Morning Consult Health, Presented by Purdue Pharma: CMS to Pay $468.5 Million to New York, Minnesota for Lost Cost-Sharing Subsidies

Top Stories

  • The Centers for Medicare and Medicaid Services will pay $468.5 million to New York and Minnesota combined after both states brought forth cases against the Trump administration in response to losing funding for Affordable Care Act programs that provide health care to low-income residents. The elimination of cost-sharing reductions by the administration reduced funding for the states’ Basic Health Programs, and CMS issued an administrative order to make payments of $422,206,235 to New York and $46,276,090 to Minnesota for the first three quarters of 2018 to compensate for the loss of the CSR payments. (The Washington Post)
  • Senate Republicans have signed off on a legislative package to fight the opioid crisis, and Majority Leader Mitch McConnell (R-Ky.) said he hopes Democrats will do the same so a vote can be held next month. The package is expected to include a bill backed by President Donald Trump that will aid the Postal Service in preventing illicit fentanyl from entering the United States. (The Washington Examiner)
  • The number of uninsured people in the United States declined to 28.3 million in the first quarter of 2018, or 12.5 percent of the population, according to the Centers for Disease Control and Prevention, down from 29.3 million last year and 48.6 million in 2010, when the ACA became law. About 20 percent of the insured population was covered by a public plan, while 70 percent was covered by a private plan. (Bloomberg)

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Events Calendar (All Times Local)

VHA Innovation Experience 8 a.m.
International Conference on Emerging Infectious Diseases 8 a.m.
Senate HELP hearing on FDA Oversight: Leveraging Cutting-Edge Science and Protecting Public Health 10 a.m.
Anatomy of a Healthcare Data Breach—HIPAA, FTC, and EU GDPR Implications 12 p.m.
VHA Innovation Experience 8 a.m.
Introduction to the Hospice Quality Reporting Program (HQRP) 2 p.m.
No events scheduled

We make prescription opioids. And we want to limit their use.

For more than 25 years, Purdue Pharma has developed opioid medications for patients with acute and chronic pain. Due to the public health risks opioids can create, we support doctors and pharmacists in reducing prescription drug abuse; educators in addressing the crisis in schools; and law enforcement in providing the overdose rescue drug naloxone. Together, we can develop meaningful solutions to this complex crisis.


California gov candidate backs universal healthcare for undocumented immigrants
Megan Keller, The Hill

California Lt. Gov. Gavin Newsom (D), who is running for governor, said in an interview released Tuesday that he would like to see the state pay for universal healthcare for all illegal immigrants. “I did universal healthcare when I was mayor — fully implemented, regardless of pre-existing condition, ability to pay, and regardless of your immigration status,” Newsom told the podcast Pod Save America, referencing his stint as San Francisco’s mayor.

Judge dismisses lawsuit challenging petition to put Medicaid expansion before Nebraska voters
Joe Duggan, Omaha World-Herald

A judge has tossed out a lawsuit intended to prevent voters from deciding whether more Nebraskans should qualify for Medicaid assistance. Lancaster County District Judge Darla Ideus on Tuesday rejected arguments that the successful Medicaid petition is “invalid and legally insufficient.”

GOP eyes another shot at ObamaCare repeal after McCain’s death
Alexander Bolton, The Hill

Senate Republicans say they would like Arizona Gov. Doug Ducey (R) to appoint a successor to late Sen. John McCain (R-Ariz.) who, unlike McCain, would support GOP legislation to repeal ObamaCare. GOP lawmakers say they won’t have time to hold another vote to repeal the law in 2018 but vow to try again next year if they manage to keep their Senate and House majorities.

Gun-related homicides, suicides kill more people than war, study says
Jen Christensen, CNN

Mass shootings and acts of terrorism may dominate headlines, but it’s the homicides and, to a lesser extent, the suicides that happen out of the spotlight that make up the bulk of firearm-related deaths around the world, according to a study published Tuesday in the journal JAMA. More gun deaths happened outside of war than in it during the years researchers examined (1990 through 2016) in 195 countries and territories.

South Dakota asks Trump administration to approve Medicaid work requirements for parents, caretakers
Jessie Hellmann, The Hill

South Dakota health officials are asking the Trump administration to approve a program that would impose work requirements on some Medicaid recipients who are parents or caretakers. Under the proposal, parents aged 19 to 59 and other caretakers on Medicaid who live in South Dakota’s two most populous counties would have to work at least 80 hours a month, take classes or complete other activities to keep their coverage.

Former HHS Secretary Donna Shalala wins Democratic House primary in Florida
Max Greenwood, The Hill

Democrat Donna Shalala, a former Health and Human Services secretary under President Clinton and a long-time educator, won her House primary on Tuesday. Shalala emerged from a crowded Democratic primary in Florida’s 27th District with 32 percent of the vote, the Associated Press projected with 95 percent of precincts reporting.

NIH Comes Out Swinging On Opioid Abuse With Anticipated $40.4 Million To Research Chronic Pain
Robin Seaton Jefferson, Forbes

The NIH is pulling out all the stops to make President Donald Trump’s Initiative to Stop Opioid Abuse and Reduce Drug Supply and Demand a reality. And older Americans are likely to benefit every bit as much as young people.

McMaster’s SC Planned Parenthood Medicaid ban thwarted, for now
Gregory Yee, The Post and Courier

An attempt to ban South Carolina abortion clinics from receiving taxpayer money in the form of Medicaid payments has been thwarted for the time being. U.S. District Judge Mary Geiger Lewis granted a preliminary injunction against Gov. Henry McMaster’s ban, which originated in an executive order he issued in July.

Trump administration warns California against ‘safe’ opioid injection sites
Victoria Colliver et al., Politico

The Justice Department is threatening to shut down San Francisco’s proposed test of supervised injection sites amid the opioid crisis even before the governor has a chance to sign the pilot program into law. The looming showdown could affect similar efforts in New York, Philadelphia and Seattle, where officials have grappled with the ramifications of setting up spaces where drug users could shoot up while gaining access to clean syringes, medical professionals and treatment services as an approach to curb opioid addiction and overdose deaths.

Worldwide gun deaths reach 250,000 yearly; US ranks high
Lindsey Tanner

Gun deaths worldwide total about 250,000 yearly and the United States is among just six countries that make up half of those fatalities, a study found. The results from one of the most comprehensive analyses of firearm deaths reveal “a major public health problem for humanity,” according to an editorial published with the study Tuesday in the Journal of the American Medical Association.

Stocks Edge Higher With Treasuries; Dollar Steady: Markets Wrap
Samuel Potter, Bloomberg

European stocks and U.S. equity futures edged higher on Wednesday after a lackluster Asian session, with investors largely treading water as they await the next developments on trade. The euro slipped and the pound drifted.


Thousands plead with the feds to stop Bevin’s Medicaid overhaul
Deborah Yetter, Louisville Courier Journal

An unprecedented number of comments — 11,561 of them — poured in by the Aug. 18 close of a 30-day federal public comment period on Bevin’s plan, compared to about 1,800 public comments the first time Bevin introduced his plan in 2016. Comments are running about 20 to 1 against the plan known as a “waiver,” according to an analysis by a team of Kentucky health advocates who have been working since Aug. 18 to read all of the comments.

Why CBO won’t estimate cost of Bernie Sanders’s ‘Medicare for all’ bill
Peter Sullivan, The Hill

A recent study concluding that Sen. Bernie Sanders’s “Medicare for all” bill would cost $32 trillion has set off a furious debate over the cost of the plan. But there’s one estimate that would make an even bigger splash: the score from the nonpartisan Congressional Budget Office (CBO).

Obamacare premiums set to increase by 5% in 2019
Naseem S. Miller, Orlando Sentinel

The cost of premiums in the 2019 Obamacare marketplace is projected to increase by 5.2 percent, a modest rise compared with last year’s rates, which went up by as much as 45 percent, according to data released by the Florida Office of Insurance Regulation on Tuesday afternoon. Seven insurance companies have signed up to offer plans in the marketplace next year, with rate increases ranging from 2.4 percent to 9.8 percent.

TennCare favors insurers over hospitals for needy
Jonathan Mattise, The Associated Press

A large hospital system in Tennessee has sued the state’s Medicaid program, TennCare, saying it’s purposefully siphoning money from hospitals that treat the neediest patients in order to favor insurance companies that often employ former TennCare employees. Erlanger Health System in Chattanooga says Tennessee officials are ignoring a 2007 state law in terms of how it pays some hospitals.


A Little-Known Windfall for Some Hospitals, Now Facing Big Cuts
Austin Frakt, The New York Times

Most hospitals are nonprofit and justify their exemption from taxation with community service and charity care. But the Trump administration could require some of them to do more to help the poor, and the hospitals that are in the cross-hairs are those benefiting from an obscure drug discount program known as 340B.

Henry Ford, DMC aim to get closer to patients
Jay Greene, Modern Healthcare

Henry Ford Health System is planning at least two other new outpatient medical centers in Bloomfield Hills and Macomb County and two expanded medical centers in Royal Oak and Downriver to further build out its 28-center network in metro Detroit, health system officials say. Looking to provide care closer to patients in a less costly and more convenient way than hospitals can, six-hospital Henry Ford also wants to stay ahead of its competitors, which include health systems like Detroit Medical Center, Beaumont Health and Ascension Health in Southeast Michigan, but also a growing number of physician and corporate-owned outpatient centers.

Doctors Would Like Trump To Reduce Paperwork Without Cutting Their Pay
Bruce Japsen, Forbes

In a rare showing of support for a Trump administration healthcare policy, 150 medical groups praised a White House effort to ease “documentation requirements”  but they don’t want billing codes so simple they cut doctor pay. The Centers for Medicare & Medicaid Services (CMS) has introduced a “Patients Over Paperwork” initiative as part of the administration’s proposed 2019 Medicare physician payment rule, which establishes regulations and fee schedules for hundreds of thousands of doctors.

Pharma, Biotech and Devices

Watchdog asks ethics officials to probe Azar over industry ties and views on rebates
Ed Silverman, Stat News

A watchdog group has asked ethics officials at the Department of Health and Human Services to investigate the relationship between Alex Azar, who heads the department, and Eli Lilly (LLY), his former employer, over a recently proposed rule that would benefit drug makers. The request by the Campaign for Accountability, a nonprofit, comes in response to a proposal the Trump administration is considering to reduce or restrict rebates, which are essentially a type of discount that drug makers provide pharmacy benefit managers off the wholesale, or list, price for their medicines in order to receive favorable placement on formularies, which are lists of insured drugs.

The Trump administration is starting to overhaul its guidelines for companies that make mail-order DNA
Ike Swetlitz, Stat News

The Trump administration wants to modernize the federal guidelines for companies that sell made-to-order DNA in hopes of keeping dangerous genetic material — like smallpox or the Ebola virus — out of the hands of malicious potential customers, federal officials confirmed to STAT this week. The administration’s work is still in early stages, and it’s too soon to tell whether or how the government will make the guidelines more stringent, as companies and experts in the space have called for.

MetroHealth sues Purdue Pharma, other drug companies over nation’s opioid epidemic
Eric Heisig,

MetroHealth, the Cuyahoga County-based hospital system, filed suit Tuesday against drug companies over the nation’s opioid epidemic. The hospital system says companies like Purdue Pharma and Johnson & Johnson overstated the benefits of powerful pain medication such as OxyContin and downplayed the addiction risks of prescription opioids.

Health IT

Epic cautions against irresponsible data-sharing
Rachel Z. Arndt, Modern Healthcare

Judy Faulkner and other leaders from Epic System Corp. issued words of warning about the data-management practices of companies outside of healthcare, urging customers to be wary of products claiming to do anything for free. These companies often do not comply with HIPAA and they sometimes steer patients toward inappropriate services or share too much data, as Facebook did with Cambridge Analytica, Faulkner said at Epic’s users group meeting where she donned a scout costume, duck boots, and a ranger hat to celebrate the meeting’s “great outdoors” theme.

A Message from Purdue Pharma:

For more than 25 years, Purdue Pharma has developed opioid medications for patients with acute and chronic pain. Due to the public health risks opioids can create, we support doctors and pharmacists in reducing prescription drug abuse; educators in addressing the crisis in schools; and law enforcement in providing the overdose rescue drug naloxone. Together, we can develop meaningful solutions to this complex crisis.

Opinions, Editorials and Perspectives

Advanced Practice Providers Critical in Reversing America’s Opioid Crisis
Jonathan Sobel, Morning Consult

For Richard Bottner, a physician assistant practicing hospital medicine and palliative care at a community hospital in Texas, it’s common for him to encounter patients suffering from opioid use disorder. So, he decided to learn more about OUD, but he had no idea that what he would learn would end up saving a patient’s life.

Trump might actually lower drug prices
Dana Goldman and Anupam Jena, The Washington Post

Surprise! The Trump administration is actually making progress to reduce drug prices, and not just by “browbeating” pharmaceutical executives. The Centers for Medicare & Medicaid Services recently announced new options to increase competition for physician-administered drugs and lower the cost of some innovative medications, and the Food and Drug Administration is exploring importation to create more competition in the generics market.

FDA’s continuing use of ‘black box’ for antidepressants ignores the harms of this warning
Stephen Soumerai and Ross Koppel, Stat News

The Food and Drug Administration’s “black box” warnings and advisories give important safety information about drugs. But they can sometimes go too far and harm more people than they help. Take the FDA’s highly publicized warnings that taking antidepressants increases the risk of suicidality (defined as serious thoughts about taking one’s own life or planning or attempting suicide) among children, adolescents, and young adults. We have evidence, as do many others, that these warnings have decreased youths’ access to mental health care and increased suicide attempts.

Research Reports

Analysis of the Impacts of the ACA’s Tax On Health Insurance In Year 2020 and Later
Chris Carlson et al., Oliver Wyman

This report provides an analysis of the impact of the tax on health insurance premiums beginning in 2020. In addition, we provide the allocation of these taxes across each state and line of business and describe the number of individuals whose coverage is impacted by the tax on health insurance.

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