Stay in the know with Becker's Hospital Review's weekly roundup of the nation's biggest healthcare news. Here's what you need to know this week.
1. Supreme Court: Hospitals can't sue states over Medicaid reimbursement
In a 5-4 decision, the U.S. Supreme Court ruled that hospitals and other healthcare providers cannot sue to challenge Medicaid reimbursement rates set by states. The lawsuit was brought to the high court by healthcare providers who claimed the rates set by the state of Idaho for people with developmental disabilities were too low to comply with the federal Medicaid law. According to Bloomberg, a lower court agreed with the providers and ruled the rates didn't consider provider costs and were unlawful. In the Supreme Court case, the state of Idaho contested the providers had no legal recourse to sue, while the providers argued they had the right to sue under the supremacy clause of the Constitution. Going forward, providers must request the federal government intervene on their behalf if they feel Medicaid reimbursement rates are too low, according to the majority opinion in the case.
2. 36k sign up during ongoing special enrollment period for PPACA
Although millions of Americans are eligible, only about 36,000 people signed up for health insurance plans sold on HealthCare.gov from March 15 through March 29, according to CMS. Charles Gaba, operator of the PPACA tally-tracking site ACASignups.net, had expected about 220,000 people would have signed up under the grace period. HealthCare.gov's special enrollment period began March 15 and closes at the end of April. It is intended for individuals and families who did not have health coverage in 2014 and are subject to the fee or "shared responsibility payment" when they file their 2014 taxes in states which use the federally-facilitated marketplaces.
3. CMS delays RAC enforcement of 'two-midnight' rule
CMS announced the prohibition of Recovery Audit Contractor inpatient hospital patient status reviews under the "two-midnight" policy until April 30. The current statuary prohibition expired March 31. In late March, the House overwhelmingly voted in favor of legislation that repeals the sustainable growth rate in a 392-37 vote. The measure also includes a six month partial enforcement delay of the two-midnight policy. The Senate still needs to vote on the legislation.
4. House bill provision protects physicians in malpractice cases
When the U.S. House voted to repeal the sustainable growth rate and create a permanent "doc fix," they also voted to offer new protections for physicians against medical malpractice lawsuits, according to the New York Times. The legislation requires the government to assess physicians' quality of care and rate their performance on a scale of zero to 100. These scores are used by federal health programs like Medicare and Medicaid to decide how much to pay physicians in reimbursements. A provision of the legislation protects physicians by stipulating that providers, patients and lawyers are barred from using the federal standards and scores generated by the bill to prove negligence in malpractice cases.
5. Nebraska hospital releases 5 Americans found Ebola-free
After being quarantined for 21 days, the five American health workers being observed for Ebola at the Nebraska Medical Center in Omaha have been released and are Ebola-free. The healthcare workers were flown to the U.S. from Sierra Leone, where they had been volunteering in mid-March. The Nebraska Medical Center is one of the 55 Ebola treatment centers recognized by the Centers for Disease Control and Prevention.
6. Premera faces multiple class-action lawsuits over data breach
Mountlake Terrace, Wash.-based Premera Blue Cross faces up to five class-action lawsuits associated with its recently reported data breach, according to the Seattle Times. The lawsuits, filed in the U.S. District Court in Seattle, allege negligence, breach of contract, violation of the Washington Consumer Protection Act and failure to disclose the breach in a timely manner, among other alleged violations. Weitz & Luxenberg P.C. is one firm that filed a lawsuit on behalf of policy holders, alleging Premera failed to reasonably safeguard confidential data and didn't do enough to protect beneficiaries after the cyberattack. James Bilsborrow, a co-counsel of the class action, said the credit monitoring services Premera offered customers were inadequate.
7. MEDITECH, Merge, Kareo join CommonWell
CommonWell Health Alliance announced five new members joined the alliance, including MEDITECH, Merge, Kareo, PointClickCare and Surgical Information Systems. Boston-based CommonWell, a nonprofit trade association aiming to enhance interoperability in health IT, added EHR providers MEDITECH and Kareo and imaging systems company Merge as contributing members while long-term care software company PointClickCare and surgical software developer Surgical Information Systems became general members. The alliance's members now account for 70 percent of the acute-care EHR market and 20 percent of the ambulatory care market, according to a news release.
8. eClinicalWorks to incorporate wearable data into EHR
eClinicalWorks will integrate patient-generated data from wearable medical devices and fitness trackers using Healow, a wholly-owned subsidiary of the Westborough, Mass.-based eClinicalWorks. Boston-based Healow is an application that serves as a middleman to connect wearable devices to EHR systems. Healow will direct data from a user's wearable device into his or her personal health record and to Healow's mobile app. The data will also sync with the EHR and eClinicalWorks will provide analytics of a patient's daily habits, with his or her consent.
9. Google, Johnson & Johnson subsidiary partner to develop surgical robots
Google and Ethicon, a subsidiary of Johnson & Johnson, announced a partnership to develop a platform for robotic surgery. Google has not disclosed many details of the plan, but a spokesperson said its goal is to use algorithms to analyze images from robotic surgical cameras, highlight blood vessels and display critical information on screen. The display would give surgeons a more detailed view of information as they perform surgery, improving patient safety.
10. AmSurg acquires Halifax Anesthesiology Associates
Sheridan, AmSurg's physician services division, has acquired Daytona Beach, Fla.-based Halifax Anesthesiology Associates. The practice includes eight physicians and 23 certified registered nurse anesthetists.
11. Zimmer gets European Commission's OK for Biomet acquisition after knee business sale
The European Commission conditionally cleared Zimmer to acquire Biomet. According to the Wall Street Journal, the EC granted clearance if Zimmer divests certain assets — a knee implant business in the European Economic Area — comprising the remedy package the company previously submitted to the EC. Biomet would also need to sell an elbow and knee implant business. Zimmer expects to establish an agreement with a buyer for these assets in the near future. The Japan Fair Trade Commission already cleared the transaction, but the company still needs U.S. Federal Trade Commission clearance and the transaction is subject to other customary closing conditions.
12. Patients want to cost-compare with healthcare, but are they actually doing it?
While 86 percent of survey respondents reported they thought it was important to compare costs before seeing providers, 64 percent rarely or never price shop, according to a recent report from HealthMine. More than half of respondents — 54 percent — said it is difficult to understand their health information and next steps, and 75 percent believe plans should offer programs or guidelines for health management. Eighty percent of respondents indicated they want incentives for wellness.