Becker's Hospital Review

26 CFO / FINANCE 6 things to know about the billionaire couple investing in Civica Rx By Alia Paavola L aura and John Arnold are among the early billionaire investors in Civica Rx, the hospital-owned nonprofit generic drug company. Below are six things to know about the Arnolds and their foun- dation that helped establish Civica Rx: 1. The couple retired in their 30s after Mr. Arnold made billions as a U.S. hedge fund manager. The couple has a net worth of $3.3 billion. 2. After retiring, the couple established the Laura and John Ar- nold Foundation in 2008. A few years later, they established Action Now Inc., a subsidiary of the foundation that focuses on political giving. 3. Since its establishment, the foundation has spent $119 million to address healthcare issues. The couple also has funded polit- ical candidates committed to lowering drug prices, according to NBC News. 4. In early 2019, the foundation was renamed and rebranded Arnold Ventures to combine the couple's philanthropy and political giving in a limited liability corporation. The goal is to create a more integrated push for impact on a wide range of public policy issues, including drug pricing. The foundation and Action Now are part of Arnold Ventures. 5. Arnold Ventures focuses on criminal justice, education, evi- dence-based policy, healthcare, research integrity and sustain- able public finance, according to its website. 6. The Arnolds were among three philanthropies that helped establish Civica Rx with a $10 million donation. n South Carolina healthcare providers alert patients about 'split billing' By Kelly Gooch S outh Carolina hospitals are warning patients that they could see unexpected healthcare charges due to "split billing," according to The Post and Courier. Split billing happens when patients undergo an an- nual physical or a preventive service exam and incur extra charges. These extra charges can be billed when the physician addresses a chronic pre-existing condi- tion during an annual physical. To help notify patients of the potential for split billing, Charleston, S.C.-based Roper St. Francis sent a letter to patients saying they should anticipate additional charges if a physician addresses pre-existing conditions during an annual physical, The Post and Courier reported. A Roper St. Francis spokesperson declined to provide an expert to answer the publication's questions. Other healthcare providers in Charleston are also giving a warning. Tara Vandegrift, MD, with Palmetto Primary Care Physi- cians in North Charleston, S.C., told The Post and Cou- rier patients might be better off making a separate visit from their annual physical if they want to address extensive health concerns. Terrence Steyer, MD, chairman of family medicine at the Medical University of South Carolina in Charleston, ad- vised that patients may be better off saving conversa- tions about pre-existing health concerns for diagnostic exams that monitor existing health concerns. n HHS seeks to end 'backdoor deals' to lower drug prices By Ayla Ellison U nder a proposed rule HHS released Jan. 31, drug manufacturers would no longer be able to give rebates to pharmacy benefit managers, but they would be allowed to offer discounted prices directly to consumers. Four things to know: 1. Under the current system, drug manufac- turers set a price for their products, and phar- macy benefit managers negotiate a discount in the form of a rebate on behalf of insurance companies. e rebates manufacturers pay to pharmacy benefit managers would be viewed as illegal kickbacks under the proposed rule. "e HHS proposal would expressly exclude from safe harbor protection under the An- ti-Kickback Statute rebates on prescription drugs paid by manufacturers to pharmacy benefit managers, Part D plans and Medic- aid managed care organizations," HHS said in a press release. 2. e proposed rule would create a new safe harbor for prescription drug discounts man- ufacturers offer directly to patients, as well as fixed-fee service arrangements between man- ufacturers and pharmacy benefit managers. 3."Every day, Americans — particularly our seniors — pay more than they need to for their prescription drugs because of a hid- den system of kickbacks to middlemen," said HHS Secretary Alex Azar. "President Trump is proposing to end this era of back- door deals in the drug industry, bring real transparency to drug markets, and deliv- er savings directly to patients when they walk into the pharmacy." 4. e proposal could substantially lower out- of-pocket drug costs for consumers. However, the proposed changes could lead to higher premiums if insurance plans raise prices to help offset loss of revenue from drug rebate payments, according to e New York Times. n

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