In this edition:

• 🛑 HHS finalized ban on information blocking

• 👀 Law makers call for AI oversight in Medicare

• ⚖️ Supreme Court reject challenge to Blue Cross settlement

• 📈 Rising health costs affect employment

• And more!

HHS finalizes ban on info. blocking

The U.S. Department of Health and Human Services (HHS) Monday released a final rule that establishes disincentives for health care providers that have committed information blocking.

This HHS final rule complements OIG’s final rule from June 2023 that established penalties for information blocking actors other than health care providers, as identified in the Cures Act (health information technology (IT) developers of certified health IT or other entities offering certified health IT, health information exchanges, and health information networks).

If OIG determines that any of these individuals or entities committed information blocking, they may be subject to a civil monetary penalty of up to $1 million per violation.

Supreme Court addresses Blue Cross settlement

The U.S. Supreme Court on Monday declined to hear a challenge to a $2.7 billion nationwide class action settlement with Blue Cross Blue Shield over allegations that the insurance giant overcharged commercial and individual subscribers for years.

The justices without comment denied a petition from home improvement retailer Home Depot objecting to the landmark antitrust settlement. The court also declined to hear a related challenge to a $667 million fee award for the class attorneys who negotiated the deal.

The fee amount, which a lower court judge approved, would be among the largest-ever class action attorney awards.

Health insurance subscribers in the decade-long case accused Blue Cross Blue Shield Association and others of unlawfully agreeing not to compete with one another, leading to higher insurance costs. Blue Cross denied any wrongdoing in agreeing to settle the case in 2020.

Law makers call for AI oversight

A bipartisan group of over 50 lawmakers in both the House and Senate is calling for increased oversight of artificial intelligence (AI) in Medicare Advantage (MA) coverage decisions.

In the letter addressed to Chiquita Brooks-LaSure, administrator of the Centers for Medicare and Medicaid Services (CMS), the group of lawmakers said that they are “concerned about MA plans’ use of prior authorization, specifically their ongoing use of artificial intelligence (AI) and algorithmic software to guide coverage decisions.”

The lawmakers push for CMS to take action including creating “an approval process to review AI and algorithmic tools and their inputs to ensure the integrity of their use, and conduct a review of algorithm and AI tools currently being used.”

Rising health costs affect employment

Rising health care prices have measurably increased unemployment in the United States, according to a new study in the National Bureau of Economic Research.

Why it matters: Surging health care costs don't just hit Americans in their pocketbooks — they could be costing them jobs, especially for middle-income workers.

The big picture: Most people with health insurance are covered through an employer. That system creates a "direct link" between health care prices and labor market dynamics outside of the health sector, the researchers said.

• As health care prices rise, so do the costs to employers providing health insurance.

• But the impacts are felt more broadly among workers. Previous research has found that growing health care costs have also stifled their wages.

The new research found that a 1% increase in health care prices lowers an employer's headcount by about 0.4%.