The American economy is finally recovering after more than a year of stagnation due to the COVID-19 pandemic. President Joe Biden’s administration wants to continue this momentum and further stimulate the economy. To help in that effort, President Biden recently signed an executive order aimed at increasing competition among businesses.

According to the White House, the order was designed to “promote competition in the American economy, which will lower prices for families, increase wages for workers, and promote innovation and even faster economic growth.”

The Biden administration notes that corporate consolidation has been accelerating for many years, leaving the majority of industries in the hands of only a few entities. The administration points to this trend as the main reason for slow wage growth and rising consumer prices. This latest executive order intends to reverse these effects.

All in all, the executive order includes 72 initiatives by more than a dozen federal agencies to help address competition inequality. This article briefly outlines how the order affects the health care industry.

Health Care Impact

The executive order addresses competition in health care in four main areas:

  1. Prescription drugs
  2. Hearing aids
  3. Hospitals
  4. Health insurance

Prescription Drugs

Right now, large drug manufacturers enjoy incredible profits year over year. The White House alleges that this is due to lack of competition and “pay for delay” tactics, where name-brand drug manufacturers pay generic manufacturers to stay out of the market. Such strategies result in Americans paying 2.5 times more for the same medications as peer countries.

The executive order directs the Food and Drug Administration to work with states and tribes to safely import prescription drugs from Canada, where drugs are less expensive. It also directs the Health and Human Services (HHS) Administration to increase support for generic and biosimilar drugs. Additionally, the order encourages the FTC to ban “pay for delay” and similar agreements.

Hearing Aids

Currently, the White House points out, only 14% of Americans with hearing loss use hearing aids. The administration says it’s due to high prices, costing more than $5,000 per pair (typically not covered by insurance). Additionally, hearing aids can only be obtained after a medical analysis by a doctor or specialist—an unnecessary requirement, according to the Biden administration.

The executive order directs the HHS to consider issuing proposed rules within 120 days for allowing hearing aids to be sold over the counter.

Hospitals

Hospitals have been consolidating through mergers for years, resulting in higher prices and fewer rural locations. The White House notes that consolidated hospitals charge far higher prices than hospitals in markets with more competition.

The executive order directs the FTC to review and revise its merger guidelines to ensure hospital mergers do not harm patients. Additionally, the order directs the HHS to support existing hospital price transparency rules and finish implementing bipartisan federal legislation to address surprise hospital billing.

Health Insurance

Consolidation is also an issue in the health insurance sector, according to the Biden administration. Fewer insurance companies mean fewer options for consumers. Even when there are more options, comparing plans continues to be a struggle for many individuals.

The executive order directs the HHS to standardize plan options in the National Health Insurance Marketplace so people can comparison shop more easily.

Summary

The executive order broadly addresses competition inequalities across market sectors, with a significant focus on health care. These proposed initiatives have the potential to help individuals and small businesses alike. However, it remains to be seen how all of these initiatives will play out, as executive orders are essentially a directive to federal agencies to revise their regulations.

In other words, some of the proposals may never come to fruition, and those that do may take months to implement. At the very least, this executive order and its initiatives indicate the position of the Biden administration—signaling that it may pursue these agenda items through alternative means, if necessary.

Employers should continue to monitor exactly how the executive order plays out.

  1. HIPAA – Patient Record Privacy. It’s a guideline for your office on following the correct procedures to ensure that your patient’s information is kept private.
  2. OSHA – This manual ensures that your office is fully compliant with occupational health and safety rules set forth by the Department of Labor. For example, exam Room Policy (i.e. how to clean up spills, dispose of needles, etc) Very important for risk management.
  3. Corporate Compliance – Simply stated, this manual is a guide on how to run your business. For example, how to bill and code correctly. Everything is run in accordance with the regulations set by the United States Government. Best thing for running a business. Should be reviewed by a labor attorney once it is customized to your practice.
  4. Employee Policy Manual – All of the office rules and regulations specific to that particular practice (Paid time off, lunch hours, computer policy, bereavement days…etc). This manual not only protects the physician as an owner, but it also keeps the staff in line when it comes office rules and conduct. Once tailored to your practice we do recommend that this manual also be reviewed and signed off on by a labor attorney, just stating that all of the federal rules and regulations as they pertain to certain sections (i.e. The Family Leave Act) are up to date.
  5. Office Policy and Procedures Manual – This manual is basically putting in writing job descriptions for each of your staff members, from start to finish it covers each persons daily tasks. The purpose of this manual is to minimize amount of time training replacements and/or new hires. It also includes clinical guides for Physician Assistants and Nurse Practioners.
  6. Administration Manuals – This is basically a binder that contains every contract and insurance policy the practice might have. From Malpractice, Business owners, EPLI, Shareholder agreements, buy sell agreements and leases. We suggest that you also scan the documents into a computer and then keep the binder off-site in case of emergency. This is something that you (or your staff) can prepare, we would be happy to review it to make sure it contains all the necessary documents.

If you don’t already have a Cyber Security or Cyber Liability policy, you likely don’t understand what it is or what it does for your business. The reason behind that is that most insurance professionals don’t understand it either.

“Cyber” is afforded lots of publicity through such notable hacking events as Target, Home Depot and even our last presidential election. All too many business owners assume that “it can’t happen to me”. In fact, over 40% of cyber attacks today, target small businesses.

Do you need cyber security insurance? If you have employees or customers or you use computers in the operation of your business, then you absolutely need the protection a cyber policy affords. Any number of the “circumstances” listed below could have a negative impact on your business.

Exposures to financial loss you are facing today:

  • Employee Information
  • Client Information
  • Credit Card Information
  • Online Payments
  • Rogue Employee
  • Former Employee
  • Libel / Slander
  • Online Sales
  • Social Engineering
  • Information sold on “Dark Web”
  • Extortion / Ransomware
  • Disposal of Equipment
  • Indemnification Agreements
  • Stolen Laptop / Tablet / Cell Phone
  • PCI Compliance
  • Missing Paper Files

We can help you eliminate the guesswork and provide an explanation of exactly how this will work for you.

Cyber Security Insurance you can understand.

We have been committed to providing financial protection to OBGYNs for over 20 years and have developed a program that makes our rates the most competitive in New Jersey. Our focus on group benefits has enabled us to provide significant savings for physicians and their practices.

There is no need to wait for your renewal date to begin to save money. It is easy to transfer your coverage midterm and we will assist you in the process for a seamless transition. Eliminate the uncertainty of premium spikes, take control of your expenses and reinforce the protection of your reputation with our exclusive risk management tools.

Below is a brief review of our member benefits:

  • Premiums:
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    • For part-time OBs – we offer significantly reduced rates.
  • Group protection: Our group protection strategy protects you from premium spikes by reducing the impact of individual claims
  • Expanded coverage: Our clients can see obstetrical patients through to full-term
  • Free options:
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    • Specialized consent forms
    • $50,000 in coverage for RAC-Audit (MPAI) and HIPPA (PDS) coverage
    • $50,000 in coverage for Employment Practice Liability Insurance (EPLI)

We know your time is valuable so we’ve made it easy for you to request an accurate quote.

You can fill out a form online, you can call us at (973) 227-0025 and talk with one of our Malpractice Account Specialists, or you can receive a premium indication by completing this Quick Quote Form and faxing it to (973) 227-4026.