| | | |   | Good morning, D.C. Diagnosis readers! I’m watching for bill text on the Senate’s gun safety compromise, to see whether cancelling the Trump administration’s Medicare drug rebate rule — the pay-for that keeps on giving — will emerge yet again as a way to finance the legislation. Got tips? Drop me an email at rachel.cohrs@statnews.com. | | | Blue Cross Blue Shield system cashed in on Trump tax cuts  Source: statutory financial statements (bob herman / stat) It’s not just the ultra-wealthy who are navigating tax law to ensure they don’t pay income tax — some insurers are too. The Blue Cross Blue Shield system insurers in particular have minimized their federal income tax, my colleague Bob Herman found, in part because of special treatment they receive under tax law. Some in the system haven’t paid any at all. Bob reviewed four years’ worth of audited financial statements for 32 nonprofit BCBS insurers and identified 12 that haven’t paid any net federal taxes since the calendar flipped to 2018, right after Republicans in Congress and former President Trump overhauled the corporate tax system. “It’s a huge deduction, and it’s an artificial deduction that no one else gets,” said Elizabeth Plummer, an accounting professor at Texas Christian University. | A hospital industry divided Some hospitals scored a big win at the Supreme Court yesterday, but another fight is already brewing. Three hospital lobbies banded together to sue the Trump administration for slashing Medicare pay to hospitals that participate in the 340B drug discount program. Read more about the details of that case in my rundown from yesterday. However, Medicare’s hospital pay rates are a zero-sum game. So if 340B hospitals are going to get higher rates again, it could come at the expense of other, for-profit facilities. The winning hospitals are already trying to argue that they should get back pay for the lower rates in the past, too. Watch for Medicare’s outpatient pay rule, which usually drops during the summer, for the agency to address what’s next. | Facebook may be watching hospital websites A tracking tool installed on many big hospitals’ websites — think Johns Hopkins, New York-Presbyterian, and UCLA — may be sending sensitive health information to Facebook, according to a new investigation published by The Markup. Former regulators, health data security experts, and privacy advocates who reviewed The Markup’s findings said the hospitals in question may have violated the federal Health Insurance Portability and Accountability Act (HIPAA). Read the full investigation here. | Voters report delaying or skipping health care due to concern over out-of-pocket costs More Americans have health insurance than ever before, yet 72% of voters are concerned with the cost of getting care. New polling reveals consumer worries about the unpredictability and pressure caused by these costs, the prevalence of medical debt, and the lack of access to mental health care. Voters across party lines want elected officials to act and provide quality, affordable health care. Learn more. | A wave of anti-PBM action on 340B in the states As any legislative or regulatory action at the federal level on 340B has been excruciatingly slow, states have taken matters into their own hands. A wave of new laws are designed to stop PBMs from reimbursing pharmacies that participate in the 340B program less than they would to regular pharmacies, or impose extra fees or requirements — meaning PBMs can’t capture any of the discount that was designed to benefit providers. Twenty states have these types of laws on the books, including 2022 additions Colorado, Illinois, Maryland, Michigan, Nebraska and Virginia, and a bill is pending the governor’s signature in Arizona, according to 340B Health’s tracking. Michigan’s law protects full reimbursement for pharmacies that contract at the federal level too, which has been a hotly debated topic in D.C. | What we're reading - A ‘veritable playground’: CVS whistleblower details how patients were charged higher drug prices, STAT
- AMA Annual Meeting Marred by Election Violation Charge, MedPage Today
- The irony — and ignominy — of medical conferences as superspreader events, STAT
- Buy and Bust: When Private Equity Comes for Rural Hospitals, Kaiser Health News
- FDA oversight of pharma manufacturing facilities plunges during the pandemic, STAT
| Thanks for reading! More next week,  | | | |
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