Four decisions by the Supreme Court in the last 10 days will fundamentally change U.S. healthcare for decades to come:
June 15, 2022: American Hospital Association v Becerra (20-1114) In a unanimous (9-0) decision, the Court found that a reading of the statutory language makes clear that without surveying hospitals as to their drug acquisition costs, HHS may not change drug reimbursement rates for a subset of hospitals. The court noted that this “protects all hospitals by imposing an important procedural prerequisite—namely, a survey of hospitals’ acquisition costs for prescription drugs—before HHS may target particular groups of hospitals for lower reimbursement rates.”
The issue going forward: under what authority and by what mechanisms will HHS and its agencies with responsibility for provider payments (CMS, FDA, IHS, HRSA, et al) modify methodologies to shift payments to its priorities or direct resources to programs it deems appropriate? And the practical implication for providers (hospitals, federal clinics, public health providers, physicians, post-acute and long-term care providers et al) is budgeting for long-term strategic initiatives if HHS is locked into funding and reimbursement methodologies tethered to old business models and faulty assumptions about how care CAN be delivered, by whom and where.
June 21, 2022: Marietta Memorial Hospital Employee Health Benefit Plan et al. V. Davita inc. Et al (20-1641 In a 7-2 decision, SCOTUS said employer health plans can make all dialysis providers out-of-network opening the door for other employers to make similar changes to their health coverage and encourage workers who have kidney failure to drop their private plans and enroll in Medicare. Writing for the majority, Justice Brett Kavanaugh explained that “If Congress wanted to mandate that group health plans provide particular benefits, or to require that group health plans ensure parity between different kinds of benefits, Congress knew how to write such a law. It did not do so in this statute,”
Background: Currently, if a worker has kidney failure and health insurance through a job, employers must cover that person for 33 months — an initial three-month waiting period as the patient qualifies for Medicare and then the next 30 months. During that time, Medicare fills some coverage holes as a backup to the employer, but after that time lapses, Medicare primarily pays the bills, according to the Medicare Secondary Payer Act. Current law says employers “may not differentiate in the benefits it provides between individuals who have ESRD and others enrolled in the plan, on the basis of the existence of ESRD, or the need for renal dialysis, or in any other manner.” Thus, companies can’t design insurance plans that treat people with kidney failure differently than others.
The issue going forward: with employers free to design insurance benefits that encourage sicker/more at-risk workers to enroll in public insurance programs including Medicare, might other costly conditions be added to ESRD as carve-outs that enable employers to limit their financial risk while maintaining the tax deduction for the benefits they provide? Might high risk pregnancies, severe mental health conditions, and others be added to off-load health costs and care management to Medicare/Medicaid? What is the long-term implication for employer sponsored coverage if it’s geared primarily to healthier workers only? And is Medicare funding adequate to add these populations since its solvency is already in question? Should employers and healthy workers pay higher payroll taxes to accommodate this shift?
June 24: Becerra v. Empire Health Foundation (20-1312) Becerra v. Empire Health Foundation concerns the U.S. Department of Health and Human Services’ (HHS) 2005 rule that changed how it calculated the annual reimbursement rate Medicare pays to hospitals serving low-income patients. More specifically, the Empire Health Foundation is challenging HHS’ use of the phrase “entitled to” instead of “eligible to” when calculating these payments. In a 5-4 decision, SCOTUS held that “those individuals “entitled to [Medicare Part A] benefits” are all those qualifying for the program, regardless of whether they receive Medicare payments for part or all of a hospital stay.” The majority opinion held that “everyone who qualifies for Medicare benefits in the Medicare fraction—and no one who qualifies for those benefits in the Medicaid fraction—accords with the statute’s attempt to capture, through two separate measurements, two different segments of a hospital’s low-income patient population.”
The issue going forward: calculating payments using this expanded definition for the Medicare fraction will expand payments to Disproportionate Share Hospitals and possibly lead to lower payments to non-DSH hospitals.
June 24, 2022 Dobbs v. Jackson Women’s Health Organization (19-1392) By a vote of 6-3, the Court sided with the Mississippi law that bans abortion after 15 weeks of pregnancy. It concluded “The Constitution does not confer a right to abortion; Roe v. Wade, 410 U. S. 113, and Planned Parenthood of Southeastern Pa. v. Casey, 505 U. S. 833, are overruled; the authority to regulate abortion is returned to the people and their elected representatives.” Justice Alito, author of the majority opinion, added “The Constitution makes no reference to abortion, and no such right is implicitly protected by any constitutional provision. “This ruling reversed the 1992 companion precedent known as Planned Parenthood v. Casey, which held that states can’t impose significant restrictions on abortion before a fetus becomes viable for life outside the womb.
And in a separate 5-4 vote, the court overturned Roe v. Wade, with Chief Justice Roberts switching sides arguing the court should not have decided the broader question of whether the Constitution protects abortion at all (Roe v Wade 1973).
The immediate issue is this: how will regulations be set in the 26 states that are likely to ban/limit abortions including 13 that have “trigger laws” making abortion illegal almost immediately. Regulations outlining access to abortion pills from “certified providers”, access to out-of-state abortion services, the role of telemedicine advisory services and criminality risks for providers and enablers are immediate concerns. Lawmakers in at least 20 states have already proposed restrictions or bans on abortion pills (mifepristone and misoprostol) approved by the FDA for ending pregnancies up to 11 weeks and Attorney General Merrick Garland said: “States may not ban Mifepristone based on disagreement with the FDA’s expert judgment.” Thus, access to abortion pills may result in a jurisdictional stand-off between the FDA’s approval process and individual state restrictions.
The longer-term impact is more sobering: how will U.S. infant mortality be impacted—already the highest in industrialized nations. How will employers adjust benefits and assess liability risks associated with coverage for their workforce, especially women of childbearing age? How will abortion opponents address the needs of moms and newborns most directly impacted by restrictions? And so on.
My take:
In the near term, these rulings assure that healthcare, especially abortion-rights, will be prominent in Campaign 2022 and in FY2023 budget planning for Medicare in DC and Medicaid in states. They’ll prompt every employer to revisit the design of their health benefits programs in light of the potential to off-load costs for ESRD workers. They’ll prompt hospitals that do not benefit from DSH reimbursement method changes to find additional areas for operating cost reductions in anticipation of cuts. And they require every state to prepare for disruption in providing abortion services, whether restricted or otherwise.
The longer-term impact is perhaps more impactful than these short-term effects. Supreme Court Justices are appointed for life. The court’s current composition is conservative-leaning and 3 of the 5 are in their fifties: Thomas (74), Alito (72), Gorsuch (55), Kavanaugh (57) and Barrett (50). With that, a number of challenges to the status quo might work their way through this high court’s conservative filter that’s inclined toward individual freedoms, state’s rights, free market capitalism and competition.
These court decisions open the door for big questions that impact the health system directly: they’ll start with challenges in communities and states, and then in the courts.
· Is access to healthcare in America a right or privilege? What do healthcare, affordability and access mean’?
· When does “life” begin? When does a fetus become a person? at 24 weeks per Roe v. Wade? At 15 weeks per Mississippi?
· Is a state’s abortion policy discriminatory against low-income women?
· Is an employer obligated to provide insurance coverage to all employees?
· Is a private hospital obligated to provide a community benefit?
· · What role should personal accountability (health habits) play in eligibility for insurance coverage, and should less accountable persons pay more?
· Per Justice Thomas suggestion, which “enumerated rights” have constitutional protections and which don’t? contraception? same-sex marriage? et al?
While Dobbs v. Jackson Women’s Health Organization has garnered the lion’s share of media attention, the four decisions taken together change the immediate and longer-term future of U.S. healthcare.
It’s a new day.
Paul
Hospitals, Outpatient Care
CMS proposes 3.2% hospital increase in FY 2023: Last Monday, CMS proposed increasing inpatient hospital payments by $1.6 billion in fiscal 2023–a 3.2% increase from FY 2022. CMS also plans to add health equity measures to the hospital inpatient quality reporting program and designations of “birthing friendly hospital” for those providing newborn services. Most hospital trade groups reacted negatively claiming the after-effects of Covid on labor and supply costs and overall inflation require at least a 4.5% to 5% increase to breakeven.
Maya Goldman Hospitals call Medicare pay proposal ‘woefully inadequate’ Modern Healthcare June 20, 2022 www.modernhealthcare.com
Study: hospital price transparency compliance related to resource availability: This examination of hospital adherence to the Hospital Price Transparency Executive Rule is based on analysis of 4484 hospitals in 2892 hospital systems in 306 HRRs. Findings:
· As of December 2021, 68% of hospitals had released payer-specific negotiated prices, more than 50% higher than rates reported earlier in the year
· Multihospital systems, for-profit hospitals and teaching hospitals had higher compliance. Government hospitals had lower compliance but the association did not remain after controlling for integration into multihospital systems.
· Hospital systems with more beds had higher compliance whereas critical access hospitals and those lacking intensive care units had lower compliance.
Ji, Kong US Hospital Characteristics Associated with Price Transparency Regulation Compliance JAMA Health Forum June 24, 2022;3(6): e221702. doi:10.1001/jamahealthforum.2022.1702
CMS proposes pay boost for ESRD facilities: Last Tuesday, the Centers for Medicare and Medicaid Services proposed a 3.1% Medicare pay hike for dialysis providers next year and plans for quality improvement measurement changes:
· The base rate for dialysis services would increase by $6.19 to $264.09, increase payments to hospital-based end-stage renal disease providers by 3.7% and to freestanding facilities by 3.1%.
· Adjusted ESRD quality metrics would include a readmission ratio and a measure of prevalent patients waitlisted, adding healthcare employees’ COVID-19 vaccination status as a factor.
Center for Medicare and Medicaid Services www.cms.gov
Public Health, Abortion, Disparity
Study: out of pocket costs for abortion increased, insurance coverage decreased: The Hyde Amendment prevents federal funds, including Medicaid, from covering abortion care, and many states have legal restrictions that prevent private insurance plans from covering abortion. As a result, most people pay for abortion out of pocket. Researchers examined patient self-pay charges for three abortion types (medication abortion, first-trimester procedural abortion, and second-trimester abortion) as well as facilities’ acceptance of health insurance, during the period 2017–20. Findings:
· Median patient charges increased for medication abortion (from $495 to $560) and first-trimester procedural abortion (from $475 to $575) and decreased for second-trimester abortion (from $935 to $895).
· The proportion of facilities that accept insurance decreased over time (from 89% to 80%).
“We noted substantial regional variation, with the South having lower costs and lower insurance acceptance. Charges for first-trimester procedural abortions are increasing, and acceptance of health insurance is declining.”
Upadhyay Trends in Self-Pay Charges and Insurance Acceptance for Abortion in The United States, Health Affairs April 2022 https://doi.org/10.1377/hlthaff.2021.01528
Report: Assaults at abortion clinic staff and patients increased 128% last year: Per the report from the National Abortion Federation released last week comparing 2021 to 2020, clinics saw…
· A 600% increase in stalking.
· A 63% increase in burglaries.
· A 54% increase in acts of vandalism (which included multiple incidents of bullets being fired through clinic windows).
· A 163% increase in hoax devices or suspicious packages at clinics.
· An 80% increase in bomb threats.
2021 VIOLENCE & DISRUPTION STATISTICS, National Abortion Federation www.prochoice.org
Study: Obesity among adolescents increasing especially in low-income households: Background: An association between obesity and low socioeconomic status (SES) was observed in a 2021 study of trends among US adults. However, obesity trends by SES among adolescents had not been fully studied since 2008. Study findings:
· Adolescents from low-SES households were more likely to be non-Hispanic Black (21.7%), have obesity (22.8%), or have an unmarried parent (45.5%). The trend in adjusted obesity prevalence increased over 20 years, particularly among adolescents from low-SES households.
· Living in a low-income household was associated with a 4.2% increase in obesity prevalence and lower head of household education level was associated with a 9.0% increase. The gap in obesity prevalence between adolescents from low-income households vs others was 6.4 % greater in 2015-2018 vs 1999-2002.
Goto et al Evaluation of Obesity Trends Among US Adolescents by Socioeconomic Status, 1999-2018 JAMA Pediatrics. Published online June 21, 2022. doi:10.1001/jamapediatrics.2022.1838
Deloitte: Disparities will cost the U.S. health system $1 trillion annually by 2040: The analysis found the cost of excess health services delivered due to disparities is $320 billion annually, and the rate of increase outpaces overall cost trends. Total healthcare spending is expected to rise by 5.3% annually to 2040 while spending tied to disparities is expected to increase by 6.2% per year. For consumers, the trend could mean healthcare costs increasing to $3,000 per person annually by 2040. Today, the average person spends approximately $1,000 per year on healthcare.
Economic Cost of Health Disparities Deloitte June 22, 2022 www2.deloitte.com/us/en/insights/industry/health-care/economic-cost-of-health-disparities.
Commonwealth Fund proposes overhaul of public health: 100 million Americans use one or more social services/public health programs regularly. Average per capita spending is currently $19, below the $32. Among major recommendations:
· The Federal Government Should Lead a Strong and Capable National Public Health System
· Congress Should Provide Stable Support Matched with Expectations for States, Localities, Tribes, and Territories to Protect the Health of Their Populations
· The Health Care System Should Work Closely with Public Health Agencies in Normal Times and During Emergencies
· Public Health Agencies Should Work to Earn the Public’s Trust: In 2009, 43% of Americans had a positive view of the nation’s public health system. During the pandemic, this figure fell to 34 %
· Congress should spend $8 billion to build out a public health workforce and create better information-sharing systems.
· Creation of a new position at HHS: undersecretary of public health.
· Creation of a new federal genomic pathogen database and a new cross-government effort to advance health equity.
Meeting America’s Public Health Challenge Commonwealth Fund June 21, 2022 www.commonwealthfund.org/publications/fund-reports/2022
Bipartisan gun bill becomes law: The Bipartisan Safer Communities Act passed in the Senate Thursday by a 65-33, then Friday in the House (234-193) and was signed into law by President Biden Saturday morning before his departure for the G-7 Summit in Europe. The legislation provides $15 billion in funding to help states put in place red-flag laws, to remove guns from people deemed dangerous; close the so-called boyfriend loophole related to dating partners; expand background checks to include juvenile and mental health records for buyers under 21 years old and funding for mental-health programs. It. also includes penalties for the buying a gun for someone else and gun trafficking.
S. 2938: Bipartisan Safer Communities Act www.govtrack.us/congress/bills/117/s2938/text
Covid
CDC Covid-19 data tracker: Results thru June 24, 2022 compared to prior week:
· 7-day average of new COVID-19 cases and 7-day case average decreased 5.6%
· 7-day hospitalization average was 4,375, a 1% increase.
· 7-day death average was 255, down 10.4%
· Average daily vaccinations (154,906), down 34.7%
· 7-day average test volume (544,429), down 22.6%
· 7-day average for % positivity is 13.6%.
· As of June 22, 78.1% of the U.S. population (258.9 million) have received at least 1 dose of the COVID-19 vaccine, 66.8% (221.9 million) have received both doses, 50.2% of those eligible (104.7 million) have received a booster.
US Center for Disease Control and Prevention www.cdc.gov
CDC approves Modern Covid-19 vaccine for children ages 6 to 17 years: The CDC’s decision Friday adds a second Covid-19 vaccine to the previously approved Pfizer Inc-BioNTech SE option. About 60% of 12- to 17-year-olds and 30% of children ages 5 to 11 are fully vaccinated against Covid-19, according to the American Academy of Pediatrics.
US Center for Disease Control and Prevention www.cdc.gov
Study: vaccination increases COVID-19 Infection risk but infection without vaccination provides immunity: Background: The protection conferred by natural immunity, vaccination, and both against symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with the BA.1 or BA.2 sub lineages of the omicron (B.1.1.529) variant is unclear. The case–control study in Qatar conducted by Weill Cornell Medicine researchers from December 23, 2021, through February 21, 2022 found…
· The effectiveness of previous infection alone against symptomatic BA.2 infection was 46.1%.
· The effectiveness of vaccination with two doses of BNT162b2 and no previous infection was negligible but nearly all persons had received their second dose more than 6 months earlier.
· The effectiveness of three doses of BNT162b2 and no previous infection was 52.2%.
· The effectiveness of previous infection and two doses of BNT162b2 was 55.1% and the effectiveness of previous infection and three doses of BNT162b2 was 77.3%.
Conclusions: “No discernable differences in protection against symptomatic BA.1 and BA.2 infection were seen with previous infection, vaccination, and hybrid immunity. Vaccination enhanced protection among persons who had had a previous infection. Hybrid immunity resulting from previous infection and recent booster vaccination conferred the strongest protection.”
Altarawneh et al Effects of Previous Infection and Vaccination on Symptomatic Omicron Infections NEJM June 15, 2022 DOI: 10.1056/NEJMoa2203965
CDC: access to antiviral drugs uneven: Per the CDC’s social vulnerability index analysis, COVID antiviral drugs were less frequently dispensed in poorer, more crowded communities deemed most vulnerable to disease spread, despite those places having the greatest number of dispensing sites. Key finding: at sites within ZIP codes considered “high-vulnerability,” the rate pills were dispensed was about a half of the rate in medium and low-vulnerability communities.
Gold et al Dispensing of Oral Antiviral Drugs for Treatment of COVID-19 by Zip Code–Level Social Vulnerability — United States, December 23, 2021–May 21, 2022 CDC June 21, 2022 www.cdc.gov
Health Insurance, Managed Care
Study: Medicaid managed care network adequacy varies widely in states, consistent lack measures of access, quality lacking: Researchers analyzed Medicaid managed care provider networks representing 39 of the 40 states (including the District of Columbia) with Medicaid managed care for the period 2017-2020. Findings:
A majority (89.7%) of states applied time and distance standards for network adequacy, stratified by population size or geography. Time and distance standards ranged from 15 to 90 minutes for a primary care provider (mean, 44.7 minutes in rural areas and 28.9 minutes in urban areas) to 30 to 135 minutes for a cardiologist (mean, 72.1 minutes in rural areas and 40.4 minutes in urban areas). Most states also used timely access or appointment availability standards. Relatively few states applied other quantitative standards, such as provider to enrollee ratios, or provided detailed enforcement plans in cases of poor compliance.
Zhu et al Variation in Network Adequacy Standards in Medicaid Managed Care the American Journal of Managed Care, June 9, 2022, Volume 28, Issue 6 www.ajmc.com/view/variation-in-network-adequacy-standards-in-medicaid-managed-care
Investing
PE cautious about 2023 investing: “PE deal activity, both in terms of value and volume, is expected to slow from records in 2021… with more than $1 trillion of capital to deploy—and to support existing portfolio investments—activity will remain strong despite growing financing costs for dealmaking.” Outlook:
· Targets: ‘software companies, particularly in the B2B sector, are widely recognized as being better insulated from macroeconomic headwinds, while companies in consumer-facing industries are likely to struggle.’ Also, senior care: he U.S. 65+ population added over 14.4 million people from 2009 to 2019, a 36% increase, bringing the total population of Americans 65 and older to 54.1 million. Over the past five years, the top 10 private investment firms in the sector have completed 140 deals including 36 in 2022 to date.
· Fund raising: Fund managers coming to market with bigger funds may see a slowdown in new commitments as LPs take stock: Q1 saw a slightly more modest $293.1 billion in private capital raised, less than a quarter of the $1.3 trillion raised in the year-earlier quarter.
Pitchbook Analyst Note: How PE Firms Will Navigate Today’s Complex Macro Environment Pitchbook Q2 2022 May 27, 2022 www.pitchbook.com
Pitchbook: PE take private deals increase as IPO market slows: Companies that struggled as public companies are finding attractive take-private offers from PE: the three biggest YTD:
TPG has agreed to take healthcare technology and services company Convey Health Solutions private for roughly $1.1 billion. Stone Point took Tivity Health private in a $2 billion transaction April 5, 2022 and ArchiMed took Natus Medical private April 18, 2022 in a $1.197 billion deal.
TPG to boost healthcare portfolio with $1.1B Convey take-private Pitchbook June 21, 2022 www.pitchbook.com
Alphabet (Google) becoming healthcare juggernaut: “In 2021 America’s five tech behemoths collectively spent more than $3bn on speculative health-care bets…it is Alphabet, Google’s corporate parent, whose health-care ambitions seem to be the most vaulting. Between 2019 and 2021 Alphabet’s venture-capital arms, Google Ventures and Gradient Ventures, and its private-equity unit, CapitalG, made about 100 deals, a quarter of Alphabet’s combined total, in life sciences and health care. So far this year it has injected $1.7bn into futuristic health ideas…. Alphabet’s health adventures can be divided into four broad categories. These are, in rough order of ambition: wearables, health records, health-related artificial intelligence (ai) and the ultimate challenge of extending human longevity.”
Alphabet is spending billions to become a force in health carewww.economist.com/business/2022/06/20/alphabet-is-spending-billions-to-become-a-force-in-health-care
FDA, Prescription Drugs, Over-the Counter Therapeutics
Walgreens launches clinical trial business: The company plans to leverage its expansive retail footprint of 9,000 stores, as well as its pharmacy business and other care delivery assets, to connect patients with late-stage pharmaceutical trials either at retail clinics, at home, or virtually. To match patients with trials, Walgreens is partnering with health data company Pluto Health, which aggregates information across medical records, insurance claims, and other sources.
Walgreens gets into the clinical trials business June 17, 2022 https://investor.walgreensbootsalliance.com/
Study: Medicare could save buying generic drugs from Cuban Cost-Plus pharmacy: The analysis funded by Arnold Ventures found that if Medicare had purchased 77 common generic drugs from Mark Cuban’s Cost-Plus Pharmacy in 2020, it would have saved $3.6B dollars. That translates to more than a third of the $9.6B Medicare spent on generic drugs that year. In January, Dallas Mavericks owner and billionaire Cuban launched the generic drug company as a transparency play, cutting out pharmacy benefit managers (PBMs) and negotiating directly with manufacturers. Cost Plus Drug Co. sells its products with a $3 pharmacy dispensing fee, $5 shipping fee and a 15% profit margin.
Lalani et al Potential Medicare Part D Savings on Generic Drugs From the Mark Cuban Cost Plus Drug Company Annals of Internal Medicine June 21, 2022 https://doi.org/10.7326/M22-0756
Potential Medicare Part D Savings on Generic Drugs from the Mark Cuban Cost Plus Drug Company Annals of Internal Medicine June 1, 2022 www.acpjournals.org
US Preventive Services Task Force challenges efficacy of vitamins for cancer, heart disease treatment: “For most vitamins and mineral supplements, more research is needed to make a recommendation for or against taking them to prevent CVD and cancer. The Task Force recommends against taking vitamin E and beta-carotene for this purpose.”
Final Recommendation Statement: Vitamin and Mineral Supplementation to Prevent CVD and Cancer US Preventive Services Task Force June 21, 2022
FDA launches crackdown on smoking and vaping: Last Thursday, the FDA ordered the vaping device Juul to be taken off the market and announced its intent to require makers of cigarettes and other tobacco products to reduce the amount of nicotine in their products.
US Food and Drug Administration www.fda.gov
Consumers
June University of Michigan consumer sentiment index drops to record low 50 in June– the lowest on record going back to 1952. It’s down from May’s 58.4 reading. 79% of consumers expressed pessimism about future business conditions, the highest level since 2009, and 47% blamed inflation for “eroding their living standards.” The International Monetary Fund said Friday it has lowered its growth outlook for the U.S. economy to 2.9% for 2022 from its April forecast for a 3.7% gain. For 2023, the group now sees the U.S. growth slowing to 1.7%, compared with the 2.3% expansion it projected in April. The forecast is one of several recent projections expecting a slowdown.
Bryan Mena Consumer Sentiment at Record Low Is Another Ominous Sign for Economy Wall Street Journal June 24, 2022
North Carolina advances medical debt mitigation strategy: Background: About 100 million people in the U.S. — 41% of adults — have some form of health care debt driving millions of people into bankruptcy, depleting savings and retirement accounts, and leaving black marks on credit scores that make finding housing or employment difficult per the KFF-NPR analysis released last month.
North Carolina announced a two-pronged mitigation strategy: 1-Medicaid expansion and 2-Medical Debt De-Weaponization Act which requires hospitals to offer financial assistance to patients based on their income and limit the way large medical facilities and debt collectors can pursue unpaid bills. Among key features of the bill:
-
Requiring hospitals to provide free care to patients whose household income is at or below 200% of the federal poverty level and sliding-scale discounts for patients with higher incomes. (Currently, that means a single person making less than $27,180 or a family of four making less than $55,500 would qualify for free care.)
-
Offering patients payment plans that span at least two years, with installments that don’t exceed 5% of their monthly income
-
Capping the annual out-of-pocket expense for most patients at $2,300
-
Capping the maximum interest rate on medical debt at 5%
-
Shielding family members from medical or nursing home debt incurred by a spouse or parent
-
Delaying reporting of unpaid medical debts to credit bureaus until one year after a patient is billed
-
Prohibiting home foreclosures related to medical debt
-
Requiring the attorney general to enforce the law and giving patients the ability to sue health care facilities for violations
North Carolina considers new laws to ‘de-weaponize’ medical debt and protect patients NPR June 21, 2022https://khn.org/news/article/medical-bills-can-shatter-lives-north-carolina-may-act-to-de-weaponize-that-debt
Data privacy
Data privacy bill advances in House subcommittee but future uncertain: Thursday, a House subcommittee approved the American Data Privacy and Protection Act, on a voice vote with no dissent. It now moves to the full Energy and Commerce Committee for a vote, then to the full House where it’s expected to pass before the Senate where it’s expected to face opposition.
The legislation puts new limits on how businesses can collect and use consumers’ data and gives Individuals the right to access, correct, delete and export data covered by the legislation. For some sensitive categories of data, such as geolocation data or biometric information, the bill prohibits transfer or restricts it to very limited circumstances. Individuals could opt out of targeted advertising, as well as the transfer of any covered data to a third party. And it prohibits targeted advertising aimed at users under the age of 17 as well tougher restrictions on use of their data.
The legislation designates enforcement by the Federal Trade Commission and state attorneys general. It also would allow for consumer lawsuits over violations in some circumstances.
Future Uncertain for the American Data Privacy and Protection Act National Law Review June 26, 2022 www.natlawreview.com/article/future-uncertain-american-data-privacy-and-protection-act
