Stay ahead of the headlines

Dec 14, 2023·Politico

AI regulations in healthcare coming in 2024. Increased transparency required in clinical settings for fair, appropriate, safe and effective AI use. Rule also includes software developers providing information on AI technology mechanisms and development details. 2024 expected to be a significant year for AI in healthcare according to the report from KLAS Research.

Dec 11, 2023·Reuters

Cigna drops Humana acquisition due to price disagreement; plans $10B share buyback. Potential $140B Cigna-Humana merger faces antitrust concerns. Cigna explores Medicare Advantage business sale, despite sector expansion.

Dec 11, 2023·The Hill

Quarter of US medical students consider quitting due to mental health and study-life balance concerns, detected by Elsevier survey. Streamlining for non-patient-facing roles observed.

Dec 10, 2023·BBC

UK's Competition and Markets Authority probes Microsoft-OpenAI partnership for potential merger; investigates impact on AI market. Recent turmoil at OpenAI, heightened by sudden firing of CEO Sam Altman, raises questions about competition and AI development. Microsoft, OpenAI's biggest investor, maintains partnership has fostered AI innovation and competition. Investigations could result in probe if potential restrictions to UK competition are discovered.

Dec 8, 2023·Healthcare IT News

American Hospital Association (AHA) warns U.S. Department of Health and Human Services' (HHS) new cyber resilience strategy for medical sector may adversely impact hospitals following cyberattacks. The strategy includes new cybersecurity requirements for hospitals and financial measures for non-compliance, despite AHA's billion-dollar investments in cybersecurity. AHA asserts cyber defense should involve collaboration of federal government against sophisticated, often foreign, hackers and opposes mandatory cybersecurity rules for hospitals. HHS alongside Congress plans to increase civil monetary penalties for HIPAA violations.

Dec 7, 2023·Beckers Hospital Review

Mark Cuban launched an online pharmacy in 2022, pricing medications with manufacturing fee, 15% markup, shipping and handling. Subsequently, Express Scripts and CVS adopt similar approaches. U.S. drug prices are averagely 2.5 times higher than in 32 countries, with complex pricing methods. Pharmacies negotiate prices with distributors and pricing models often include markup and handling fees. With rising drug costs, many health system pharmacy leaders fear cutting services. Cuban, Express Scripts, CVS aim for more transparent pricing, while Cigna Group's Express Scripts' ClearNetwork, CVS's CostVantage and Caremark's TrueCost, UnitedHealth Group's Optum Rx, and Elevance Health plan to offer cost-based services for drugs, aiming for price transparency.

Dec 6, 2023·CNN

US Department of Health and Human Services (HHS) plans to increase federal funding for cybersecurity in rural hospitals and impose stricter fines for inadequate security. New plan addresses ongoing cyberattacks disrupting healthcare. Plan implementation depends on securing increased Congress funding. Cybersecurity lack in small healthcare providers is critical issue. Federal policies must accelerate to mitigate increasing harms to public safety and trust.

Dec 3, 2023·Vinson & Elkins LLP

New York’s Department of Financial Services fined First American Title Insurance Company $1m for inadequate implementation of cybersecurity policies, marking reminder to organizations for practical cybersec policy execution. Issue was noted with EaglePro app, offering unauthorized document access. Triggering review for other firms under cybersecurity regulations like Federal Trade Commission Act, Sarbanes-Oxley Act.

Dec 3, 2023·STAT News

UnitedHealth Group employs or affiliates 90,000 U.S. doctors, 10% total, adding 20,000 past year. The major insurer seeks greater control over health care delivery, amid unchecked growth by antitrust agencies.

Dec 1, 2023·AMA

AMA released principles for AI in health care fostering consistent governance. AMA advocacy aims to support implementation of national policies prioritizing ethical, equitable, responsible, transparent AI development and deployment. Recognizing AI's potential and ethical considerations, principles guide AMA engagement in policy discussion. Principles call for comprehensive policy mitigating risks and maximizing benefits. Key principles include oversight, transparency, disclosure/documentation, generative AI, privacy/security, bias mitigation, and liability. Also addressed, AI usage by payors in decision-making, urging to not reduce or systematically withhold care. AMA aims to ensure safe, quality, unbiased, validated AI products brought to market.

Nov 30, 2023·Beckers Payer

Cigna and Humana negotiate merger; to finalize stock-cash deal by end 2023. Cigna-Humana merger would create US healthcare giant and rival UnitedHealth Group, Elevance Health, and CVS; Cigna and Humana's market values are $83 billion and $62 billion. Cigna previously considered selling its Medicare Advantage business and attempted merger with Elevance Health.

Nov 28, 2023·Healthcare IT News

HHS advances proposed info-blocking rules that could penalize noncompliant Medicare providers. Comments due by 2024; penalties possibly enforced sooner. HHS, Foley & Lardner, and American Telemedicine Association review key exceptions, data security strategies. Noncompliant providers may be fined thousands under Promoting Interoperability Program, affecting eligibility of clinicians within other CMS programs. Info-blocking referrals investigated case-by-case; participants in Medicare Shared Savings Program may face year-long bans. Eight exceptions necessitate employee training to avoid unintentional rule violations. Info-blocking rules require privacy exception authorize disclosure, impacting HIPAA regulations. Infeasibility, preventing harm exceptions have conditions. Interference with access, exchange or use of EHI may result in harm exception application. Penalties apply annually.

Nov 27, 2023·Fortune

OpenAI co-founder Altman, restored as CEO after abrupt ousting, spotlight with ChatGPT's popularity in AI advance. Microsoft drove his return, funding OpenAI. Experts call for government AI regulation, not corporate control, for safety, trust. Generative AI's risks currently governed by tech companies as world regulation lags.

Nov 23, 2023·Axios

New York proposes first state mandate for minimum hospital cybersecurity, including attack response plans. Proposed redistribution of $500m from 2024 fiscal budget to support hospitals in preparations. Proposes securing systems to support normal operations, designating security officer, conducting risk assessments, multiplayer authentication, and audit trails for quicker response to attacks. Cybersecurity viewed increasingly as patient safety issue. Federal government eyeing minimum standards for critical infrastructure. If passed, hospitals have one year to comply.

Nov 20, 2023·Beckers Hospital Review

Intermountain Health is developing innovative pay models for sustainable care system. The healthcare is built around acute care, focusing on end-of-life care, with limited reimbursement for prevention and wellness. Intermountain aims to change the transactional nature of healthcare, proposing a prepaid model for faster access to services and healthier lives. The prepaid approach allows the adoption of new technologies and care delivery methods. It's working to build care networks with full financial accountability and capitation arrangements. The focus is reducing costs, creating value amid increasing demand and clinician shortages, using models that reduce the need of seeing a provider. The prepaid model supports value-based transitions, allowing efficient care and new treatment methods.

Nov 17, 2023·The Register

UnitedHealthcare sued for allegedly denying healthcare claims based on unreliable AI model. Post-2020 Navihealth acquisition, insurer reportedly refused senior Medicare Advantage Plan users' claims, advised by flawed algorithm. Law firm alleges 90% error-rate AI overriding post-acute care recommendations for elders, contravening Medicare Advantage rules, favoring UnitedHealthcare financially. Alleged generic predictions, forbidding deviation from AI model; 'three-day stay hospital' patients reportedly receive denials after 14-day nursing home stays. 90% nH Predict AI model decisions reversed on appeal, demonstrating inaccuracies, lack of human review, and claims-communication opacity. UnitedHealthcare remained unresponsive.

Nov 17, 2023·MedCity News

UK first to approve CRISPR-based therapy, Casgevy, for treating blood disorders sickle cell disease and beta thalassemia. Vertex Pharmaceuticals and CRISPR Therapeutics commercialize gene-edited, one-time treatment. MHRA approval given after trial results indicate reduced pain, transfusion needs; side effects comparable to similar procedures. Post-approval research required; authorization potentially renewed annually. Upcoming FDA decisions await for US approval.

Nov 15, 2023·Time

ICBC's US unit hit by a cyberattack, causing disruption in US Treasury trades. Trades routed manually via USB stick. Suspected attack by Russia-linked Lockbit gang, forcing rerouting of transactions. Incident underscores cyberattack risks for financial system. Bank's defenses to be strengthened. Ransomware attacks expected to hit record levels this year, prompting further vigilance.

Nov 10, 2023·CSO Online

US initiates "Shields Ready" campaign, hosted by DHS, CISA, and FEMA, for critical national infrastructure (CNI) security. Shields Ready strategizes CNI resilience and disruption-preparedness. CISA's "Shields Up" encourages immediate action to individual threat intelligence. Shields Ready makes CNI entities more resilient to various hazards, from cyberattacks to natural disasters.

Nov 10, 2023·Healthcare Info Security

American Hospital Association (AHA) and three other groups sue U.S. Department of Health and Human Services (HHS) over claim that hospital web tracking potentially violates HIPAA. AHA also seeks injunction to stop HHS from taking enforcement action against member hospitals for web tracking.