The COVID-19 pandemic accelerated the exodus from private practice to corporate medicine, Fierce Healthcare reports. Between January 1, 2019, and January 1, 2021, hospitals, payers, and other corporate entities acquired 20,900 physician practices, according to the Physicians Advocacy Institute. During that period, 48,400 physicians left independent practice to work for a larger employer. About half of those increases occurred between July 1, 2020, and January 1, 2021. As of January 1, 2021, nearly half of all U.S. practices were owned by hospitals or corporate entities, and 70 percent of physicians were employed by them.

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Highmark Health will grow by more than 350,000 members if state regulators approve a proposed deal to acquire sole ownership of Gateway Health. The acquisition would expand Highmark’s insurance rolls from 6 million to 6.355 million members, a nearly six percent increase. For nearly three decades, Highmark Inc., has owned 50 percent of Gateway, which is headquartered a few blocks from Highmark’s corporate high-rise in Pittsburgh. The remaining 50 percent of Gateway has been owned by Livonia, Michigan-based Trinity Health, whose provider network spans 90 hospitals and other services across 22 states. Gateway offers Medicaid, Medicare and dual-eligible coverage across Pennsylvania. Highmark’s proposed acquisition of Gateway comes just a few months after the insurer’s affiliation with HealthNow New York Inc. became effective. The newly affiliated organization — which expanded Highmark’s reach to four states — has been rebranded Highmark Blue Cross Blue Shield of Western New York and Highmark Blue Shield of Northeastern New York.

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The Office of Management and Budget released their Unified Regulatory Agenda (URA). The URA, which is updated twice each year, serves as an indicator of discrete regulatory priorities of the Administration and a timeline for expected action. However, the timelines are often aspirational and should not be viewed as hard and fast deadlines. The URA for the U.S. Department of Health and Human Services includes several Medicaid-oriented proposals, including:

• Streamlining the Medicaid and CHIP Application, Eligibility Determination, Enrollment, and Renewal Processes
• Medicaid Drug Misclassification, Beneficiary Access Protection, and Drug Program Administration
• Mandatory Medicaid and CHIP Core Set Reporting
• Medicaid Managed Care Risk-Sharing Mechanisms
• Temporary Federal Medical Assistance Percentage (FMAP) increase under the Families First Coronavirus Response Act

On July 9, President Biden signed an Executive Order aimed at curbing anti-competitive practices within several industries, including in health care. A fact sheet on the order is available here. Key provisions include:

• Drug Importation. The order directs the Food and Drug Administration (FDA) to work with states and Tribes on a plan to import prescription drugs from Canada, pursuant to the Medicare Modernization Act of 2003.
• The order directs the Department of Health and Human Services (HHS) to increase support for generic and biosimilar drugs.
• Drug Pricing. HHS is directed to issue a comprehensive plan within 45 days to combat high prescription drug prices and price gouging.
• Pay for Delay. The order encourages the Federal Trade Commission (FTC) to ban “pay for delay” and similar agreements in the pharmaceutical sector by way of federal rulemaking.
• Hospital Mergers. The order emphasizes that hospital mergers can be harmful to patients, encouraging the Department of Justice (DOJ) and FTC to review and revise hospital merger guidelines.

U.S. Rep. Glenn Thompson (R-PA) plans to soon reintroduce his HEALTH Act (H.R. 7187 in the 116^th).

This bill would codify Medicare reimbursement for FQHCs and rural health clinics for telehealth services. The bill would permanently allow FQHCs/RHCs the ability to provide telehealth services under Medicare. A change from the earlier bill is that reimbursement, instead of being associated with the Medicare Physician Fee Schedule, would be at the same level as if a Medicare beneficiary would receive the same services at a brick-and-mortar FQHC/RHC. The bill includes a provision to make permanent the waivers contained in the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020, relating to originating site rules (waivers which are otherwise in effect for the public health emergency period), specific to services where the FQHC/RHC is the distant site provider.

Changes to the benefits and rules for unemployment during the COVID-19 pandemic have been identified by many economists and employers as a reason for the substantial number of currently unfilled jobs throughout the nation while unemployment rates remain high. Pennsylvania is struggling with the same situation – continuing levels of high unemployment while there are a sizable number of available jobs – but that might soon start changing as the state’s work search requirement (suspended since March 2020) for those receiving jobless benefits is reinstated this week. Technically, because Unemployment Compensation (UC) claimants always file for benefits the week after they are unemployed, individuals will start certifying they looked for work beginning July 18 – but that doesn’t change that they need to start looking this week.

State officials late last week said job seekers can find help through the state’s PA CareerLink® website or their local PA CareerLink® office, with programs available to help with job search, training and resume assistance as well as provide adult education and other referral services. Additionally, the state Department of Human Services offers employment and training programs that support job seekers specifically within low-income populations.