare and Medicaid Services (CMS).” In the case, Health & Hospital Corporation of Marion County (HHC) v. Talevski, the family of a deceased nursing home resident sued a state operated nursing home under Section 1983, alleging the nursing home violated the Federal Nursing Home Reform Act (FNHRA). A federal district court initially dismissed the case “ruling that Medicaid enrollees cannot enforce the FNHRA.” The Seventh Circuit reversed the district court ruling and the Supreme Court now considers two questions. As reported by Kaiser Health News, “[t]he first is broadly whether the court should reexamine its longstanding position that individuals have a right to sue in federal court to protect rights for legislation created under the Spending Clause of the constitution (e.g., federal laws including Medicaid, the Children’s Health Program, and the Supplemental Nutrition Assistance Program (SNAP)). The second, more narrow question, is assuming that individuals do have enforceable rights, are the rights guaranteed under FNHRA enforceable.”
Cyber Attacks an “Increasingly Dangerous Threat” to American Health Care Providers
In a report released this month, the Senate Intelligence Committee found that the health care sector is “uniquely vulnerable to cyberattacks” and that cybersecurity amongst the sector is “inadequate.” Noting that severe cyberattacks impacting patient care is “no longer a matter of if or when, but how often and how catastrophic[,]” the report includes several recommendations to improve cybersecurity, including enhancing federal cybersecurity leadership, improving HIPAA regulations, and providing incentives to private providers to adopt minimum cybersecurity practices to mitigate threats.
Tricare Drops 15,000 Pharmacies from Network
Kaiser Health News reports that Tricare dropped nearly 15,000 pharmacies from its network at the end of October, which is estimated to impact more than 400,000 military beneficiaries. “The move has upset customers and many independent pharmacies and has raised concerns among some service member advocates and lawmakers, especially those in rural states, who feel it disproportionally affects rural veterans.”
Source: Kaiser Health News
Senate Investigation Reports Medicare Advantage Plans Misled Seniors
A November 2022, investigatory report released by the U.S. Senate Committee on Finance found that Medicare beneficiaries are being “inundated with aggressive marketing tactics as well as false and misleading information” from Medicare Advantage Plans. Medicare Advantage plans provide coverage for over half of all Medicare beneficiaries and account for approximately $427 billion in Federal spending. The Senate’s report found that false and misleading marketing from Medicare Advantage plans often results in beneficiaries experiencing “higher out-of-pocket costs” and increased difficulty in finding and accessing providers. As a result, Medicare intends to begin reviewing marketing materials more closely, including requiring television ads to be approved prior to airing.