Litigation and Enforcement Highlights – January 2021
Amy Y. Gu, Managing Editor January 14, 2021
We kick off the new year with a handful of new developments in healthcare litigation and enforcement that transpired at the end of 2020. In price transparency, a pair of legal challenges intended to block transparency efforts in drug pricing and hospital pricing, respectively, were denied by the circuit courts. On the antitrust front, the Federal Trade Commission saw both victory and defeat in its challenges of proposed mergers that would lessen competition in the healthcare markets. Judges Refuses to Block California’s Drug Pricing Transparency Law SB 17 On …
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Health Affairs Blog Posts Highlight the Database of State Laws Impacting Healthcare Cost and Quality
Amy Y. Gu, Managing Editor January 14, 2021
The Source kicked off the New Year with a trio of blog posts in the Health Affairs Blog that highlights the Database of State Laws Impacting Healthcare Cost and Quality (SLIHCQ). The SLIHCQ Database was developed in partnership with the Catalyst for Payment Reform (“CPR”) and is an interactive tool that hosts ongoing state legislative efforts to implement healthcare reform. It is intuitively designed to allow policymakers and other stakeholders to customize and filter their searches by key issue and state. In collaboration with CPR, The Source Executive Editor Jaime …
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The Source Roundup: January 2021 Edition
Alex Montague, Health Policy Researcher January 4, 2021
Happy New Year Source readers! In this month’s roundup, we take a look back at the last health policy articles of 2020 and look ahead to what 2021 holds. These pieces examine the continuing rise of national healthcare spending, the impacts of health market consolidation under the guise of healthcare delivery integration, the importance of state-level all-claims payer databases (APCDs), and the potential healthcare system reforms under the Biden administration. Healthcare Costs Underpinning most topics in this roundup is the issue of healthcare costs, prices, and spending. According to …
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Expanding Scope of Practice for Nurse Practitioners in California: AB 890 Compromises to Permit Independent Practice
Alex Montague, Health Policy Researcher December 15, 2020
This legislative session, California Governor Gavin Newsom signed AB 890, legislation that expands the existing scope of practice laws for nurse practitioners (NPs).[1] The law brings California in line with over half of the states in the U.S. by permitting NPs to practice independently and to the full extent of their training and education. As demand for healthcare workers continues to surge with the number of COVID-19 cases in this country, AB 890 helps pave the way for more healthcare providers to provide crucial care where it is needed. This …
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Year in Review: 2020 Sees A Flurry of Federal Healthcare Antitrust Challenges
Amy Y. Gu, Managing Editor December 14, 2020
As the COVID-19 pandemic continues to ravage the nation, it has put economic stress on smaller healthcare providers, giving larger health systems the opportunity to gain market power through more rampant merger and acquisition activity. In response, the Federal Trade Commission and the Department of Justice also stepped up their antitrust enforcement efforts. In this year-end Litigation and Enforcement Highlights issue, we round up federal enforcement challenges of provider mergers in 2020 and look at the latest status of these actions. Jefferson Health/Albert Einstein (Pennsylvania) The Federal Trade Commission …
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[Sutter Case Watch] 60 Minutes Episode: “The High Cost of Healing” Highlights Sutter Health Antitrust Case
Amy Y. Gu, Managing Editor December 14, 2020
In a new 60 Minutes episode aired on 12/13/20 (S53 E15), CBS interviews California attorney general Xavier Becerra in its investigation of anticompetitive practices by Sutter Health that led to higher health care costs in California. Watch the story here.
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A Decision in Rutledge: The Supreme Court Upholds States’ Rights to Regulate Health Care Costs
Katie Gudiksen, Senior Health Policy Researcher December 11, 2020
On December 10, 2020, the Supreme Court overturned a decision by the Eighth Circuit and upheld an Arkansas Law to regulate pharmacy benefit managers (PBMs). In a unanimous decision (8-0, Justice Barrett did not participate in the case), the court reaffirmed that state regulation of prices is not preempted by the Employee Retirement Income Security Act of 1974 (ERISA). The ruling in this case found that Arkansas’ law was a price regulation. In effect, the law required PBMs to reimburse pharmacies at a rate above the price the pharmacy paid …
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[Article Highlight] Why the Biden Administration Should Help States Develop Capitated Public Options
Amy Y. Gu, Managing Editor December 9, 2020
A new article published in the Milbank Quarterly Opinion proposes the new Biden administration should help states develop capitated public options as part of its health policy agenda, which could lay the groundwork for a federal public option. Authored by Source Advisory Board Member Richard Scheffler and Thomas Rice, the article examines the recent efforts of Washington and Colorado in developing quasi-public options in their states. The authors identify specific states, including California, Massachusetts, and Rhode Island, as being most ready for such a risk-based capitation program. Finally, they call …
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The Source Roundup: December 2020 Edition
Amy Y. Gu, Managing Editor December 1, 2020
In the final monthly roundup of this tumultuous year, we highlight articles and reports that examine 1) rising and varying healthcare costs and their pronounced impact on Americans during the pandemic; 2) antitrust enforcement challenges of private equity partial ownership and joint ventures; 3) continued success of the Affordable Care Act in both marketplace participation and coverage protections for Americans amidst the pandemic; and 4) value-based pricing for COVID-19 treatment and vaccines. Rising and Varying Healthcare Costs Increase Burden to Americans In the Kaiser Family Foundation report How costly …
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[Case Brief] Atrium Health Settlement Encourages Enforcement of Anti-tiering/Anti-steering Clauses in Healthcare Contracts
Amy Y. Gu, Managing Editor November 16, 2020
Editor’s Note: An abbreviated summary of this case appears in the research report “Preventing Anticompetitive Contracting Practices in Healthcare Markets”, which provides a detailed analysis of anti-tiering/anti-steering clauses, including economic justification and procompetitive use and states that have restricted its use in healthcare contracts. The antitrust case against Sutter Health in California has drawn the attention of state regulators and policymakers across the country, spawning legislative reform efforts to curb dominant hospitals’ market power. Prior to this, an enforcement action against Atrium Health, a large health system on the …
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