Month: June 2023

June 29, 2023

KARA HARTNETT 

The Supreme Court ruling that higher education institutions may not consider race when making admission decisions could have far-reaching consequences for the healthcare industry.

The ruling issued Thursday applies to public and private schools that receive federal funding and culminates legal challenges to the admissions polices at the University of North Carolina and Harvard University. In 2014, applicants sued the colleges, arguing that applying affirmative action to admissions unfairly diminished their chances of being accepted. The Supreme Court’s conservative majority ruled 6-3 in their favor.

June 29, 2023

ALEX KACIK  

Healthcare costs are expected to rise 7% next year as providers deal with higher expenses and seek rate increases during contract negotiations with insurers.

The projection by PricewaterhouseCoopers’ Health Research Institute tops the consultancy’s estimates in 2022 and 2023, which were 5.5% and 6%, respectively.

For their annual report, PwC researchers spoke with actuaries who work with insurers covering 100 million employer-sponsored members and 10 million Affordable Care Act members to forecast healthcare inflation. The results were weighted by each health plan’s size.

June 28, 2023

Associated Press

WASHINGTON — The Justice Department has charged dozens of people in several healthcare fraud and prescription drug schemes, including one totaling $1.9 billion and a doctor accused of ordering fake ankle braces for a patient whose leg had been amputated, officials said Wednesday.

The scheme involving the submission of nearly $2 billion in bogus claims is one of the largest healthcare fraud cases ever brought by the Justice Department, the agency said. It’s one of several announced as part of a crackdown in states around the country.

Yakima Valley Memorial Hospital in Washington settles breach that affected 419 people

June 15, 2023

Today, the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced a settlement with Yakima Valley Memorial Hospital, a not-for-profit community hospital located in Yakima, Washington resolving an investigation under the Health Insurance Portability and Accountability Act of 1996 (HIPAA).  OCR investigated allegations that several security guards from Yakima Valley Memorial Hospital impermissibly accessed the medical records of 419 individuals.  HIPAA is a federal law that protects the privacy and security of protected health information.  The HIPAA Privacy, Security, and Breach Notification Rules apply to most health care organizations and set the requirements that HIPAA-regulated entities must follow to protect the privacy and security of health information.

June 14, 2023

VICTORIA TURNER 

National health expenditures will surpass $7 trillion and consume nearly one-fifth of the U.S. economy in 2031, according to projections the Centers for Medicare and Medicaid Services’ Office of the Actuary published Wednesday.

Healthcare spending will rise by an average of 5.4% a year from 2022 through 2031, when it will reach $7.17 trillion, or 19.6% of gross domestic product. “Health spending over the course of the next 10 years is expected to grow more rapidly, on average, than the overall economy,” CMS actuaries wrote in the journal Health Affairs.

June 08, 2023

NONA TEPPER 

Medicaid beneficiaries have the right to sue state agencies they allege break federal law, the Supreme Court ruled Thursday.

The 7-2 decision reaffirms previous precedent that U.S. District Court for the Northern District of Indiana challenged in 2020 when it dismissed a case against a county-owned nursing home accused of violating federal patient protection laws. The high court decision upholds a 2021 ruling by the U.S. Court of Appeals for the 7th Circuit. The case now returns to the district court.