The FLATLINING Podcast from Fulcrum Strategies

This week on the FLATLINING Podcast from Fulcrum Strategies, Matthew Handley and Ron Howrigon discuss recent actions by the Biden Administration to combat medical debt. The White House announced last week that they would be working to bar medical debt from being reported to the major credit bureaus which would then help patient's credit scores. But what happens to physicians and hospitals when consequences are taken away from medical debt? Plus: you'll be suprised to hear that the Biden Administration is taking on action on an issue that most credit agencies have already dealt with. Matthew and Ron look at these questions: Like, comment, and share. Let us know what you think by emailing us: flatlining@substack.com Follow and message Matthew Handley on Twitter: @radioHandley Read more healthcare news and subscribe to our newsletters at www.FLATLINING.net. Find out what Fulcrum Strategies can do for your practice at www.FSDOC.com.

This week on the FLATLINING Podcast from Fulcrum Strategies, CEO Ron Howrigon and Matthew Handley discuss political holdups to Medicaid expansion in North Carolina. The House wants to separate the Medicaid from the state budget and pass it with a casino bill but the state Senate is refusing to agree. So who gets hurt? Is the state ready to handle more patients on Medicaid? Why should you care? Matthew and Ron break it down on the FLATLINING Podcast from Fulcrum Strategies. Articles mentioned in this program: House to vote on budget and separate casinos-Medicaid bill this week, top appropriator says - The News and Observer The fate of North Carolina's Medicaid expansion could be tied to casinos - Becker's Payer Issues Follow Matthew Handley on X.

This week on the FLATLINING Podcast from Fulcrum Strategies, Matthew and Ron break down several healthcare news items that are relevant to the business administration of provider practices. They take a look at these stories: Cigna, UnitedHealthcare, and BlueCross BlueShield of Michigan claim they have cut prior-authorizations by 20% - Becker's Payer IssuesAffordable Care Act (ACA) compliant plan enrollment reaches record high - Kaiser Family FoundationPrisma Health and UHC get into a nasty contract negotiation - Becker's Payer Issues Matthew and Ron discuss whether or not the prior authorization cuts will help patients and their physicians. They also talk about ACA Marketplace plan reimbursement and how the record enrollments will affect provider revenue. And they share some tips on what to do in nasty negotiations. Follow Matthew and Ron on X. Matthew is @RadioHandley and Ron is @RonHowrigon. Subscribe, like, and share!

Matthew and Ron dive into the debate on whether Medicare should cover every FDA-approved drug, focusing on the case of Aduhelm and Leqembi, two Alzheimer's drugs. Aduhelm was is not covered by Medicare due to limited effectiveness and high cost. The Centers for Medicare and Medicaid Services announced Leqemebi would be in certain circumstances. Key highlights Follow Matthew and Ron on X: Matthew Handley on X Ron Howrigon on X Subscribe to the FLATLINING Podcast from Fulcrum Strategies to stay informed about healthcare and policy topics.

Matthew Handley and Fulcrum Strategies president and CEO Ron Howrigon discuss the recent rulings in the third Texas Medical Association case against the Centers for Medicare and Medicaid Services (CMS), commonly known as TMA 3. Judge Jeremy Kernodle ruled that CMS violated the No Surprises Act by publishing guidelines on the Qualified Payment Amount that contradicted the law in several ways. However, Judge Kernodle ruled against the plaintiffs by deciding that the QPA does not have to be transparent. Matthew and Ron discuss what this means for physicians, hospitals, and the general public. Follow Matthew and Ron on X.

Matthew Handley and Ron Howrigon discuss the ongoing relevance of COVID, the cost of weight loss drugs in the US, and public opinion on prescription weight loss drugs. Key highlights Resources mentioned Health System Tracker - How do prices of drugs for weight loss in the U.S. compare to peer nations’ prices? Kaiser Family Foundation - KFF Health Tracking Poll July 2023: The Public’s Views Of New Prescription Weight Loss Drugs And Prescription Drug Costs Facts Action steps Listener challenge: Reflect on your own opinion about prescription weight loss drugs and consider the potential impact of covering them under insurance. Matthew Handley on X Ron Howrigon on X Subscribe to the Flatlining Podcast to never miss an episode and join the conversation about important healthcare topics.

We received the news last week that Dr. Dan Hurley, who Matthew interviewed on the FLATLINING Podcast several months ago, had lost his battle with cancer. This week, Fulcrum Strategies president and CEO Ron Howrigon shares how Dr. Hurley's story affected him and continues to motivate him to fight for physicians. You can listen to our entire interview with Dr. Dan Hurley by clicking here.

This week on the FLATLINING Podcast, Matthew and Ron discuss a claim made by Senator Bernie Sanders (I-VT) that millions of Americans cannot access a primary care physician or have to wait months to get an appointment. Are these claims true? If so, what can be done? Subscribe to the FLATLINING Podcast on Apple Podcasts, Spotify, the iHeartRadio app, Amazon Music, Google Podcasts, Stitcher, Pandora, TuneIn, and Audible. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.flatlining.net

This week on the FLATLINING Podcast, Matthew and Ron talk about Senator Amy Klobuchar’s (D-MN) SMART Prices Act which would speed up the drug price “negotiations” in the Inflation Reduction Act. They also talk about an idea that would eliminate the difference in costs between seeing a doctor at a hospital versus and office. Subscribe to the FLATLINING Podcast on Apple Podcasts, Spotify, the iHeartRadio app, Amazon Music, Google Podcasts, Stitcher, Pandora, TuneIn, and Audible. Articles mentioned in this program: Klobuchar, Welch, Colleagues Introduce Legislation to Boost Medicare Prescription Drug Price Negotiation, Lower Costs for Americans - Sen. Amy Klobuchar’s Office Text of the SMART Prices Act - Congress.gov The SMART Prices Act Deserves a Failing Grade - RealClear Health Fix Medicare Payments - RealClear Health This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.flatlining.net

This week on the FLATLINING Podcast, Matthew and Ron talk about three current healthcare proposals from three different groups. First, the Biden administration is proposing changes to how short-term health plans work. These were deregulated during the Trump administration and allowed to last 364 days and be renewed four times. Ron explains why that doesn’t really work. Then, the US House of Representatives passed the CHOICE Act which expands association plans. This would allow more different businesses to get together to buy healthcare. How might that affect patients though? Finally, Rep. Chip Roy (R-TX) has proposed the Personalized Care Act which expands and deregulates Health Savings Accounts (HSAs). The problem is that this legislation will not actually lower costs or help people get healthcare. Matthew and Ron explain why. Subscribe to the FLATLINING Podcast on Apple Podcasts, Spotify, the iHeartRadio app, Amazon Music, Google Podcasts, Stitcher, Pandora, TuneIn, and Audible. Articles mentioned in this program: Everything Old Is New Again? The Latest Round of Health Policy Proposals Reprises Existing Ideas - KFF Health News Rep. Roy introduces the Personalized Care Act to help restore Americans’ healthcare freedom - Roy.House.gov This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.flatlining.net

This week on the FLATLINING Podcast, Matthew and Ron discuss a few news items in North Carolina. First, the state budget has been held up by members of the state Senate effectively putting Medicaid expansion on hold. When can we see any changes and how many more Medicaid patients should providers expect to see? Then, BlueCross BlueShield of North Carolina got approval from the state legislature and the governor to act more like a for-profit insurance company. What does this mean for patients and providers? How will this change the healthcare landscape in North Carolina. Matthew and Ron break it down on the FLATLINING Podcast. Subscribe to the FLATLINING Podcast on Apple Podcasts, Spotify, the iHeartRadio app, Amazon Music, Google Podcasts, Stitcher, Pandora, TuneIn, and Audible. Articles mentioned in this episode: North Carolina indefinitely delays specialty Medicaid plans - Becker’s Payer Issues North Carolina Governor Signs Bill Allowing Blue Cross to Restructure - US News Despite state budget deadlock, Wake County plans for Medicaid expansion - WRAL News This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.flatlining.net

This week on the FLATLINING Podcast, Matthew Handley takes a look at the “two cents to save America” plan touted by Michigan businessman Perry Johnson. Johnson says it will save America’s debt crisis. Who knew it could be so simple? Plus, Matthew tells you what federal department Johnson wants to cut completely and how his policies affect your healthcare. Subscribe to the FLATLINING Podcast on Apple Podcasts, Spotify, the iHeartRadio app, Amazon Music, Google Podcasts, Stitcher, Pandora, TuneIn, and Audible. Previous Pulse Check on the Candidates: Robert F. Kennedy, Jr. - 24 May 2022 - CLICK HERE TO LISTEN NOW This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.flatlining.net

Matthew Handley and Ron Howrigon continue their discussion about Ron’s new book. In this second part of the episode, they discuss what some possible reforms would be to fix the system and save the economy. CLICK HERE TO PURCHASE THE BOOK. (https://amzn.to/3CgXfmt) From the description: With healthcare spending accounting for nearly 20% of the U.S. economy and growing, Ron lays out a logical approach to healthcare reform that is needed to change this unsustainable trajectory. Subscribe to the FLATLINING Podcast on Apple Podcasts, Spotify, the iHeartRadio app, Amazon Music, Google Podcasts, Stitcher, Pandora, TuneIn, and Audible. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.flatlining.net

This week on the FLATLINING Podcast, Matthew Handley talks to Ron Howrigon about his new book CLEAR!: Reforming Healthcare to Save the US Economy. In the first of this two-part episode, they talk about some of the reasons healthcare is breaking the economy. CLICK HERE TO PURCHASE THE BOOK. (https://amzn.to/3CgXfmt) From the description: With healthcare spending accounting for nearly 20% of the U.S. economy and growing, Ron lays out a logical approach to healthcare reform that is needed to change this unsustainable trajectory. Subscribe to the FLATLINING Podcast on Apple Podcasts, Spotify, the iHeartRadio app, Amazon Music, Google Podcasts, Stitcher, Pandora, TuneIn, and Audible. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.flatlining.net

Yesterday, the 5th Circuit Court of Appeals heard arguments for a case that could end free preventative care in the Affordable Care Act. Listeners of the podcast may remember when Ron and Matthew discussed the first case last year. Judge Reed O’Connor, the federal judge who previously attempted to rule that the ACA was unconstitutional entirely, ruled that Preventative Services Task Force was not appointed by Congress and therefore could not determine what counts as “preventative care.” Ron and Matthew break down the problems with that argument. Then, pharmaceutical giant Merck ($MRK ) is suing the Department of Health and Human Services and Centers for Medicare and Medicaid Services over the drug price negotiation provisions in the Inflation Reduction Act. They claim that it would be a violation of the 5th Amendment. Do they have a case? Finally, Johnson and Johnson’s ($JNJ ) COVID-19 vaccine lost its emergency use authorization. Why and does it matter? Subscribe to the FLATLINING Podcast on Apple Podcasts, Spotify, the iHeartRadio app, Amazon Music, Google Podcasts, Stitcher, Pandora, TuneIn, and Audible. Articles mentioned in this program: Appeals court to hear arguments about ObamaCare preventive coverage - The Hill Appeals court to weigh fate of ACA preventive care requirement - Axios Merck sues US government to halt Medicare drug price negotiation - Reuters US FDA revokes emergency use authorization for J&J's COVID vaccine - Reuters This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.flatlining.net

This week on the FLATLINING Podcast, Matthew and Ron provide an update on the debt ceiling talks in Washington. Now that a tentative deal has been agreed to, what delays, if any, can providers expect from Medicare payments? Then, a new budget deal in Sacramento may raise reimbursement for some office visits and maternity care for Medi-Cal, California’s Medicaid program. How much of an increase could physicians see and is it enough to keep doctors in-network for the program? Plus, Democratic lawmakers there are at odds with Governor Gavin Newsom over a tax he collected but then didn’t use. Matthew and Ron break down the fight. Subscribe to the FLATLINING Podcast on Apple Podcasts, Spotify, the iHeartRadio app, Amazon Music, Google Podcasts, Stitcher, Pandora, TuneIn, and Audible. Articles mentioned in this program: California wants to increase pay for some Medi-Cal providers. How it might help patients access care - The Press Democrat California Governor and Democratic Lawmakers at Odds Over Billions in Health Care Funds - KFF Health News This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.flatlining.net

Robert F. Kennedy, Jr. is one of the few Democrats who have decided to mount a primary challenge to President Joseph Biden in the 2024 election. He has espoused conspiracy theories about childhood vaccinations, the use of fluoride in water purification, and COVID-19. At the same time, he pushes for bonafide Democratic policies including protecting the environment and limiting special interest involvement in government. His beliefs may help him draw an interesting mish-mash of progressives disappointed in President Biden and conservatives still upset about COVID-19 policies. Matthew Handley breaks down his policies and their consequences in this special series of the FLATLINING Podcast. He takes a pulse check on Robert F. Kennedy, Jr. Subscribe to the FLATLINING Podcast on Apple Podcasts, Spotify, the iHeartRadio app, Amazon Music, Google Podcasts, Stitcher, Pandora, TuneIn, and Audible. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.flatlining.net

This week on the FLATLINING Podcast, Matthew and Ron discuss a new policy from UnitedHealthcare ($UNH ) that requires diagnostic and surveillance colonoscopies to undergo prior authorization. At the same time UnitedHealthcare claims they are cutting twenty percent of prior authorizations across the board. Then, the Senate Health, Education, Labor, and Pensions Committee passed several new regulations on Pharmacy Benefits Managers, including a prohibition on price spreading. Matthew and Ron discuss that and its impacts on patients. Subscribe to the FLATLINING Podcast on Apple Podcasts, Spotify, the iHeartRadio app, Amazon Music, Google Podcasts, Stitcher, Pandora, TuneIn, and Audible. Articles mentioned in this program: ‘Stunning’ change to United’s colonoscopy coverage roils physicians and patients - STAT News Easing the prior authorization journey - UnitedHealthcare Senate panel advances drug pricing bills, including PBM reforms - The Hill Pfizer CEO calls US drug price plan 'negotiation with a gun to your head' - Reuters This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.flatlining.net

This week on the FLATLINING Podcast, Matthew and Ron discuss the debt ceiling. Why does the United States have a debt ceiling? What happens if the US defaults on its debt? How will Medicare claims be paid if the government hits the debt ceiling? Subscribe to the FLATLINING Podcast on Apple Podcasts, Spotify, the iHeartRadio app, Amazon Music, Google Podcasts, Stitcher, Pandora, TuneIn, and Audible. Articles mentioned in this episode: What is the debt ceiling? Why it's important and how it affects you - CNBC via Microsoft Start Five things to know about the debt ceiling bill passed by House Republicans - The Washington Examiner via Microsoft Start How Is the 14th Amendment Connected to the Debt Ceiling? - Newsweek This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.flatlining.net

Dan Hurley, MD is an otolaryngologist in Arizona who has been diagnosed with a rare and fatal form of cancer. While he was preparing to receive chemotherapy, his insurance carrier denied a PET scan. When the decision was eventually overruled, Dr. Hurley had to make the choice to delay chemo treatment and get the scan or start the treatment to try and save his life. Matthew Handley discussed that decision with him, how he has helped his patients in similar situations, and what sparked his initial interest in medicine. Subscribe to the FLATLINING Podcast on Apple Podcasts, Spotify, the iHeartRadio app, Amazon Music, Google Podcasts, Stitcher, Pandora, TuneIn, and Audible. Articles mentioned in this program: How Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them - ProPublica UnitedHealthcare Tried to Deny Coverage to a Chronically Ill Patient. He Fought Back, Exposing the Insurer’s Inner Workings. - ProPublica Aetna settles suit alleging claim-denying medical director never read patient’s records - CNN This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.flatlining.net