California terminates contracts with Walgreens
Plus: Connecting IV pumps to MyChart and exceptions to indoor smoking laws
Good morning and happy Friday. Welcome to this week’s edition of the Friday Pulse Check from FLATLINING.net and Fulcrum Strategies. Read on to see what is coming up in the next few weeks on the FLATLINING Podcast and about a curious exception to indoor smoking laws.
In the news:
California cutting ties with Walgreens
Last week, in the “Other Articles of Interest” section, I shared a news story about Walgreens (WBA 0.00) which said they would not be distributing the abortion pill (mifepristone) in twenty states. On 1 February, Attorneys General from those states warned that ongoing litigation and enforceable legislation would prohibit pharmacies from distributing the drug. So far, Walgreens is the only chain that said they wouldn’t sell the drug in those states and as a result, California Governor Gavin Newsom ordered state officials not to renew contracts with the pharmacy giant. He said, “California will not stand by as corporations cave to extremists and cut off critical access to reproductive care and freedom.” Walgreens has pushed back on the state saying that once they are certified by the Food and Drug Administration, they will sell mifepristone in areas where it is legal to do so, including California. California’s move could mean Medicaid patients will not be able to fill prescriptions at Walgreens with their benefits. Read more from the Associated Press.
In January 2023, the FDA changed a long-standing provision that mifepristone must be obtained and taken in an abortion clinic or hospital. The new rule allows commercial pharmacies to distribute the drug to women with a prescription.
Interested pharmacies must seek FDA certification. Walgreens, part of the international Walgreens-Boots Alliance, and CVS (CVS 0.00) , which owns Aetna insurance, were among the first to announce they would be seeking certification. RiteAid (RAD 0.00) has said they will sell the drug at some locations. Kroger (KR 0.00), Walmart (WMT 0.00), and Meijer have not confirmed if they will be seeking certification.
After the Supreme Court overturned Roe v Wade, abortion regulation was transferred back to the states’ control. Some states which have enacted laws that restrict access to abortion are also working to prohibit access to mifepristone in brick-and-mortar pharmacies and via the US Mail. Some of the states that sent letters to Walgreens and other pharmacies include Kansas, Alaska, Iowa, and Montana.
More problems with internet trackers accessing PHI
More and more health companies are facing scrutiny after the Department of Health and Human Services warned in December 2022 that the use of certain internet trackers on hospital websites and electronic charting systems could violate HIPAA regulations. This week, online mental health services website Cerebral sent emails to its patients admitting that trackers on its website had accessed personal data, protected health data, and financial data. Depending on the user’s browser configuration, that information may have been sent to Google (GOOG 0.00) , Meta (Facebook) (META 0.00), and TikTok. Cerebral said it has “disabled, reconfigured, and/or removed” and has disabled the function that shares information with other sources to comply with HIPAA regulations. Read more from LegalScoops.
One hospital has connect IV pumps to Epic MyChart
Speaking of tech, Hastings, Nebraska based Mary Lanning Healthcare has announced that it has made its IV pumps interoperable with Epic MyChart. This change allows the IV pumps and the electronic charting system to communicate with each other. The hospital says that now the IV pumps will give exactly as what the physicians ordered; previously the hospital relyed on nurses to manually adjust IV pumps. They say this will help reduce the chance of manual errors. Read more from Mary Lanning Healthcare.
New regulations for mammograms
Yesterday the FDA issued a final rule for the Mammography Quality Standards Act of 1992 which changed some of the requirements for mammograms. Most notably, providers are now required to tell women who undergo the screening whether or not they have dense breasts. Dense breast tissue can make it more difficult to see cancers on a mammogram. The Mammography Quality Standards Act grants the FDA the authority to oversee and regulate mammography facilities and enforce standards. Read more from the FDA and a summary from CNN.
Other articles of interest:
Women’s History Month: 14 women making moves in healthcare - Becker’s Hospital Review
Opinion: WSJ Editorial Board - Biden’s Tax and Rationing Plan for Medicare - Wall Street Journal 🔒
Scientists have revived a ‘zombie’ virus that spent 48,500 years frozen in permafrost - CNN
GSK expects US launch of RSV vaccine with no supply issues - Reuters
Virtual or In Person: Which Kind of Doctor’s Visit Is Better, And When It Matters - Kaiser Health News
The health costs of daylight savings time - US News
Opinion: Newt Gingrich - Debate over COVID-19 origin “is the biggest scandal in American history” - FOX News
The FLATLINING Podcast
This week on the podcast, Ron and I broke down two interesting news stories that are affecting doctors across the country. First is the obvious physician shortage that is on track to only get worse. Researchers from Stamford University School of Medicine, the University of California Los Angeles, and the American Medical Association determined that many more physicians died during the COVID-19 pandemic than previously estimated.
Lindsey Carlasare, research and policy manager for the American Medical Association, said “beyond the deaths directly attributable to the virus, we see the extended impact by quantifying the number of physicians deceased beyond what would have been expected under normal circumstances.”
This, coupled with the fact that the median physician age is quite high does not bode well for an already strained healthcare system. Ron and I discussed how long it might be able to continue and what can be done to reverse it.
Also on the podcast was a story about a bill in the Indiana state legislature. Lawmakers there seem to think that the nonprofit hospitals in that state make too much money and act essentially as monopolies. There solution: fine hospitals that charge more than 260% of Medicare. As most readers of this newsletter know, the charges that a hospital sends to an insurance company or employer are almost never what is actually paid; they will be reimbursed at their contracted rate. So what is the motivation behind this bill? Ron and I discuss it.
Subscribe to the FLATLINING Podcast on Apple Podcasts, Spotify, the iHeartRadio app, Amazon Music, Google Podcasts, Stitcher, Pandora, TuneIn, and Audible.
North Carolina is finally reforming its Certificate of Need laws. We’ll discuss who can build an MRI machine or an ambulatory surgery center and when.
What is all the hype about weight loss drugs like Wegovy and will the insurance companies ever cover them?
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I’ve written several times in this section about the mental health crisis brought about by the Russian invasion into Ukraine. This week the Indianapolis Star profiled a new mental health center designed to help Ukrainian civilians and military who have suffered from traumatic experiences because of the war. The center will provide outpatient and inpatient services, including psychiatric care, psychotherapy, and rehabilitation and was funded in part by the United States and the European Union. Read more from the Indianapolis Star.
I am just old enough to remember smoking and non-smoking sections in restaurants, though by the time I was in middle school they were completely gone. I had a professor in college that said he was there long enough that he could remember when students could smoke in class, then in the back of the class, then in the hall, then outside, and now off campus.
Thats what I was a little surprised to see this article cross my desk about casinos in Atlantic City, New Jersey. Apparently the 2006 law banning smoking in that state left a clause in favor of the casinos. CBS News calls it a loop hole but I suspect it was part of some good, old-fashioned lobbying. Casinos in Atlantic City are allowed to have up to 25% of their floors as smoking sections.
Now, casino employees, including those undergoing cancer treatment, are testifying in front of the state Assembly in favor of banning the practice. Governor Phil Murphy (D) has said he will sign a bill that comes to him banning smoking in the casinos, but the legislature has yet to produce such a bill.
The Casino Association of New Jersey says a ban on smoking would cause a twenty to twenty-five percent revenue drop. The Atlantic City casinos are still hurting from the pandemic; only three have surpassed pre-pandemic revenue levels. Upon further reading, several other states allow some amount of indoor smoking inside casinos.
Best quote from the article: Assemblyman Don Guardian, former mayor of Atlantic City said, “I don't want to take away your right to kill yourself by smoking. I do want to take away your right to kill someone else by smoking in a casino.” Read more from CBS News.
Have a good weekend,
A previous version of this article linked to CNN instead of the official FDA website. That link has been corrected.