Home Health & Hospice Week

‘Corporate greed’ and ‘corporate profiteers’ are in the feds’ in the crosshairs.

MedPAC isn’t the only one turning its attention to private equity activity in healthcare and Medicare Advantage. The White House has announced steps it will be taking on the matters.

“Private-equity ownership in the health care industry has ballooned, with approximately $750 billion in deals between 2010 and 2020” in sectors including home health and hospice, the Biden-Harris administration says in a fact sheet released on Dec. 7.

The administration will launch “a cross-government public inquiry into corporate greed in health care,” the fact sheet insists. “The Biden-Harris Administration believes that the health care system should serve patients, not corporate profiteers.”

The Department of Justice, the Federal Trade Commission, and the Department of Health and Human Services will issue a “joint Request for Information to seek input about how private equity and other corporations’ increasing power and control of our health care is affecting Americans,” it explains. “The agencies will use this joint Request for Information to identify areas for future regulation and enforcement prioritization, and they will continue to work together on case referrals, reciprocal training programs, data-sharing, and further development of additional health care competition policy initiatives.”

New leadership: “As part of this effort, HHS will appoint a Chief Competition Officer and DOJ’s Antitrust Division and FTC will name Counsels for Health Care to lead these efforts,” the administration details.

The administration also celebrates the steps the Centers for Medicare & Medicaid Services has already taken to publicize ownership data for HHAs and hospices, among other provider types. “Making ownership information transparent allows for identification of common owners with histories of poor performance, analysis of trends on how market consoli­dation impacts consumers, and evaluation of the relationships between ownership and changes in health care costs and outcomes,” it notes.

On the Medicare Advantage front, the administration pledges to increase program transparency. “CMS must have comprehensive and high-quality Medicare Advantage programmatic data, including understanding the effects of market shifts on consumers and care outcomes,” it says. “CMS has taken steps to improve Medicare Advantage data transparency” and will start “soliciting information from the public early next year to strengthen CMS’ data capabilities and Medicare Advantage transparency efforts,” according to the fact sheet.

The administration also reiterates recent steps it has taken to crack down “on anticompetitive and anti-consumer practices in Medicare Advantage.” That includes last month’s proposed rule from CMS “to stop large insurance plans from offering brokers and agents lavish compensation — such as cash bonuses, volume bonuses, and perks,” among other things.

Plus: The Biden-Harris administration touts the FTC’s proposed ban of “non-compete agreements that trap health care workers and others” (see HHHW by AAPC, Vol. XXXII, No. 18). Affected healthcare workers will have “more employment opportunities” under the ban, it says.

The statement also highlights new steps the administration will take in negotiating drug prices, which has grabbed the lion’s share of mainstream press attention.

“Anticompetitive acquisitions and practices can chill fair competition, leading to higher health care costs, degraded working conditions, and less innovation across the health care and pharmaceutical industries,” the FTC, DOJ, and HHS say in a joint release. “Through regulatory and legal actions [the agencies] are each working to promote competition to lower health care costs for families and taxpayers and improve the quality and availability of health care for patients,” they pledge.

Spotlight To Get Hotter For PE In Healthcare

“These initiatives reflect a broad range of concerns about rising costs in health care, including pointed references to ‘price gouging’ and ‘profiteering’ by private equity and big business,” note attorneys Benjamin Dryden and Adria Warren with law firm Foley & Lardner. “These initiatives build on the dozens of other regulatory efforts that President Biden ordered in his 2021 Executive Order on Promoting