Home2019-01-17T20:58:16-05:00

Trump’s Return Poised To Tangle Health Care Safety Net

By STEPHANIE ARMOUR

Former President Donald Trump’s return to the White House will likely bring changes that scale back the nation’s public health insurance programs — increasing the uninsured rate, while imposing new barriers to abortion and other reproductive care.

The reverberations will be felt far beyond Washington, D.C., and could include an erosion of the Affordable Care Act’s consumer protections, the imposition of work requirements in Medicaid and funding cuts to the safety net insurance, and challenges to federal agencies that safeguard public health. Abortion restrictions may tighten nationwide with a possible effort to restrict the mailing of abortion medications.

And with the elevation of vaccine skeptic Robert F. Kennedy Jr. to Trump’s inner circle of advisers, public health interventions with rigorous scientific backing — whether fluoridating public water supplies or inoculating children — could come under fire.

Trump’s return will give a far broader platform to skeptics and critics of federal health programs and actions. Worst case, public health authorities worry, the U.S. could see increases in preventable illnesses; a weakening of public confidence in established science; and debunked notions — such as a link between vaccines and autism — adopted as policy. Trump said in an NBC News interview on Nov. 3 that he would “make a [Read More]

MI Hospitals Entering ’25 Big On 340B Contract Restriction Ban

This year, Michigan hospitals will continue pushing legislators to ban drug manufacturers from creating restrictions and limited-access conditions around their “340B Drug” products, which they say will preserve discounted drug access for rural hospitals.

The federal 340B Drug Pricing Program was established in 1993. According to the federal Health Resources and Services Administration, drug manufacturers participating in the Medicaid insurance program must supply outpatient drugs to 340B facilities at “significantly reduced prices.” Becoming a 340B facility depends on the number of Medicaid recipients and considerably “underserved” individuals that a hospital serves.

In a recent interview with MIRS, Laura Appel – the Michigan Health and Hospital Association’s executive vice president – said 87 hospitals in the state were 340B hospitals at the time.

She spoke to MIRS while the Senate was wrapping up its overnight, 29-hour Senate session. However, as she observed the Capitol from her office window, she admitted that one of the biggest bills MHA most wanted to be passed in the 2023-24 term was dead.

Right now, states like Arkansas, Louisiana, Mississippi and Missouri outlaw drugmakers in their state from putting up “340B Contract Pharmacy Restrictions.” On Dec. 13, the Senate passed a bill 30-5 – with three senators not voting – prohibiting manufacturers from setting up guardrails in their 340B contracts.

The [Read More]

LANSING LINES

Lansing Lines is presented in cooperation with MIRS, a Lansing-based news and information service.

Whitmer Signs Maternal Health Package, Pharmacist Birth Control Bills, Other Insurance Changes

Gov. Gretchen Whitmer signed 16 bills this month, many surrounding women’s reproductive health care, including two that let pharmacists prescribe birth control, a nine-bill package putting pregnancy on Medicaid, and two on birthing centers and doulas.

Whitmer was slated to sign HB 5435 and HB 5436 in Flint today, but the event was canceled because of the snow and freezing weather. Whitmer posted the signing on social media, where she thanked Reps. Stephanie Young (D-Detroit) and Kara Hope (D-Holt) for sponsoring the bills.

“Today, I’m signing commonsense bills to further protect everyone’s fundamental freedom to make their own decisions about their own body,” Whitmer said. “These bills will save women time and money so they can access the birth control they need and cut unnecessary red tape that stands between people and their health care.”

The bills would not only allow pharmacists to prescribe birth control, but would also require insurance to cover birth control, as well.

The bills passed along party lines and Republicans voiced their opposition to the bills, opening the guidelines to allow prescriptions regardless of age.

Planned Parenthood of Michigan applauded the passage of the two bills.

“As [Read More]

CMS Selects Michigan To Participate In Innovation In Behavioral Health Model     

By ROLF LOWE
Wachler & Associates

On Dec. 18, 2024, the Center for Medicare and Medicaid Services, announced that Michigan, along with New York, Oklahoma and South Carolina were selected to participate in the Innovation in Behavioral Health (IBH) Model. The IBH Model is another step forward by CMS in integrating health care services and improving outcomes for Medicare and Medicaid beneficiaries. The IBH Model was announced in January of 2024 with CMS providing funding opportunities for state Medicaid agencies willing to participate in the IBH Model. The Implementation of the IBH Model started on January 1, 2025, and is scheduled to be in effect for eight years.

The IBH Model in Michigan is being implemented in designated sub-state geographic service areas. The provider participants in the in the IBH Model are specialty behavioral practices, community mental health centers, opioid treatment programs and public or private practices where individuals can receive outpatient mental health or Substance Use Disorder (SUD) services or both. The IBH Model refers to the providers as practice participants. The Michigan Department of Health and Human Services (MDHHS) intends to implement the IBH Model in both urban and rural areas. Providers being selected to become practice participants in the IBH Model are those that [Read More]

FCC Updates Broadband Map to Highlight Health Disparities

By GLENN S. RICHARDS & LEE G. PETRO
Dickinson Wright

Introduction

On December 13, 2024, the Federal Communications Commission (FCC) announced significant updates to its Mapping Broadband Health in America platform. This enhanced tool, now incorporating a range of new health metrics, aims to provide deeper insights into the connection between expanding broadband connectivity and critical health outcomes, with a particular focus on maternal health.

Background

The FCC administers two healthcare subsidy programs under its Universal Service Fund: the Rural Health Care (RHC) program and the COVID-19 Telehealth program. The RHC program provides funding to eligible health care providers to support the cost of broadband and telecommunications services that enable telehealth and telemedicine. The COVID-19 Telehealth program was created during the pandemic to provide funding to eligible health care providers to purchase telecommunications services, information services, and connected devices to provide connected care services to patients in response to the COVID-19 pandemic.

In addition to these efforts, the FCC’s Mapping Broadband Health in America platform was launched to visualize and analyze the relationship between broadband access and chronic diseases. The platform has evolved to address various public health challenges, including opioid abuse and maternal health. The latest update significantly expands the platform’s capabilities, making it a valuable [Read More]

Public Mental Health Plans File Against DHHS

Michigan’s public mental health plans filed a lawsuit accusing the state’s Department of Health and Human Services of imposing unnegotiated contract terms and threatening to cut off funding.

The plans, known as prepaid inpatient health plans argued DHHS’ actions violate state law and jeopardize mental health and substance use disorder services for thousands of residents.

“This isn’t just a contract dispute – it’s about ensuring the stability of behavioral health services that families across the state rely on every day,” said Robert Sheehan, chief executive officer of Community Mental Health Association of Michigan.

The six-count complaint, filed on behalf of NorthCare Network Mental Health Care Entity and Northern Michigan Regional Entity in the Court of Claims, alleges in part violation of the Headlee Amendment, and the PIHPs seek a writ compelling the state to continue providing Medicaid and general funds to the PIHPs as well as retraction of any communications and actions “taken to terminate the relationship between DHHS and plaintiffs.”

The plaintiffs, who want a preliminary injunction prohibiting DHHS from withholding substance abuse disorder health home services funding, also want a hearing to dispute DHHS’ decision to terminate contracts and they seek unspecified damages.

DHHS said in a late statement that “the Michigan Department of Health and Human Services is [Read More]

How UnitedHealth’s Playbook for Limiting Mental Health Coverage Puts Countless Americans’ Treatment at Risk

By ANNIE WALDMAN

This story was originally published Nov. 19, by ProPublica, a nonprofit newsroom that investigates abuses of power.

For years, it was a mystery: Seemingly out of the blue, therapists would feel like they’d tripped some invisible wire and become a target of UnitedHealth Group.

A company representative with the Orwellian title “care advocate” would call and grill them about why they’d seen a patient twice a week or weekly for six months.

In case after case, United would refuse to cover care, leaving patients to pay out-of-pocket or go without it. The severity of their issues seemed not to matter.

Around 2016, government officials began to pry open United’s black box. They found that the nation’s largest health insurance conglomerate had been using algorithms to identify providers it determined were giving too much therapy and patients it believed were receiving too much; then, the company scrutinized their cases and cut off reimbursements.

By the end of 2021, United’s algorithm program had been deemed illegal in three states.

But that has not stopped the company from continuing to police mental health care with arbitrary thresholds and cost-driven targets, ProPublica found, after reviewing what is effectively the company’s internal playbook for limiting and cutting therapy expenses. The insurer’s strategies are [Read More]

COMPLIANCE CORNER: Medicare Telehealth Flexibilities Set to Expire Dec. 31, 2024

 By JENNI COLAGIOVANNI
Wachler & Associates, P.C.

The COVID-19 Public Health Emergency (PHE) resulted in the waiver of certain pre-pandemic restrictions to expand Medicare coverage of telehealth services and increase access to care for Medicare patients.  More than a year and a half after the end of the PHE, several of these continuing telehealth flexibilities are set to expire on December 31, 2024, returning Medicare coverage of some telehealth services back to their pre-pandemic requirements.

Background: Prior to the COVID-19 pandemic, Medicare coverage of telehealth services was primarily limited to patients located in rural areas and restricted to certain provider types and services. Patients were generally required to travel to approved clinical sites to engage in telehealth services from providers in other locations. Early in the pandemic, the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) broadened the Secretary of the Department of Health and Human Services’ waiver authority under section 1135 of the Social Security Act.  Pursuant to this broadened authority, CMS waived the requirements of section 1834(m)(4)(E) of the Act and 42 CFR § 410.78 that specified the types of “distant site” practitioners that could bill Medicare for telehealth services to include all practitioners eligible to bill Medicare for their professional [Read More]

LEGAL LEANINGS: Healthcare Developments to Expect in 2025

By KIMBERLY J. RUPPEL
Dickinson Wright

As is the case in many industry sectors, the end of the year brings us to wonder what is in store for healthcare in 2025. Although the future is anyone’s guess, the following three areas of healthcare are most likely to experience robust activity.

  1. Non-Compete Litigation

Non-compete provisions are designed to prohibit an employed or contracted healthcare provider from competing against the contracting entity by working for or starting a competing business within a particular geographic area for some time. In April 2024, the Federal Trade Commission (“FTC”) promulgated a rule (the “Rule”) generally prohibiting non-compete clauses in employment agreements except for certain “Senior Executives” with policy-making authority who were compensated greater than $151,164 per year. There was also an exception for non-compete agreements entered into as part of a sale of a business. That Rule was to become effective September 4, 2024. However, a number of lawsuits were filed seeking to prevent its application.

  • Fifth Circuit Appeal Ryan

In this case, the plaintiffs argued the FTC exceeded its statutory authority in promulgating the Rule and asked the court to declare the Rule illegal, and the court agreed. As a result, the court determined the Rule was not enforceable nationwide. The FTC [Read More]

Lansing Lines

Bill To Relax Public Employee Health Insurance Moves

Public employee unions would have more ability to collectively bargain their members’ health insurance costs under legislation that moved early last month in the Senate on a party-line vote and, later in the day, in the House.

In response to local government employees and teachers getting fed up with soaring health insurance costs, Sen. Kevin Hertel (D-St. Clair Shores) sponsored bills (introduced before the hunting break) that give some flexibility to what’s known as the “80/20” and “hard cap” options.

The revamped versions of SB 1129 and SB 1130 address the same issue as bills that moved out of a House committee last week, but are not the same.

“By taking swift action on this critical issue, the legislators have taken a critical step in reigning in skyrocketing health care costs for Michigan teachers and school support staff, which can keep the best and brightest educators working in our local schools and helping our students learn,” said Michigan Education Association President and CEO Chandra Madafferi.

“Our students deserve to have great educators in every school, and we can only do that by allowing school districts to offer competitive wages and benefits that can keep talented educators in the profession.”

Meanwhile, the House passed HB 6058 , sponsored by [Read More]

Scientists Fear What’s Next for Public Health if RFK Jr. Is Allowed To ‘Go Wild’

By ARTHUR ALLEN

Many scientists at the federal health agencies await the second Donald Trump administration with dread as well as uncertainty over how the president-elect will reconcile starkly different philosophies among the leaders of his team.

Trump announced Thursday he’ll nominate Robert F. Kennedy Jr. to be secretary of the Health and Human Services Department, after saying during his campaign he’d let the anti-vaccine activist “go wild” on medicines, food, and health.

Should Kennedy win Senate confirmation, his critics say a radical antiestablishment medical movement with roots in past centuries would take power, threatening the achievements of a science-based public health order painstakingly built since World War II.

Trump said in a post on the social platform X that “Americans have been crushed by the industrial food complex and drug companies who have engaged in deception, misinformation, and disinformation when it comes to Public Health,” echoing Kennedy’s complaints about the medical establishment. The former Democratic presidential candidate will “end the Chronic Disease epidemic” and “Make American Great and Healthy Again!” Trump wrote.

Vaccine makers’ stocks dipped Thursday afternoon amid news reports ahead of Trump’s RFK announcement.

If Kennedy makes good on his vision for transforming public health, childhood vaccine mandates could wither. New vaccines might never win approval, even as [Read More]

What To Know About RFK Jr.’s Stances on Key Health Issues and What He Could Do at HHS

Robert F. Kennedy Jr., President-elect Donald Trump’s pick to lead the Department of Health and Human Services, is coming into the nomination process in an unusual position, with a long list of his own policy priorities separate from the president-elect’s, and a public promise by Trump to let him “go wild” on his ideas.

Céline Gounder, the editor-at-large for public health at KFF Health News and a CBS News medical contributor, answers questions below about the role Kennedy has been tapped to take on and some of the ideas in the sweeping “Make America Healthy Again” platform he may try to push through.

Q: What is the role of the Department of Health and Human Services, and how much power does the HHS secretary have over its work?

A: The U.S. Department of Health and Human Services comprises several agencies and offices including the National Institutes of Health, the Centers for Disease Control and Prevention, the Food and Drug Administration, the Centers for Medicare & Medicaid Services, the Office of the Surgeon General, and much more.

There is a big difference between political appointees and career civil servants. Political appointees set strategic priorities and align their department or agency’s policies with the current administration’s objectives. Civil servants have the institutional [Read More]

Use Caution Before Resigning From Hospital

By JESSE ADAM MARKOS, ESQ.
Wachler & Associates, PC

 The National Practitioner Data Bank (Data Bank) published an article in a recent version of their in-house publication, NPDB Insights, that reinforces the importance of exercising caution before resigning from a hospital.  For those on staff or employed by a hospital, a resignation may at first glance appear to be the best path forward when their relationship with that hospital has deteriorated.  However, that resignation will often create more problems than it resolves if it triggers a report to the Data Bank because the resignation occurred during an ongoing investigation by the Hospital.  And since a Data Bank report can have significant professional and economic ramifications, it is important for physicians to understand how to appropriately disengage from a hospital and avoid a Data Bank report when possible.

By way of background, the Data Bank is an alert system that collects and discloses certain adverse information about physicians and other health care providers.  An adverse report to the Data Bank can significantly impact a physician’s reputation and career.  State licensing authorities, hospitals and other health care entities, and professional societies search the Data Bank when investigating qualifications.  A response that contains an adverse report can act as a permanent [Read More]

Texas Hospitals on the Clock to Report Medical Costs for Patients without Legal Status

By KATHLEEN WALKER
Dickinson Wright

On November 1, Texas hospitals faced a new requirement under an Executive Order issued by Governor Greg Abbott on August 8, 2024 (Order), requiring them to document medical costs related to the care of individuals without legal immigration status. Governor Abbott provided the following statement explaining the reasoning behind his Order:

“Due to President Joe Biden and Vice President Kamala Harris’ open border policies, Texas has had to foot the bill for medical costs for individuals illegally in the state,” said Governor Abbott. “Texans should not have to shoulder the burden of financially supporting medical care for illegal immigrants. That is why today I issued an Executive Order requiring the Texas Health and Human Services Commission to collect and report healthcare costs for illegal immigrants in our state. Texas will hold the Biden-Harris Administration accountable for the consequences of their open border policies, and we will fight to ensure that they pay back Texas for their costly and dangerous policies.”

Under the Order, the Texas Health and Human Services Commission (HHSC) must collect data on the use of Texas acute care hospitals for inpatient and emergency care for “illegal immigrants.” Beginning November 1, covered hospitals and designated providers must collect this data and [Read More]

LANSING LINES

Lansing Lines is presented in cooperation with MIRS, a Lansing-based news and information service.

$15.6M Contract For COVID-19 Test Kits Goes To Florida Company

The state awarded a $15.6 million contract to Orlando-based Abbott Rapid Dx North America to continue in-state COVID-19 testing.

The funding is coming from the federal government through the COVID Epidemiology and Laboratory Capacity funds and must be spent by July 31, 2026, but Michigan Department of Health and Human Services (DHHS) spokesperson Lynn Sutfin said there was no obligation to spend the funds if testing wasn’t needed.

“We continue to urge all Michigan residents to use the tools available to them to protect themselves and their families from all respiratory viruses. This includes taking preventative measures such as testing and getting vaccinated for influenza, COVID-19 and RSV,” Sutfin said.

She said DHHS has continued to make COVID-19 testing available for free at several testing sites, wellness centers and participating libraries across the state.

“Although demand for testing has decreased from the early years of the pandemic, it remains an important tool to help protect residents and their families from this virus with an average of 5,400 tests per month occurring in 2024,” Sutfin said.

A list of testing sites is available on the DHHS website and people can still [Read More]

Trump Election Creates Unpredictable Environment For Healthcare

Trump Election Creates Unpredictable Environment For Healthcare

In the uncertain times that lie ahead, seismic regulatory changes flavored with reactionary populist notes frame the environment awaiting the healthcare community.

It’s difficult to figure how and when a Trump presidency will affect healthcare nation. At this early stage, speculation is the only prism available and Trump’s policy detail is vague at best.

The Affordable Care Act
The fate of the Affordable Care Act is as good a place to start as any. Trump has been promising to scrap the ACA and replace it with something better since early in his first term. His latest pronouncement down the stretch in ’24 is that he and his team have “the concepts of a plan” gathered and will put it all together soon. For the time being, Obamacare could benefit from repeated stays of execution. The ACA has gained enough traction during the past eight years to make it tougher to kill than it was a decade ago.

Medicaid & Medicare
Trump has promised to protect Medicaid, Medicare and Social Security, again without explaining how. Politically, these programs would be difficult to gut, but Medicaid and Medicare are arcane enough programs to subtly snip at some point, should it become politically expedient. During his first [Read More]

Harris’ Emphasis on Maternal Health Care Is Paying Dividends With Black Women Voters

By STEPHANIE ARMOUR

Vice President Kamala Harris is seeing a surge of support from Black women voters, galvanized in part by her work on health care issues such as maternal mortality, reproductive rights, and gun control.

The enthusiasm may be key for Democratic turnout at the polls in critical battleground states.

Black women have always been among the most reliable voters in the Democratic base and were central to former President Barack Obama’s victories in 2008 and 2012. Enthusiasm was also robust for President Joe Biden in 2020. But this year, before he bowed out of the race and Harris became the Democratic nominee, his support among this critical demographic had been fading, which could have dampened turnout in swing states.

Black voters’ support for the top of the Democratic ticket has since increased. In July, before he left the race, 64% of Black voters supported Biden, according to the Pew Research Center. Seventy-seven percent of Black voters supported Harris in August.

Black voter turnout, especially in rural areas of Georgia, North Carolina, and Pennsylvania, could help propel Harris to victory. That support — especially among Black women — has swelled since Biden’s departure, polling shows.

“This is a renaissance,” said Holli Holliday, a lawyer in the Washington, D.C., area who [Read More]

COMPLIANCE CORNER: Remote Patient Monitoring Faces Increased Scrutiny Following OIG Recommendations

KAITLYN DELBENE
Wachler & Associates, PC

The Office of Inspector General recently issued a report recommending increased oversight following a data analysis of Medicare fee-for-service claims for remote patient monitoring services. Providers should be aware of possible increased scrutiny by CMS, including audits and new proposed coverage criteria.

What Is Remote Patient Monitoring?

Remote patient monitoring (“RPM,” also at times referred to as remote physiologic monitoring) is the collection and transmission of health data in a patient’s home that providers use to remotely monitor a patient’s health status and manage a patient’s condition. To qualify as RPM, the monitoring device must automatically transmit data to the patient’s provider. The provider is then able to review the data, make decisions about the patient’s treatment, and communicate with the patient to discuss any recommendations, such as medication adjustments.

A common example of RPM is the use of a connected blood pressure cuff to regularly collect blood pressure readings in order for a provider to monitor a patient with hypertension. Medicare covers RPM for both chronic and acute conditions, but OIG found that the vast majority of patients are receiving RPM for chronic conditions. In the data reviewed by the OIG, more than half of the patients receiving RPM received it for hypertension. [Read More]

LEGAL LEANINGS: Final Rules Released: What They Mean for Mental Health and Substance Use Disorder Benefits

By NICOLETTE TABER
Dickinson Wright

On Sept. 9, 2024, the Departments of Health and Human Services, Labor, and the Treasury (collectively “the Departments”) released final rules strengthening and clarifying the rules previously set forth in the Mental Health Parity and Addiction Equity Act (MHPAEA). These new rules signify the Departments’ commitment to enforcing existing mental health parity laws by imposing additional requirements on insurers while also outlining guidelines for compliance.

The final rules reinforce the MHPAEA’s mandate of group health plans and health insurance issuers that offer group and individual health insurance coverage of mental health or substance use disorder benefits to do so in parity with medical and surgical benefits. The MHPEAEA prohibits imposing more significant restrictions on mental health or substance use disorder benefits as compared to medical and surgical benefits. Since the passing of the MHPAEA in 2008, however, the Departments have noted through their audits of group health plans and health insurance issuers that many beneficiaries still encountered barriers to accessing mental health and substance use disorder care compared to medical and surgical care. Therefore, the Departments issued these new final rules to address this discrepancy.

The new rules also reinforce the prohibition of group health plans’ and issuers’ use of more restrictive, nonquantitative [Read More]

LANSING LINES

Lansing Lines is presented in cooperation with MIRS, a Lansing-based news and information service.

New PPOs For Seniors And Disabled Passes Senate

Beginning at 60 years old, senior Michiganders can petition for restraining orders against relatives and caretakers who they fear are abusive or exploitative, under legislation the Senate approved.

The Senate passed SB 922 by Sen. Veronica Klinefelt (D-Eastpointe), creating a system for elderly Michiganders and vulnerable adults to seek a new type of personal protection order. Under the legislation, a vulnerable adult includes someone 18 or older who’s unable to live on their own because of a physical or developmental disability or a mental illness.

Courts can issue one of these PPOs if there’s reasonable cause to believe the person to be restrained may refuse to leave the premises of the petitioner’s home.

The restraining orders could also be issued if there’s concern that the person could assault or wound the petitioner, remove a pet from the petitioner’s possession, withhold their access to medication and phone calls or could financially exploit them.

If the person resides with the petitioner, and there’s a belief they might use “a pattern of derogatory” names or sexual comments to emotionally distress them, the court could additionally issue one of these PPOs.

“I think the [Read More]

Trump, Harris Spar Over Abortion Rights and Obamacare In Their First Face-Off

By KFF Health News and PolitiFact staffs

When Vice President Kamala Harris walked across the debate stage Sept. 11 to shake the hand of former President Donald Trump, it was the first time the two had met in person. But that was the rare collegial moment in a face-off otherwise marked by false and sometimes bizarre statements by the former president.

The debate was hosted by ABC with moderators David Muir and Linsey Davis, who occasionally fact-checked Trump. He complained on the Fox News show “Fox & Friends” on Wednesday morning that it was a “three-to-one” contest.

The two presidential candidates covered a wide range of issues — from job and inflation numbers to abortion and immigration — in exchanges marked by personal attacks. As our PolitiFact partners noted, Harris often directly addressed Trump while answering the moderators’ questions. Trump mostly stared straight ahead. In response to Trump’s claims about the Biden administration’s record on crime, Harris cited Trump’s criminal conviction in New York and other indictments.

The moderators questioned Trump about whether he would attempt to dismantle the Affordable Care Act, also known as Obamacare — the health insurance program he pledged and failed to repeal and replace during his previous administration.

He said, if president, he would “only [Read More]

Fearing The Worst, Schools Deploy Armed Police To Thwart Gun Violence

By CHRISTINE SPOLAR

PITTSBURGH — A false alarm that a gunman was roaming one Catholic high school and then another in March 2023 touched off frightening evacuations and a robust police response in the city. It also prompted the diocese to rethink what constitutes a model learning environment.

Months after hundreds of students were met by SWAT teams, the Catholic Diocese of Pittsburgh began forming its own armed police force.

Wendell Hissrich, a former safety director for the city and career FBI unit chief, was hired that year to form a department to safeguard 39 Catholic schools as well as dozens of churches in the region. Hissrich has since added 15 officers and four supervisors, including many formerly retired officers and state troopers, who now oversee school campuses fitted with Stop the Bleed kits, cameras, and defibrillators.

When religious leaders first asked for advice after what are known as “swatting” incidents, the veteran lawman said he didn’t hesitate to deliver blunt advice: “You need to put armed officers in the schools.”

But he added that the officers had to view schools as a special assignment: “I want them to be role models. I want them to be good fits within the school. I’m looking for someone to know how to [Read More]

New Biden Administration Rules Aim to Hold Insurers Accountable for Mental Health Care Coverage

By MAYA MILLER & ANNIE WALDMAN

This story originally published by ProPublica, a nonprofit newsroom that investigates abuses of power.

The Biden administration announced on Monday that it has finalized new regulations to strengthen protections for mental health care coverage and hold insurance companies accountable for unlawfully denying it.

The rules update the Mental Health Parity and Addiction Equity Act, which was passed in 2008, requiring health insurance plans to provide the same access to mental health care as medical care. The new provisions will force health insurance plans to collect and report more robust data on how they limit and deny mental health claims. If disparities exist between mental and medical care, insurers will need to lay out how they are attempting to address these gaps.

“Mental health care is health care. But for far too many Americans, critical care and treatments are out of reach,” President Joe Biden said in a press release announcing the final rules. “There is no reason that breaking your arm should be treated differently than having a mental health condition.”

The updated rules seek to address a problem captured in numerous studies and reports and examined in a new level of detail in a recent ProPublica investigation.

Although nearly all Americans have health insurance, millions still [Read More]

Real Medicines

By SUSAN ADELMAN, MD
Doctors, do you know whether your patients actually are taking the medicines you have prescribed? Brick and mortar retail pharmacies are vanishing these days, or at least dwindling, and on-line pharmacies are proliferating. We need to understand what this means. Rite-Aid has gone bankrupt, closing 500 stores. CVS closed 244 stores between 2018 and 2020, and in 2021 it announced it would close 900. Walgreens announced in 2019 that it would close 200 stores, and in 2023 it announced it would close 150 more. Walmart is closing 11 stores in 2024, and it is divesting itself of 51 health clinics. The reason given is that these stores were unprofitable. But why? High on the list of reasons is retail theft, followed by lower fees for prescription (as a result of pharmaceutical managers) and reduced profits from household goods because of competition from Amazon and big box stores. Oh, and those on-line pharmacies.

According to Capsa, in 2010, 10% of all U.S. prescriptions were filled by mail order. Ten years later, it was close to 16%. This is unfortunate, because many of these online pharmacies lack important safeguards for the patient, and they are notoriously difficult to spot. In one study, fewer than 60% [Read More]

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