News

U.S. Surgeon General Declares Gun Violence a Public Health Crisis

• On June 25, U.S. Surgeon General, Dr. Vivek Murthy, declared gun violence a public health crisis that is directly driven by the fast-growing injuries and deaths involving firearms throughout the country. Dr. Murthy is calling on the nation to ban automatic rifles, introduce universal background checks for purchasing guns, further regulate the firearm industry, pass laws that will restrict gun use in public spaces and penalize those who do not safely store their guns. Additionally, Dr. Murthy calls for increased research on gun violence and for the health system to promote gun safety education during doctor visits (The Associated Press, June 25).
• Did you know, Sellers Dorsey’s latest white paper, “Addressing Health Equity and Support for Justice-Involved Populations” addresses violence prevention services to support victims of gun violence? Explore the white paper to understand Medicaid as a funding source for the prevention and treatment of individuals subject to violence by clicking here.

Expanded Approval of DMD Gene Therapy Could Increase State Medicaid Costs

• On June 20, the FDA announced expanded approval of the first gene therapy to treat Duchenne muscular dystrophy (DMD) in children. This approval provides an opportunity for more than 80% of patients with the condition to have expanded access to treatment. However, due to the drug’s $3.2 million list price and predicted higher sales due to increased demand from patients who can be prescribed the drug, state Medicaid program coverage could be challenging. Policymakers are currently discussing new policies to ensure Medicaid programs can afford incoming high-cost cell and gene therapies for the increased coverage (Inside Health Policy, June 21).

CMS Awards School-Based Services Grants to 18 States

• On June 25, CMS announced the 18 states awarded grants for the implementation, enhancement, and expansion of Medicaid and CHIP School-Based Services (SBS). SBS plays an important role in the health of children and provides the unique opportunity of identifying health needs and facilitating access and coverage options while in the school setting. SBS promotes health and educational equity by helping students enroll in Medicaid, connecting students’ families with Medicaid, and providing Medicaid-covered health services in school, performing Medicaid administrative activities to improve student wellness. The 18 states awarded grants are: Alaska, Delaware, Kansas, Kentucky, Maryland, Massachusetts, Minnesota, Nevada, New Hampshire, North Carolina, Oklahoma, Oregon, Pennsylvania, Rhode Island, Vermont, Washington, West Virginia, and Wisconsin. All awarded states will receive up to $2.5 million over three years and use their funds to connect children to critical healthcare services, especially mental health services, while at school (CMCS, June 25).

Federal Litigation

Supreme Court to Hear Gender-Affirming Care Case

• On June 24, the Supreme Court announced it will take up a case challenging a ban on gender-affirming care for minors for the first time. In United States v. Jonathan Skrmetti, et al., a physician and a group of anonymous transgender minors and their parents have challenged Tennessee’s ban on gender-affirming care for children. The Supreme Court will consider whether the laws constitute sex discrimination and violate the 14^th Amendment’s Equal Protection Clause. While the Supreme Court has previously ruled that prohibitions on sex discrimination also include discrimination against transgender people, it has yet to consider a case involving state law related to transition healthcare. The case will be considered in the court’s Fall term (Inside Health Policy, June 24).

Federal Court Rules Against HHS in Suit About HIPAA Violation Policy

• On June 20, the U.S. District Court for the Northern District of Texas determined that HHS does not have the authority under the Health Insurance Portability and Accountability Act (HIPAA) to forbid providers from utilizing third-party tracking technologies on their websites. The suit against HHS was initially filed in November 2023 by the American Hospital Association in response to an HHS Office of Civil Rights bulletin involving how regulated entities, such as hospitals, cannot use tracking technologies on their websites, because it would be considered impermissible disclosure of personally identifiable health information in certain situations (Modern Healthcare, June 21).

Appeals Court Largely Upholds ACA’s Preventive Coverage Mandate, Remands Birth Control and Vaccine Mandates

• The Fifth Circuit Court of Appeals largely upheld the ACA’s preventive coverage mandate in a ruling on June 21. However, the matter was remanded to the lower court to address questions on birth control and vaccine mandates. In their decision, the appeals panel sided with HHS and reversed District Judge Reed O’Connor’s previous ruling from September 2022 which prevented HHS from enforcing the preventive coverage mandate on the plaintiffs, Braidwood Management, and insurers across the country. As a result of the appeals court reversal, HHS cannot enforce the preventive coverage mandate on the plaintiffs in Braidwood Management but can otherwise enforce the mandate on other insurers. However, the appeals court agreed with Judge O’Connor that the preventive coverage mandate violates the Appointments Clause of the Constitution and ratifying the United States Preventive Services Task Force recommendations will not alleviate this violation. According to court records, 172 healthcare and consumer organizations filed amicus briefs in the case, with the overwhelming majority supporting the preventive care mandate. An appeal to the Supreme Court could be filed this summer and heard next term (Inside Health Policy, June 21; Health Payer Specialist, June 24).

Federal Regulation and Guidance

HHS Final Rule Imposes Penalties for Information Blocking

• On June 24, HHS published a final rule, that discourages information blocking by imposing Medicare reimbursement cuts on providers that knowingly prevent authorized users from appropriate use of electronic health record (EHR) data. Information blocking occurs when a provider knows that a practice is unreasonable and likely to interfere with the access, exchange, or use of EHR information. Hospitals, ACOs, and clinicians that have committed information blocking are subject to different penalties. Hospitals will have their EHR “meaningful use” status and payment incentives revoked. Critical Access Hospitals will have a 1% point cut to their Medicare reimbursements. Physicians and other clinicians in Medicare’s Merit-based Incentive Payment System (MIPS) will lose their payment incentives and meaningful use status and potentially face reduced reimbursements. Finally, ACOs and their participants who engage in information blocking can potentially be barred from the Medicare Shared Savings program for at least one year. The HHS final rule is a companion rule to a July 2023 rule that subjects technology companies and health information exchanges to fines up to $1 million for information blocking. More information can be found on the Office of the National Coordinator for Health Information Technology (ONC) website (Modern Healthcare, June 24).