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Week in Washington 07/25/24
On The Campaign Trail CMS Flu Vaccine Axios reported that demand for flu vaccine shots has declined over the past two years, including among the elderly. 2023 to 2024 flu season saw about 63.2 million US adults get a vaccine shot compared to 69.5 million the prior flu season. Flu related hospitalizations and death increased ... Read more
Events & More
Don't wait! Discount ends July 31 for HMA's Fall Conference!
Dive into the payer side of the industry at HMA’s 7th annual Fall Conference:
Payer Innovation: Scaling Innovations, Tools, and Technology to Achieve Whole Person Care
Our panelists are tackling the big issues head on: adapting to the demands for value-based care; harnessing tools they have and exploring those still needed to deliver, measure, and improve on quality at the person level; and shaping the future of integrated care for Medicare and Medicaid dually eligible individuals. They’re also navigating through the headwinds of increased scrutiny on payment; charting a course for the transformative potential of AI in healthcare, and other critical topics on the horizon. Attendees will gain insights into how plans are adapting to new regulatory frameworks and what plans need and expect from potential partnerships to address health disparities.
Newsworthy Findings
PBMs Battle Bipartisan Scrutiny as Lawmakers Eye Industry Reform
Top executives of CVS Caremark, Optum Rx and Express Scripts made a rare congressional appearance to defend pharmacy benefit managers’ drug pricing policies.
Pharmacy Group, Providers Sue Change Healthcare After Cyberattack
The National Community Pharmacists Association and dozens of providers argue UnitedHealth-owned Change didn’t have adequate cybersecurity protections and caused them financial losses.
CMS: Insurers to Make $10.3B in 2023 Risk Adjustment Payments
Risk adjustment state transfers as a percent of premiums declined from 2022, according to the report. This trend is likely driven by shifts in the risk pools, according to CMS, which are likely impacted by ongoing insurer expansion into new regions.
HHS Announces Major New AI, Cybersecurity and IT Reorganization
Oversight for healthcare technology, data and AI policy and strategy will be grouped under the renamed ASTP/ONC, while the 405(d) cybersecurity program will move to the Administration for Strategic Preparedness and Response.
What the CMS 2025 PFS Proposed Rule Means for Virtual Care
The 2025 PFS proposed rule extends existing virtual care payment rules and introduces new codes for digital therapeutics, highlighting virtual care's lasting role in healthcare.
Bonus Article
Blood Test That Detects Sepsis in 10 Minutes by Squeezing Blood Cells – Hailed as ‘the Holy Grail’
Just for Fun
Math Joke:
Why was the triangle the MVP of the basketball team?
Prior Week
Q: What is a math teacher’s favorite snake?
A: Pi-thon
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