'Walgreens to accept Medicare Advantage OTC benefits online'

 Walgreens will now accept a slew of Medicare Advantage supplemental benefits online, including the option for home delivery, the company announced this week.

The digital option will be available for 1,700 eligible products, Walgreens said in an announcement. When a member connects to Walgreens' app or website, they'll be able to see which items are available under their plan, as well as over-the-counter products that are commonly offered in these benefit packages.

The items can then be purchased using the member's Medicare Advantage card, using the stipend provided in their plans, the retail pharmacy giant said.

Offering these products online can address access challenges as well as improve convenience for the member, according to Walgreens.

“As a health and wellbeing destination for everyone, Walgreens is always looking for ways to enhance the customer experience with solutions for every shopper,” said Tracey Brown, president of Walgreens Retail and chief customer officer, in the press release. “Accepting Medicare Advantage supplemental benefits online and on the Walgreens app improves shopping solutions for those who are homebound, have limited mobility or are simply short on time.”

The retailer has accepted Medicare Advantage supplemental benefits in its stores since 2019, according to the announcement.

Once the member finds the product they need, they can choose between one-hour or 24-hour home delivery or pick-up in their local store, Walgreens said.

The team will also work to add additional product options and payer partners over time, Walgreens said.

https://www.fiercehealthcare.com/retail/walgreens-accept-medicare-advantage-otc-benefits-online

Affordable Care Act preventive services under threat: Previewing Braidwood oral arguments

 A core provision of the Affordable Care Act (ACA), responsible for ensuring hundreds of millions of Americans receive free access to preventive services, faces a serious legal challenge March 4.

On Monday, the Fifth Circuit Court of Appeals will listen to oral arguments for Braidwood v. Becerra. In September 2022, a lower court ruled that nonprofit Christian-owned Braidwood Management should not be required to cover PrEP drugs for HIV as it violates their rights under the Religious Freedom Restoration Act.

The lower court decision was appealed by the federal government in March 2023. While the lower court's ruling is not yet in effect, the Fifth Circuit's decision later this year could spell trouble for one of the most critical aspects of the ACA. Regardless of the outcome, the case will almost certainly get appealed up to the Supreme Court, experts told Fierce Healthcare.

The appeal will judge whether the preventive services provisions in the ACA are unconstitutional. Since 2010, private plans and Medicaid expansion programs are mandated to cover preventive products and services without cost sharing.

Natalie Davis (United States of Care)

"The uncertainty this creates for patients can't be undersold," said United States of Care co-founder and CEO Natalie Davis. "It's the most important part of the ACA. It has literally saved lives."

She added: "My sense is that not only do the American people not know that this court case is happening, but that even people in the healthcare industry are unaware of this case and the widespread implications that it would have for people."

Plaintiffs argued in the district court that officials within the U.S. Preventive Services Task Force (PSTF), the Advisory Committee on Immunization Practices and the Health Resources and Services Administration were not properly appointed, meaning they must be appointed by the president, a court or senior department head, therefore violating the appointments clause. The lower court declared that only PSTF violated this clause.

They also argued all three entities violated the nondelegation doctrine, which forbids Congress from delegating responsibilities to administrative agencies under some cases. The district court ruled the ACA did not violate the nondelegation doctrine, though it left open the possibility a higher court could disagree.

Preventive services have positively impacted nearly 152 million people in 2020 and have led to increases in disease screenings and detections, according to the Commonwealth Fund.

What to expect
 

"I don't think the arguments will be anything unpredictable," said Richard Hughes IV, a healthcare attorney for Epstein Becker Green and lead counsel for the HIV+Hepatitis Policy Institute. The organization submitted an amicus brief with 24 other groups in support of the federal government in June.

He said the plaintiffs will continue to argue members of each of the three governmental entities were unlawfully appointed, effectively putting the authority of these bodies in the spotlight. They will also bring up the religious rights they have, though Hughes anticipates the feds will avoid this topic.

The government may suggest the court sever a statutory provision of the PSTF that says it must be insulated from political influence, allowing the task force to be preserved, he said.

Richard Hughes IV (LinkedIn)

Andrew Twinamatsiko, co-director of the O'Neill Institute's Health Policy and the Law Initiative, expects the litigation will not center around the nondelegation doctrine, as the plaintiffs will be preserving that argument for the Supreme Court.

"The strategy here is that the Supreme Court might be more receptive to changing the approach to nondelegation than what has been in existence," he explained.

Hughes also sees a parallel between this case and the cases involving the Chevron deference that the Supreme Court has already heard oral arguments about, an idea that allows federal agencies to administer laws that are ambiguous and require expert opinion when law is not abundantly clear. It allows civil servants to create technical rules, in agencies like the Centers for Medicare & Medicaid Services, when expertise is required.

But the conservative majority Supreme Court is wary of the power and regulatory authority given to these agencies over the years.

"It's going to offer a preview into how this court really thinks about these issues," said Hughes.

The Fifth Circuit is a traditionally conservative-leaning court that often hears health regulatory challenges. Two Trump-appointed judges and one Biden-appointed judge will be on the panel. Twinamatsiko said it's possible the court will hear the case before a larger panel.

All this points to a world where it may be likely federal agencies have less say in regulatory decision-making and preventive services are not covered by insurers.

"It very well could uphold the district court's decision," said Barbara Zabawa, owner of the Center for Health & Wellness Law, and an associate professor of law and healthcare attorney.

She said if preventive services are no longer required by plans, people will seek out these services through the wellness industry. Although the ruling could help insurers and employer plans in the short term, she argues that patients and the Medicare system will suffer.

"Before the ACA was passed in 2010, very few insurers actually provided preventive services, especially at no cost sharing because it's not in their economic interest," said Zabawa. "If you're going to have people use preventive care, the economic benefit isn't realized until many, many years down the road."

https://www.fiercehealthcare.com/payers/aca-under-threat-previewing-braidwood-oral-arguments

What the ransomware attack on Change Healthcare should teach the industry

 As the disruption caused by the cyberattack at Change Healthcare stretches beyond its tenth day, cybersecurity experts say that the incident could spur greater emphasis on enhancing protocols — and greater oversight from the feds.

On Feb. 21, Change Healthcare's systems were taken offline and its parent company, Optum, disclosed the following day that a cybersecurity issue was behind the outage. UnitedHealth Group initially pinned the blame for the attack on a "nation-state" affiliated actor before acknowledging on Thursday that it was caused by BlackCat, a notorious cybercriminal gang also known as ALPHV or Noberus.

The hackers had taken credit for the breach in a quickly-deleted post on its dark website.

Steve Cagle, CEO of Clearwater, which provides cybersecurity services to healthcare organizations, told Fierce Healthcare that ransomware hackers like BlackCat see the clear value in the wealth of data that the industry has stored in its systems.

"You have threat actors —  over 114 threat actors — specifically targeting healthcare, and they recognize the value of the data, they recognize the value of the technology that they can hold up in a ransomware attack," Cagle said. "And they're criminals and criminals are motivated by money."

Ransomware attacks are growing, and healthcare is a frequent target

Addressing ransomware, or attacks where critical data or technology is extracted and then encrypted to be held for a ransom, needs to be a key focus for healthcare cybersecurity leaders, as they're frequent targets of these hackers given the data at stake.

A study published in January 2023 in JAMA Health Forum found that the number of ransomware attacks in healthcare has doubled over the past five years alone. The Department of Health and Human Services issued a report (PDF) earlier this year on ransomware and its impacts on healthcare, saying that there were more than 630 ransomware incidents impacting healthcare globally in 2023, with 460 of them hitting organizations in the United States.

BlackCat is one of the primary hacking groups targeting healthcare, according to the report. The group was also behind massive cyberattacks on MGM Resorts International and Caesars Entertainment last year.

"The long-time perceptions of domestic, rogue, individual hackers as primary perpetrators do not match the current reality in the healthcare and life sciences sector," HHS wrote. "Institutions are routinely targeted by full-time professional cyber actors that are well-trained, well-equipped, well-funded, and often supported and sheltered by adversarial nation-states."

Cagle said that BlackCat took the gloves off in its hacking efforts after the Federal Bureau of Investigation briefly seized its websites late last year. Once it regained access to its sites, the organization's leaders encouraged affiliates to attack hospitals and other vulnerable targets, when previously they had avoided fully taking these organizations offline.

"So this is a very aggressive threat actor, again, targeting healthcare," he said, "now targeting with fewer restrictions."

Federal agencies issued a warning about BlackCat specifically to healthcare organizations in December that was updated this week after the breach at Change.

It's still not clear at present how the hackers accessed Change's systems. Cybersecurity experts posited that they were able to breach Change through a recently identified vulnerability in Connectwise's ScreenConnect platform, though the hackers themselves refuted that theory in a now-deleted statement on their website.

Troy Hawes, a health IT consultant and managing director at Moss Adams, told Fierce Healthcare that the BlackCat hackers are known to use "sophisticated social engineering techniques" to get into target systems, including research on company employees and leveraging that knowledge to gain access.

"They really target IT employees," he said. "They're known to do a lot of homework upfront."

Where healthcare organizations should focus

So what can healthcare companies do to put themselves in a better position to prevent or respond to a ransomware attack? Cagle said that while the number of attacks is growing, many prominent people in the industry are working hard to set the industry up to respond proactively to these breaches.

In February, the Health Sector Coordinating Council's Cybersecurity Working Group released its strategic plan, a five-year roadmap to addressing some of the most challenging cybersecurity trends facing healthcare. It established 10 goals that organizations can adopt to be better prepared.

For one, it recommends that cybersecurity requirements be made readily available, understandable and feasible for every segment of healthcare to implement. Emerging technologies should be "rapidly and routinely" screened for risks, and any platforms deployed either inside or outside of a healthcare organization must be "secure-by-design and secure-by-default," according to the plan.

The goal, the working group said, is to upgrade the diagnosis for cybersecurity in healthcare from "critical condition" to "stable condition" over the next several years.

It's critical to view cybersecurity on the same level as other key priorities within the organization, Cagle said.

"For smaller organizations, do I put more money in security, or do I buy that new MRI machine or hire the additional staff that I need?" he said. "But if cybersecurity is patient safety, that's table stakes. That should make the answer to that question easier for you because patients come first. Patients have to be at the center of everything that we do."

Hawes noted that the Department of Health and Human Services also released voluntary guidelines in January that aim to support healthcare companies in beefing up their cybersecurity practices as the first step in a broader strategy around this issue.

He said that he believes broad change in healthcare around cybersecurity will likely hinge on what the next phases of that strategy look like. Down the line, these voluntary goals will have potential incentive payments tied to them, but Hawses said he expects to see at least some of the guidelines become mandatory in the future, especially as the breach at Change continues to grab headlines.

"It's a necessary piece that can't just be, 'Hey, here's some funds, go to it.' There needs to be oversight," he said. "There needs to be people actually evaluating that it's been done. There needs to be third-party assessments and things like that to help assess those entities."

Cagle said that the sheer size of Change Healthcare, and its parent company UnitedHealth Group, and the scale of the disruption will likely be a "wake-up call" for those in the industry who may not be putting cybersecurity front and center.

"What happens a lot of times is something will happen and then people kind of go back to what they're doing," he said. "And they forget, and I hope that doesn't happen here."

"Because if this can happen to such a large organization, and such an important organization, and one that probably has a good security program in place...it could happen to anybody," he said.

https://www.fiercehealthcare.com/health-tech/cybersecurity-patient-safety-what-ransomware-attack-change-healthcare-should-teach

Georgia state House passes bill allowing police to arrest anyone suspected of being in country illegally

 The Georgia state House passed a bill that allows for anyone suspected of being in the United States illegally to be arrested.

The state House voted 97-74 to approve House Bill 1105, which would allow police to arrest anyone with probable cause who is suspected of being in the U.S. unlawfully and detain them for deportation.

The bill comes after the killing of 22-year-old nursing student Laken Riley in Athens, Ga. The suspect in her death is Jose Ibarra, a Venezuelan citizen whom authorities say crossed into the U.S. unlawfully in 2022.

Ibarra was detained by U.S. Immigration and Customs Enforcement (ICE) but released for further processing. He later was arrested in New York and charged with acting in a manner to injure a child, but was released before ICE could ask local authorities to take him into custody, The Associated Press reported.

Riley’s death has sparked outrage among the community and some Republicans have used her death as an opportunity to call out President Biden and Democrats on the subject of immigration. Democrats are arguing that her death shouldn’t shape broad immigration policy.

The bill, passed Thursday, would require jailers and sheriffs to report to federal authorities when someone in their custody has been found to not have legal documentation. Local governments could lose state funding or state-administered federal funding if they don’t report it, according to the Atlanta Journal Constitution, which first reported the legislation passing.

State Rep. Jesse Petrea (R) sponsored the legislation. He said he worked on the effort for at least a year but the bill took on new importance after Riley’s death, the Atlanta Journal Constitution reported.

Rep. Pedro Marin (D), Georgia’s longest-serving Latino legislator, said the crimes committed by individuals should not be used to generalize entire communities. He said the bill is an attempt to promote racial profiling, the Atlanta Journal Constitution reported.

https://thehill.com/homenews/state-watch/4500897-georgia-state-house-passes-bill-allowing-police-to-arrest-anyone-suspected-of-being-in-country-illegally/

Senegalese migrants illegally crossing US border relying on TikTok, WhatsApp to plan

 Senegalese migrants are illegally crossing the border in waves with many relying on apps like TikTok and WhatsApp to plan their journeys to the United States through Nicaragua.

U.S. authorities arrested Senegalese migrants 20,231 times for crossing the border illegally from July to December. That’s 10 times higher than 2,049 arrests during the same period of 2022, according to U.S. Customs and Border Protection. Many cross in remote deserts of western Arizona and California.

Word of the Nicaragua route began spreading early last year in Sengal’s capital city of Dakar and took hold in May, according to travel agent Abdoulaye Doucouré.

4

Gueva Ba, who was deported back to Senegal, is spotted selling using phones in Dakar’s Colobane market on Feb. 1.AP

He said sold about 1,200 tickets from Dakar to Nicaragua in the last three months of 2023 at around several thousand dollars each.

“People didn’t know about this route, but with social networks and the first migrants who took this route, the information quickly circulated among migrants,” he told The Associated Press.\

The Senegalese migrants who’ve made their way to New York City include nearly 80 men who authorities recently discovered living in a cramped basement under a Queens furniture store. The beds were so in-demand that only half the inhabitants can sleep there at one time.

Fire prevention inspectors discovered the illegal boarding house Monday night when they were called to 132-02 Liberty Avenue in South Richmond Hill to investigate reports of a large collection of e-bike batteries, according to the FDNY.

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Gueva Ba shows video of his trek from Nicaragua to Mexico-United States border.AP

Gueva Ba told the outlet he failed 11 times trying reaching to reach Europe by boat from Morocco as part of his quest to get to the U.S.

In 2023, the former welder heard about a new route to the U.S. by flying to Nicaragua and making the rest of the journey illegally by land to Mexico’s northern border.

“In Senegal, it’s all over the streets — everyone’s talking about Nicaragua, Nicaragua, Nicaragua,” said Ba, 40, who paid about $10,000 to get to Nicaragua in July with stops in Morocco, Spain and El Salvador. “It’s not something hidden.”

Ba was deported from the U.S. with 131 compatriots in September after two months in detention, but thousands of other Senegalese have gained a foothold in America.

Many turn to savvy travel agents who know the route — touted on social media by those who’ve successfully settled in the U.S.—and seek help via social networks, and apps like WhatsApp and TikTok.

Some are motivated by Senegal’s political turmoil — authorities delayed February’s presidential elections by 10 months — but the sudden draw seemed to hinge largely on social media posts and the spread of the route there.

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Migrants walk along the highway through Arriaga, Chiapas state in southern Mexico.AP

Spikes attributed to social media have occurred in other West African nations, whose people have historically turned first to Europe to flee.  Many are eventually released in the U.S. to pursue asylum in immigrant courts that are backlogged for years with more than 3 million cases.

As U.S. sanctions against Nicaragua’s repressive government have increased, the government of President Daniel Ortega has used migration to push back.

The Nicaraguan government hired a Dubai-based firm to train Nicaraguan civil aviation to manage national immigration procedures for charter flight passengers.

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Gueva Ba sells used cell phones in Dakar’s Colobane market Thursday, Feb. 1, 2024.AP

The U.S. State Department has demanded Nicaragua to “play a responsible role” in managing migration, but that has yet to be seen. Nicaraguan first lady and Vice President Rosario Murillo did not respond to a request for comment on the surge in extra-continental migration through her country.

Ousmane Anne, 34, left Senegal on Sept. 25 with a plane ticket to Nicaragua, purchased from a travel agency. His journey took a month — longer and costlier than anticipated. Mexico was treacherous, he said, describing his traveling group as frequently harassed, threatened and robbed by gangs.

Despite the enthusiasm back home, he said, he’d be hard-pressed to recommend the trip to anyone who doesn’t understand the risks. But he made it to New York, which has the largest Senegalese population of any U.S. metropolitan area, according to census data.

“I knew it would not be very easy to come here to the States, but the hope that I had was higher than all the obstacles and problems,” Anne said. “I knew the opportunities would be greater here.”

https://nypost.com/2024/03/02/world-news/senegalese-migrants-illegally-crossing-us-border-relying-on-tiktok-whatsapp-to-plan-out-their-journeys/

Fed’s Powell to Double Down on ‘No Rush to Cut’ Message

 

• Set pieces include Fed testimony, China congress, UK budget
• ECB, Bank of Canada may keep interest rates unchanged

Federal Reserve Chair Jerome Powell is expected to double down on his message that there’s no rush to cut interest rates, especially after fresh inflation data showed that price pressures persist.

Powell is headed to Capitol Hill, where he’ll deliver his semiannual monetary policy testimony to a House committee on Wednesday and a Senate panel on Thursday. The US central bank chief and nearly all of his colleagues have said in recent weeks that they can afford to be patient in deciding when to cut rates given underlying strength in the US economy.

https://www.bloomberg.com/news/articles/2024-03-02/fed-rates-latest-powell-is-about-to-double-down-on-no-rush-to-cut