Pennsylvania Governor Tom Wolf signed SB 115, which authorizes Pennsylvania to join the Nurse Licensure Compact (NLC). To date, 34 states are part of the NLC, which recognizes mutual agreement in the requirements of the professional licensure of nurses and reciprocity of license transfer between member states. ​In 2016, Gov. Wolf signed Act 112 into law which authorized the Commonwealth to join the Interstate Medical Licensure Compact (IMLC). Like the NLC, the IMLC recognizes mutual agreement in the requirements for physician licensing and provides the benefit of easier transfer of licenses from states within the compact.

The Southwest Rural Health Research Center at Texas A&M University with funding support from the Federal Office of Rural Health Policy is conducting a survey as part of Rural Healthy People 2030 – a project designed to understand the most important health priorities for rural Americans. This once in a decade survey allows individuals who care about rural health like you to voice your opinions on important topics for the health of rural individuals in the United States.  The study should take no longer than 15 minutes.

Follow this link to the Survey:
Take the Survey

CMS is proposing Medicare payment rates for hospital outpatient and Ambulatory Surgical Center (ASC) services.

The Calendar Year (CY) 2022 Hospital Outpatient Prospective Payment System (OPPS) and ASC Payment System Proposed Rule is published annually. Statute requires the final rule display by November 1. The rule addresses the Inpatient Only and ASC Covered Procedures lists, using 2019 claims data for payment rates, seeking comment on remote mental health services made eligible for payment during the Public Health Emergency, a new quality measure on vaccination rates for front line health workers, seeking comment to advance health equity through new rural emergency hospitals, and updating policies related to CMMI’s Radiation Oncology Model​.

Below are three links with information relating to the long anticipated OPPS_ASC Proposed Rule which was released by CMS and is scheduled to be published in the Federal Register on August 4, with a 60 day comment period.

Web links

Federal Registrar: https://www.federalregister.gov/public-inspection/current

Press Release: https://www.cms.gov/newsroom/press-releases/cms-proposes-rule-increase-price-transparency-access-care-safety-health-equity  

Fact Sheet:  https://www.cms.gov/newsroom/fact-sheets/cy-2022-medicare-hospital-outpatient-prospective-payment-system-and-ambulatory-surgical-center

The COVID-19 pandemic accelerated the exodus from private practice to corporate medicine, Fierce Healthcare reports. Between January 1, 2019, and January 1, 2021, hospitals, payers, and other corporate entities acquired 20,900 physician practices, according to the Physicians Advocacy Institute. During that period, 48,400 physicians left independent practice to work for a larger employer. About half of those increases occurred between July 1, 2020, and January 1, 2021. As of January 1, 2021, nearly half of all U.S. practices were owned by hospitals or corporate entities, and 70 percent of physicians were employed by them.

Read more.

Highmark Health will grow by more than 350,000 members if state regulators approve a proposed deal to acquire sole ownership of Gateway Health. The acquisition would expand Highmark’s insurance rolls from 6 million to 6.355 million members, a nearly six percent increase. For nearly three decades, Highmark Inc., has owned 50 percent of Gateway, which is headquartered a few blocks from Highmark’s corporate high-rise in Pittsburgh. The remaining 50 percent of Gateway has been owned by Livonia, Michigan-based Trinity Health, whose provider network spans 90 hospitals and other services across 22 states. Gateway offers Medicaid, Medicare and dual-eligible coverage across Pennsylvania. Highmark’s proposed acquisition of Gateway comes just a few months after the insurer’s affiliation with HealthNow New York Inc. became effective. The newly affiliated organization — which expanded Highmark’s reach to four states — has been rebranded Highmark Blue Cross Blue Shield of Western New York and Highmark Blue Shield of Northeastern New York.

Read more.

The Office of Management and Budget released their Unified Regulatory Agenda (URA). The URA, which is updated twice each year, serves as an indicator of discrete regulatory priorities of the Administration and a timeline for expected action. However, the timelines are often aspirational and should not be viewed as hard and fast deadlines. The URA for the U.S. Department of Health and Human Services includes several Medicaid-oriented proposals, including:

• Streamlining the Medicaid and CHIP Application, Eligibility Determination, Enrollment, and Renewal Processes
• Medicaid Drug Misclassification, Beneficiary Access Protection, and Drug Program Administration
• Mandatory Medicaid and CHIP Core Set Reporting
• Medicaid Managed Care Risk-Sharing Mechanisms
• Temporary Federal Medical Assistance Percentage (FMAP) increase under the Families First Coronavirus Response Act

On July 9, President Biden signed an Executive Order aimed at curbing anti-competitive practices within several industries, including in health care. A fact sheet on the order is available here. Key provisions include:

• Drug Importation. The order directs the Food and Drug Administration (FDA) to work with states and Tribes on a plan to import prescription drugs from Canada, pursuant to the Medicare Modernization Act of 2003.
• The order directs the Department of Health and Human Services (HHS) to increase support for generic and biosimilar drugs.
• Drug Pricing. HHS is directed to issue a comprehensive plan within 45 days to combat high prescription drug prices and price gouging.
• Pay for Delay. The order encourages the Federal Trade Commission (FTC) to ban “pay for delay” and similar agreements in the pharmaceutical sector by way of federal rulemaking.
• Hospital Mergers. The order emphasizes that hospital mergers can be harmful to patients, encouraging the Department of Justice (DOJ) and FTC to review and revise hospital merger guidelines.