Senate bill could let NC pharmacists test and treat flu and strep
2 children reported dead from influenza, first pediatric deaths in North Carolina
Senate Bill 335, if passed, would allow pharmacists to diagnose and treat patients for the flu and strep throat, a role currently reserved for doctors.
The bill has already passed unanimously in the Senate Health Committee, indicating strong support among lawmakers. Currently, only doctors are authorized to diagnose these illnesses and prescribe the necessary medications.
The bill could soon be brought up for a vote on the Senate floor, potentially changing the landscape of healthcare delivery in North Carolina.
VIDEO: NC flu season deadliest since 2017
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Forbes
2 days ago
- Forbes
Oregon's Bold Stand Against Private Equity In Healthcare: What's Next?
Private Equity Has Skyrocketed In Healthcare Complex economic forces shape the U.S. healthcare landscape, with private equity (PE) firms promising efficiency and growth in the medical sector while simultaneously sparking debate. On June 9, 2025, Oregon Governor Tina Kotek signed Senate Bill 951 (SB 951) into law, representing the most recent and stringent legislative effort to restrict private equity investment in healthcare. What does the rise of private equity mean for healthcare? What will be the impact of Oregon's new law? What are the perspectives of investors and physicians regarding private equity in healthcare? The Rise Of Private Equity In U.S. Healthcare PE refers to investments made by firms or individuals in private companies with the goal of enhancing their value and selling them for a profit. These investments often involve significant control over the company's operations and strategic decisions, typically funded through a combination of investor capital and borrowed funds. In healthcare, the funding structure tends to rely more heavily on borrowed funds. In essence and in broad generalization, PE firms identify a business, believe they can operate it more efficiently, and aim to sell it for a profit. This trend reflects the increasing financialization of medical care. In healthcare, PE investments span a wide range of entities, including hospitals, physician groups, medical practices, fertility clinics, cosmetic clinics, imaging centers and ambulatory surgical centers. PE firms now own 460 hospitals, a 25-fold increase over the past twenty years. From 2010 to 2020, private equity deals in healthcare surged by over 250%. This growth is understandable. Healthcare processes often suffer from significant inefficiencies, and investors view the sector as an attractive opportunity due to its size, valuable fixed assets, and stable demand, which is largely independent of traditional market dynamics. "Private equity has revolutionized the engineering space, and it's clear what's been happening in healthcare isn't working. Private equity rewards high performing entities. Why wouldn't medicine want to lean into that?" says Michael Tobias, Founder Principal New York Engineers and shareholder Eaglestone Private Equity when interviewed for this article. This surge aligns with PE's standard approach: acquiring potentially undervalued assets, streamlining operations for short-term profits, and exiting within 3–7 years through sales or initial public offerings (IPOs). This strategy involves taking on immediate financial risk in pursuit of high returns. In healthcare, PE firms have traditionally focused on consolidating high-margin specialties such as dermatology, ophthalmology, and emergency medicine but are now expanding into more diverse areas of care delivery, including neurosurgery. Why Are Physicians Turning To Private Equity? In certain medical circles, surgeons in the latter half of their careers—typically with 15–20 years of practice—view private equity (PE) as an attractive exit strategy. The costs of operating a medical practice continue to rise steadily, driven by expenses such as staffing, equipment, and regulatory compliance. Meanwhile, reimbursement rates to physicians from insurers, including Medicare and private payers, are consistently declining. Private equity offers a way to mitigate these financial risks and exit the market with significant compensation for the assets built over years of practice. This approach can be highly lucrative for senior shareholders within a group practice. However, it may pose challenges for younger partners, who might face exclusion from the deal or diminished roles post-acquisition. What Are The Risk Of Private Equity In Healthcare? Private equity (PE) firms traditionally target high-margin specialties and procedures in healthcare. A leading article in JAMA reported that, following PE acquisition of hospitals, patient safety incidents increased significantly: a 27.3% rise in falls, a 37.7% increase in central line-associated bloodstream infections, and a doubling of surgical site infections. These outcomes occurred despite hospitals treating younger and more financially secure patients. Concerns arise that these issues stem from PE strategies, such as cost-cutting, staff reductions, and deferred investments, which are often implemented to manage debt. How Is Oregon Limiting Private Equity In Healthcare Senate Bill 951 (SB 951) establishes the most comprehensive state-level barriers to private equity (PE) in healthcare, strengthening the corporate practice of medicine (CPOM) doctrine, which prohibits non-physicians from owning or controlling medical practices. Historically, this doctrine was underenforced. The law targets the common structure used by PE for investment, focusing on management service organizations (MSOs) rather than direct PE ownership. MSOs typically handle administrative tasks such as billing and IT, but their contracts often enable indirect operational control. SB 951 closes these loopholes by prohibiting MSOs from interfering in clinical decisions, capping their fees at fair market value, and banning non-compete, nondisclosure, and nondisparagement agreements that restrict physicians or their interactions with patients. SB 951 prohibits PE participation in clinical operations, including hiring, firing, work schedules, compensation, coding decisions, clinical policies, billing collections, pricing, contract negotiations, and, most critically, setting clinical staffing levels and patient interaction time. This legislation essentially undermines the operational influence of PE investments in healthcare. Nationwide Ramifications of Oregon's New Law Oregon's Senate Bill 951 (SB 951) establishes the most stringent state-level restrictions on private equity (PE) in healthcare. Investors must comply with new regulations in a phased approach, with full compliance required by January 2029. Other states may follow Oregon's lead and adopt similar legislation. Recent high-profile health system bankruptcies, some of which involve PE-backed entities, have fueled momentum to strengthen regulations on the corporate practice of medicine in states like California. 'We're at an inflection point in this country when it comes to the corporatization of healthcare,' said House Majority Leader Ben Bowman (D-Tigard, Metzger, S Beaverton), who introduced the bill. 'With the passage of this bill, every Oregonian will know that decisions in exam rooms are being made by doctors, not corporate executives.' What Do Surgeons Have to Say About Private Equity In Healthcare? Brian Gantwerker, MD, a private-practice neurosurgeon in Santa Monica, CA, offers a nuanced perspective on PE in healthcare. "I believe private equity is a good thing in terms of commerce and goods and services outside of the medical field. The main issue is of course that private equity job is to purchase assets load them up with a lot of debt and then sell them off the commoditization of healthcare. Private equity as it is now represents a pump and dump scheme. I think it is possible to have private equity involved in a responsible way where the assets are purchased as part of an agreement with healthcare leaders in their community, and there are certain guidelines that they have to abide by such as keeping it open up to a minimum of five years and knowing and announcing when sale of assets will occur at least 6 to 12 months in advance of that transaction occurring. That way, if things fall through or if the clinic or entity fail, the community will be deprived of that service, but in a way that other services might be set up in advance to help catch those critical patients that may fall through the cracks. Responsible capitalism is possible. When it comes to patients, that must be our north star." John Abrahams, MD, a neurosurgeon at New York Brain & Spine, authored the leading paper on private equity in neurosurgery, published in The Journal of Neurosurgery. He expresses a more pessimistic view when quoted for this article: 'I don't see any benefit in the short or long term.' Dr. Abrahams argues that expected benefits, such as economies of scale, fail to materialize. Private equity (PE) firms often struggle to negotiate better insurance rates due to insufficient outcome data, and growth through acquisitions tends to diminish practice valuation. The risks are clear to practicing surgeons: PE firms impose management fees and may require surgeons to assume debt. In his defining article, Dr. Abrahams writes, 'Private practice neurosurgery is in serious trouble. Recent reports do not support its survival, and as costs increase while reimbursements decrease, new solutions and business models need to be developed. Successful business models need to be shared at a national level so we can all learn the difficult lessons at once and grow with the new knowledge gained. Private equity is not the solution for healthcare, and if you want to learn more about its perils, read the book These Are the Plunderers: How Private Equity Runs—and Wrecks—America by Gretchen Morgenson and Joshua Rosner. It describes in detail how private equity ruins companies in general, as well as gives some examples of failure in healthcare.' What's Next for Private Equity in Healthcare? The Deeper Question Oregon's SB 951, by reinforcing the corporate practice of medicine doctrine, establishes regulatory guardrails to protect the patient-physician trust, potentially curbing excesses while sparking broader debates about the limits of state oversight in complex systems. Caution is always warranted with government intervention, as overly prescriptive laws risk unintended consequences, stifling the entrepreneurial spirit that could address healthcare's inefficiencies and echoing Hayek's warnings against the hubris of centrally planned economies. At its core, the fundamental question persists: Are we content to entrust the stewardship of healthcare—our vital guardian of life and dignity—to entities such as government bureaucracies or distant investors chasing the scraps of crony capitalism, whose contributions and ownership may be mere abstractions. Or, perhaps more appropriately, we should steer reform toward those directly providing and receiving care.
Yahoo
3 days ago
- Yahoo
An Expensive Health Care Cliff Is Coming Unless Republicans Stop It
WASHINGTON — Top Senate Republicans indicated this week they'd be open to extending one of former President Joe Biden's signature health care policies to avoid a politically poisonous spike in insurance costs ahead of the 2026 midterm elections. The enhanced premium tax credits, which Democrats included in President Joe Biden's American Rescue Plan Act, reduced the cost of health insurance for many middle-class people enrolled in Obamacare exchanges. The average person who buys insurance through the exchanges is expected to pay 75% more for their premium if the tax credits expire, according to an analysis from KFF, a nonpartisan health policy research group. The nonpartisan Congressional Budget Office has also projected that letting the subsidies lapse would lead to about 5 million Americans losing their insurance over the next 10 years. 'I am part of a small group that is looking to try to find a path forward to extend those,' said Sen. Lisa Murkowski (R-Alaska). 'I think it is recognized that our failure to do that could result in some pretty precipitous increases in costs for Americans for their health insurance, and that's not where we want to end up at the end of this year.' 'It's not these people's fault that they're forced onto Obamacare in the first place and then to take away what the government promised them in terms of this credit, seems to me to be not exactly the most desirable outcome,' added Sen. Mike Rounds (R-S.D.). The looming expiration of the tax credits was put on the back burner by Republicans during the first six months of President Donald Trump's term as the party focused on passing his agenda of tax cuts and historic cuts to Medicaid, as well as slashing foreign aid and public broadcasting funding. Discussions are now underway in the Senate for a bipartisan solution to a problem that could have serious ramifications for the GOP in next year's elections, with high prices and inflation still on top of voters' minds. They are being led by Sen. Bill Cassidy (R-La.), the chair of the Senate health committee, who has previously criticized the credits, but who is also facing voters at the ballot box next year. Passing a bipartisan fix is easier said than done, however. For one, it'll be costly. An estimate from CBO said it would cost $380 billion over a decade to make the subsidies permanent. Senate Republicans are eyeing a smaller fix of about $125 billion with a lower income threshold to qualify for the credit, as well as an offset to pay for it. 'I think we'll be able to offer an appropriate offset, and I think it would be very difficult for Democrats to be able to say no to that,' Rounds said. Many conservatives are flat-out opposed to extending the tax credits, however. Some are pushing for rolling back Obamacare more broadly, including by winding down its Medicaid expansion, in future reconciliation bills. 'Nobody's losing coverage, that's what's important to me,' Sen. Rick Scott (R-Fla.) said when asked what Congress ought to do when the tax credits expire. Even if the Senate can agree on a fix — something that would require 60 votes — passage could be more complicated in the GOP-controlled House, where there's no guarantee that leadership would even take it up. Lawmakers could potentially tuck it into an end-of-the-year government funding bill, but that could also risk a government shutdown. 'I think that goes to the end of the calendar year, so we'll have discussion about the issue later. But it hasn't come up yet. But it's on the radar,' House Speaker Mike Johnson (R-La.) told reporters this week when asked about the ACA credits. Waiting until the end of the year to address the issue may be too late, however. While the tax credits technically expire on Dec. 31, insurers must file their final rates for health plans offered on ACA exchanges for next year by Aug. 13, according to the centrist think tank Third Way. That's smack-dab in the middle of Congress' annual recess. It's not clear where the White House stands on the issue. Getting Trump on board with extending the subsidies could help move Republican votes on Capitol Hill. A memo from a conservative advocacy organization, for example, warned this week that the benefits of the president's tax cut law will be nullified if the subsidies are not extended and people's health care costs go up. Not extending the subsidies will also hand Democrats — who are already eager to run against Trump's cuts to Medicaid — a further advantage on health care issues, particularly in purple battleground states that could determine the control of the House and Senate next year. The issue, for now, remains a bit of a sleeper: A KFF poll conducted last month found just 28% of Americans had heard 'a lot' or 'some' about the credits' potential expiration. But a full 77% of Americans, including 56% of self-identified MAGA supporters, back their extension. 'For some people, their premiums will as much as double, and people don't have the resources in their household income in order to be able to absorb that,' Sen. Raphael Warnock (D-Ga.) told HuffPost. 'Donald Trump and the Republicans are doing the opposite of what he said he was going to do. He said he was going to drive costs down. He's driving them up every single day. So I think they've got a decision to make about whether they're OK with that.'
The Hill
3 days ago
- The Hill
Senate Democrats demand answers on rural health fund
Senate Democrats are demanding answers over how the Trump administration plans to manage the $50 billion rural health slush fund included in the One Big Beautiful Bill Act (OBBBA) in light of reports that the fund was made to buy Republican votes. In a letter to Centers for Medicare and Medicaid Services (CMS) Administrator Mehmet Oz, a group of 16 Senate Democrats led by Senate Minority Leader Chuck Schumer (D-N.Y.) blasted the rural health fund as 'wholly insufficient to plug the massive hole created by the Big, Ugly Betrayal,' but said it was 'critical' that CMS provide clarity and guidance. 'We are alarmed by reports suggesting these taxpayer funds are already promised to Republican members of Congress in exchange for their votes in support of the Big, Ugly Betrayal. In addition, the vague legislative language creating this fund will seemingly function as your personal fund to be distributed according to your political whims,' they wrote. The Democrats cited additional reporting that some of the rural health fund has been promised to regions in states like Pennsylvania that are not rural. The fund will not make direct payments to rural hospitals, but will first go to states that must file 'rural health transformation plans' and receive approval from Oz. The federal government can take back any unobligated money before the program ends in 2030. 'The Big, Ugly Betrayal makes no meaningful investments in rural hospitals, rural health centers, and other rural health care providers, which have some of the most fragile operating margins in the nation, and often are the largest employers and economic engines of their communities,' their letter read. The Trump administration defended the rural health fund this week, writing in a memo that the law 'contains unprecedented levels of federal assistance to rural and other vulnerable hospitals.' The Senate Democrats asked to know when CMS would provide states with guidance on what to include in their applications, how much of the money will go to rural health care providers as well as what the administrative process will look like. They additionally asked to know 'what other states or districts have Trump Administration officials already promised funding from the rural health slush fund to?' Democratic senators who signed the letter include Sens. Ron Wyden (Ore.), Ben Ray Lujan (N.M.), Angela Alsobrooks (Md.), Edward Markey (Mass.), Martin Heinrich (N.M.), Dick Durbin (Ill.), Kirsten Gillibrand (N.Y.), Elizabeth Warren (Mass.), Richard Blumenthal (Conn.) Alex Padilla (Calif.), Tina Smith (Minn.) Andy Kim (N.J.), Chris Van Hollen (Md.), Jeff Merkley (Ore.) and Bernie Sanders (I-Vt.) The Hill has reached out to HHS for comment.
