Hey Digital Health Mavericks,
Just when you thought the policy landscape couldn't get any wilder, this week happened. From "beautiful bills" packed with cuts to AI playing doctor (and auditor!), let's dive into the delightful disarray.
CTeL In Action: Don't Get Lost in the Medicare Jungle!
Last Call! Webinar: Navigating the Medicare Maze! Still scratching your head over Medicare enrollment, compliance, and keeping your virtual/hybrid care operations ship-shape? Our upcoming webinar is your compass and map! We're equipping you with the strategies to conquer that intricate landscape. Don't miss out – it’s designed to make your life easier, or at least more understandable. [Register NOW Before It's Too Late!]
Industry Intel: Coding Conundrums & AI Alliances!
Patients Sicker or Coders Slicker? Upcoding Mystery Deepens. A Trilliant Health study found outpatient visits got coded at higher complexity levels from 2018-2023. Are patients genuinely presenting with more acute needs, or are we seeing some... creative coding to boost revenue? The plot, like the patient acuity, thickens.
AI Goes Global: Oracle, Cleveland Clinic & G42 Team Up! Oracle Health, the renowned Cleveland Clinic, and Abu Dhabi’s G42 are joining forces. Their mission, should they choose to accept it (they did): build an AI-based healthcare delivery platform. They're aiming for better patient care and public health management using AI, big data, and smart apps. Sounds like a plan for world (health) domination!
Administration Action: Audits, AI, and AG Victories!
White House Wants AI to Save the Kids (From Chronic Disease, That Is). The new "MAHA Report" (Make America Healthy Again) from the White House flagged drivers of childhood chronic disease and dropped 10 policy recommendations. Our favorite? "Create a task force to apply AI and machine learning to federal health and nutrition datasets for early detection of harmful exposures and childhood chronic disease trends." AI to the rescue!
CMS Unleashes the Audit Kraken (and 2,000 Coders!) on Medicare Advantage. Watch out, MA plans! CMS is beefing up its audit and oversight efforts, deploying "advanced systems" and hiring nearly 2,000 coders. Their goal? "Audit all eligible MA contracts for each payment year" and speed up current audits. Looks like someone's about to have a very busy year.
Site-Neutral Payments: Less 'Neutral,' More 'Meh' for Medicare Spending. A Health Affairs study suggests site-neutral payment reform didn't exactly revolutionize outpatient Medicare spending. The authors are nudging Congress to perhaps... reduce those pesky exemptions. So much for that silver bullet.
Score One for the AGs! Judge Slams Brakes on $11B Public Health Cuts. Following a lawsuit from 23 state attorneys general, a federal judge has indefinitely blocked $11 billion in public health funding cuts. The suit argued HHS overstepped. Chalk one up for the states!
Congressional Corner: One Big Beautiful Bill (of Cuts) & Deepfake Drama!
House Passes the 'One Big Beautiful Bill Act' (Spoiler: It's Packed with Cuts). In a nail-biting 215-214 vote, House Republicans passed their reconciliation megabill, charmingly dubbed the "One Big Beautiful Bill Act." It's got hundreds of billions in Medicaid cuts and is now Senate-bound, where changes are practically guaranteed. Oh, and a fresh CBO analysis hints that sequestration (due to the bill likely increasing the deficit) could mean nearly $500 billion in Medicare cuts over the next decade. Surprise!
Sec. Kennedy's Farewell Tour (of Justifying Cuts) Continues. HHS Secretary Kennedy was back on the Hill, this time before the Senate Appropriations Committee, making his case for those sweeping agency cuts. Committee Chair Shelley Moore Capito (WV), who previously sparred with Kennedy over NIOSH jobs in her state, was surely all ears.
Deepfake Drama: Senate Dives into AI Deception. The Senate Judiciary Committee held a hearing on AI-generated deepfakes. This comes hot on the heels of President Trump signing the "Take It Down Act" – one of Congress's first real stabs at AI regulation. Looks like lawmakers are finally waking up to the digital Wild West.
State Stories: Budgets, Breaches, and Beyond!
California Dreamin' of... Medi-Cal Cuts? Newsom Proposes Trims. Governor Gavin Newsom is looking to tighten California's belt by proposing several cuts to the state’s Medi-Cal program. On the chopping block: new patient premiums, overtime restrictions for some workers, excluding undocumented migrants, and changes to FQHC payments.
AI Vendor Blamed for Massive NY Health Data Breach. Ouch. New York-based Catholic Health is dealing with a data breach affecting over 483,000 patients. According to an HHS filing by Serviceaide (a vendor developing agentic AI products), they were the target. A stark reminder that innovative tech comes with its own set of vulnerabilities.
And that's the Telehealth Policy Scoop for this week! Stay informed, stay engaged, and remember that in the world of health policy, the only constant is change (and maybe a little bit of chaos).
Until next time, Your Pals at CTeL
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