The Rundown | Week of 4.9.2018

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Technology’s Future in Healthcare

Technology is predicted to transform the healthcare industry within the next decade, specifically with artificial intelligence, playing a huge role in diagnosis and treatment. According to a report by Hewlett Packard Enterprise, by 2030, technology will be a standard for healthcare practices ranging from patients monitoring their health through wearable tools to self-diagnosing, virtual visits, and healthcare apps. They also report that doctors will be able to make better decisions using advanced imaging technology and constantly updated digital patient records. A professor at University College London in intensive care medicine, contributed to the report, saying  that “in ten years things such as automatic diagnoses based on a blood test could be the norm”.
>> Read more: Healthcare services will be built around IoT by 2030, according to report

$2.6B Recovered from Healthcare Fraud Schemes

According to a recent report by Health and Human Services for the Health Care Fraud and Abuse Control Program, $2.6B was recovered from healthcare fraud schemes in a takedown led by HHS and the Department of Justice. In July of 2017, 412 defendants were charged with fraud schemes that resulted in around $1.3 billion from false medical bills. Of those defendants, 120 were providers who were charged for prescriptions for illegal opioids and narcotics. Secretary Azar was very proud of the recovery, stating “by holding individuals and entities accountable for defrauding our federal health programs, we are protecting the programs’ beneficiaries, safeguarding billions in taxpayer dollars, and, in the case of pill mills, helping stem the tide of our nation’s opioid epidemic.”
>> Read more: HHS, DoJ Recovered $2.6B form Healthcare Fraud Schemes in 2017

California Bill Could Call for Price Controls in the Healthcare Market

A new healthcare initiative in California would allow for the state to be in charge of setting prices for medical services that are covered by commercial insurers. The measure allows for a rate to be established based on what the government pays for services under Medicare. According to the Los Angeles Times, this commission “would determine the rates for all services covered by commercial health plans, including those offered by employers to their workers and those sold in the individual marketplace. Public health programs, including Medicare and Medicaid, would not be affected by those price caps.” The bill has taken inspiration from a model in Maryland, where the state sets the prices paid by all payers. This bill has sparked a lot of opposition, but policymakers see it as a positive as healthcare consumes a big chunk of state budgets.
>> Read more: An ambitious California bill would put the state in charge of controlling prices in the commercial healthcare market

Kentucky Attorney General vs ACA Lawsuit

Kentucky Attorney General Andy Beshear announced that a group of state attorneys general will be working together to fight against a lawsuit that aims to dismantle the Affordable Care Act. Fifteeen other attorneys general will be joining Beshear to fight a lawsuit that claims the ACA is unconstitutional. The lawsuit wants to end tax credits, stop Medicaid expansion, allow insurance companies to deny coverage for pre-existing conditions, and take away prescription drug discounts. Beshear stated that “Kentucky stands to lose a projected $49.7 billion in federal funding for our expanded Medicaid and subsidies for those on the individual market if this lawsuit moves forward,” and that “hundreds of thousands of Kentuckians are at risk of losing their health care coverage, many of whom have coverage for the first time.”
>> Read more: Kentucky Attorney General files court action to protect health care system