Weekly Spotlight: HHS Reopens the Question of Which Vaccines Get Recommended
The Department of Health and Human Services (HHS) published a Request for Information (RFI) in the Federal Register on Aug. 24 asking whether the three categories used in federal vaccine recommendations — routine, risk-based, and shared clinical decision-making — remain adequate. Comments close Sept. 20. The RFI supports the Task Force on Safer Childhood Vaccines and implements the Aug. 10 executive order narrowing the childhood immunization schedule. Secretary Robert F. Kennedy Jr. is seeking 30 days of public comment on whether childhood vaccine classifications should be adjusted.
The categories matter less to coverage than their names suggest, and the RFI says so. A shared clinical decision-making recommendation, once adopted by the CDC Director, triggers the same coverage requirements as a routine recommendation, including coverage without cost sharing under the Affordable Care Act and availability through the Vaccines for Children program. HHS frames the trouble as one of comprehension rather than entitlement, citing survey data that fewer than half of physicians knew shared decision-making vaccines are covered at all. Inside Health Policy reads the RFI as forecasting more shared clinical decision-making, emphasizing individual and parental choice over blanket routine-immunization recommendations. STAT reports the same document offers new clues to Kennedy’s planned overhaul, including possible new recommendation categories.
Two deadlines will test the machinery around the order. The Aug. 10 order gives HHS 90 days to present implementation plans, putting the report around Nov. 8, just after the Nov. 3 midterms. Inside Health Policy frames it as an early test for new CDC Director Erica Schwartz, confirmed Aug. 5 on a pledge of scientific integrity and radical transparency. Separately, the First Circuit will hold oral arguments as soon as possible in physician organizations’ challenge to Kennedy’s overhaul of the Advisory Committee on Immunization Practices (ACIP), Case No. 26-1503.
The administration is not speaking with one voice on the science. Centers for Medicare and Medicaid Services (CMS) Administrator Mehmet Oz said on CBS’s Face the Nation that the MMR vaccine is not a lethal vaccine, directly countering President Trump’s claim. In the same appearance he defended the executive order and the push to split MMR into three shots, pointing to countries where the components are given separately and to parents’ autonomy over what their children receive. Inside Health Policy read the exchange as Oz conceding the President was wrong on lethality.
The epidemiology is moving in the other direction. The Hill reports public health leaders expect the record measles outbreak to worsen as schools reopen, in what is already the worst US year in more than 35 years, with nonmedical exemptions at a record 4.2%. Georgetown’s Center for Children and Families reports new CDC data for the 2025-26 school year showing kindergarten coverage for measles, mumps, rubella, tetanus, diphtheria, polio and varicella down in more than half the states. MMR coverage fell nationally from 95.2% to 92.4%.
States are the variable the RFI cannot control, and they are moving in two directions at once. KFF finds 30 states and the District of Columbia have announced they will no longer follow CDC childhood vaccine recommendations, while at least 10 state and local jurisdictions have said specifically that their school vaccine requirements have not changed. All 50 states and the District of Columbia require school vaccines, but exemption rules vary substantially. Comments close Sept. 20; the task force report follows in November.
Centers for Medicare and Medicaid Services (CMS)
Hospital and Medicaid Groups Ask CMS to Pull Back the State-Directed Payments Rule
The American Hospital Association is urging CMS to rescind the provisions of its May proposed rule on Medicaid state-directed payments that go beyond what H.R. 1 requires, and to lessen the financial impact of the reduced payment limits. The National Association of Medicaid Directors filed its own recommendations, and a coalition of 24 organizations asked CMS to preserve state and managed care plan flexibility and to stop short of limiting services the statute does not reach. AHA puts the gap at the center of its objection: CMS projects $510.1 billion in reductions over 10 years against the Congressional Budget Office’s $149.4 billion estimate for the underlying law.
Tags: #HOSPITAL #PAYER #PROVIDER
Rural Health Transformation Program Enters Execution Without Spending Transparency
One year after its creation, the $50 billion Rural Health Transformation Program lacks transparency about how awards are made and spent, according to the Bipartisan Policy Center and other groups. The gap complicates fraud protection and makes it difficult to evaluate which projects work. The program is simultaneously moving from award to execution as CMS approves additional state initiatives, with reporting requirements and future funding determinations now driving state planning.
KFF Health News Health Management Associates
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Medicare’s $50 Obesity Drug Pilot Draws Heavy Uptake While the Medicaid Side Stays Empty
CVS has filled more than 100,000 prescriptions and Walgreens roughly 100,000 under the Medicare GLP-1 Bridge, which since July 1 has let eligible beneficiaries get obesity drugs for $50 a month. Both counts are under two months in, and neither CMS nor the chains have reported a program-wide total. The design has a gap: beneficiaries with an FDA-approved medical indication for these drugs, such as Type 2 diabetes or sleep apnea, are excluded from the $50 price and must use regular Part D coverage at copays KFF Health News puts at $200 to $600 a month. The Bridge sits inside the broader BALANCE Model, which also opened to state Medicaid agencies. States could join from May 2026 through Jan. 1, 2027, and CMS’s model page still names no participating state. The Bridge itself runs to Dec. 31, 2027.
Tags: #PATIENT #PAYER #DRUG
Hospital Groups File Parallel 340B Objections to CMS and to Cassidy
AAMC and AHA filed separate comment letters this week on 340B, running at both the regulatory and legislative tracks at once. AAMC targeted CMS’s Medicare Drug Price Negotiation Program rule; AHA targeted Sen. Bill Cassidy’s 340B Drug Pricing Integrity and Affordability for Patients Act discussion draft. AHA separately warned that the CMS rule would effectively codify HRSA’s rebate pilot by letting manufacturers reimburse covered entities after the fact rather than provide upfront discounted pricing, and urged CMS not to finalize two 2027 Outpatient Prospective Payment System proposals. The first raises the annual rate hospitals must repay toward $7.8 billion in prior 340B overpayments from 0.5% to 3%, a sixfold increase that AHA puts at more than $600,000 for the average hospital in 2027 and above $1 million a year for more than 500 hospitals. The second cuts 340B drug reimbursement to average sales price minus 33.4%, removing an estimated $4.85 billion. AHA argues CMS is repeating the reduction that produced the 2022 Supreme Court loss.
- AHA Worries CMS Proposed Rule Codifies HHS Push For 340B Rebates
- 5 provisions AAMC, AHA want rewritten in parallel 340B pushes
- CMS should learn from 340B history, not repeat it: AHA
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No Surprises Act Arbitration Costs Reach $22 Billion as CMS Prepares New Guidance
Costs tied to the No Surprises Act independent dispute resolution (IDR) process reached $22.4 billion through the end of 2025, according to a Georgetown Center on Health Insurance Reforms analysis published in Health Affairs on Aug. 26: $15.6 billion above in-network rates, $4.2 billion in administrative cost and $2.7 billion in IDR entity fees. The figure lands as the government reworks the benchmark the process runs on. The Fifth Circuit vacated the provisions letting insurers count ghost rates toward the qualifying payment amount and held that bonuses and incentives must be included, narrowing the benchmark methodology rather than voiding it. CMS says the agencies are reviewing the opinion and anticipate issuing guidance shortly. Providers and insurers are operating an arbitration system whose reference price is unsettled.
Fierce Healthcare Modern Healthcare
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Physician Fee Schedule Draws Objections on Same-Day Billing and on Primary Care Payment
The AMA is urging CMS to drop a proposed Medicare policy cutting reimbursement when a physician furnishes an office visit and a procedure to the same patient on the same day, warning the change would threaten independent practices. On the other side of the same question, Harvard physician and health services researcher Ishani Ganguli reports in STAT that G2211, designed to support longitudinal and especially primary care, is not landing where intended: specialists billed 43% of the code against 40% for primary care physicians. She argues the code is too tied to visits when primary care is so much more. Both critiques point at the same structural problem: the fee schedule pays for discrete encounters.
- AMA Warns CMS’ Proposed Same-Day Service Cut Could Threaten Independent Practices
- Opinion: A billing code was supposed to incentivize relationship-based primary care for Medicare patients. It may not be working as hoped
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RAPID Coverage Pathway Opens for Comment and Pauses TCET for New Candidates
CMS published the Regulatory Alignment for Predictable and Immediate Device (RAPID) coverage pathway in the Federal Register on Aug. 11 (CMS-3487-NC, 91 FR 51710). Comments close Oct. 13. Under the pathway CMS would post a proposed national coverage determination (NCD) the same day FDA grants market authorization, take 30 days of comment, and finalize roughly 60 days after authorization for Class II devices and 90 days for Class III. CMS puts the current gap between FDA authorization and completed Medicare coverage at nine to 12 months.
The notice also pauses the Transitional Coverage for Emerging Technologies (TCET) pathway for new candidates as of publication, with CMS directing existing TCET participants to contact the agency about alternatives. Eligibility for RAPID is narrower than the breakthrough designation count suggests: a device must be a Class II breakthrough device in FDA’s Total Product Life Cycle Advisory Program planning a De Novo submission, or a Class III breakthrough device planning a premarket approval application; it must be at the investigational device exemption pre-submission stage, separately payable under Medicare, and not already governed by an existing NCD. In vitro diagnostic products, such as diagnostic laboratory tests, are excluded.
Tags: #DEVICE #PAYER #HOSPITAL
CMS Moves the ACCESS Model Toward Launch and Tightens Prior Authorization Transparency
CMS is planning a launch event for ACCESS, its Medicare chronic care pilot. Writing in Becker’s, Andrew Kohler, MD, founder and chief executive of the managed services organization US-LTN, argues that fee-for-service electronic health record infrastructure cannot carry the model’s population health requirements, particularly continuous remote physiologic monitoring at scale for high-risk cardio-kidney-metabolic patients, and that the model’s co-management codes push health systems and independent primary care into shared accountability. It is a vendor-side argument, not a survey of participants. Separately, CMS bolstered prior authorization transparency requirements for Medicare Advantage, Medicaid managed care and ACA marketplace plans, building on the 2024 electronic prior authorization regulations that partially took effect in 2026. CMS also released Research Identifiable Files for the Increasing Organ Transplant Access (IOTA) Model, with participation data current through June 30, 2026.
- STAT+: CMS plans launch event for ACCESS, the Medicare chronic care pilot
- The silo-breaker: how the CMS ACCESS model forces health systems and primary care providers to collaborate
- CMS updates prior authorization transparency requirements for health plans
- Model Data Sharing Initiative Makes New Model Participation Data Available to Researchers
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Also in CMS
An appeals court rejected PhRMA’s challenge to Medicare drug price negotiation, the latest in a string of industry losses against the Inflation Reduction Act. Health system CEOs are weighing site-neutral payment alongside H.R. 1 Medicaid changes and 340B pressure. MedPAC published its analytic agenda for the 2026-2027 cycle, which opens with the September public meeting. HFMA posted a FY 2027 IPPS MS-DRG rate comparison against final FY 2026 rates. KFF Health News reports on a patient whose approved breast MRI still carried out-of-pocket costs, because breast MRI is not covered as zero-cost preventive care under the ACA. And a new study finds Medicaid expansion raised the share of Medicaid-covered deliveries but was not associated with reduced severe maternal morbidity.
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Food and Drug Administration (FDA)
FDA Sets Expectations for Digital Endpoints, Expands TEMPO, and Signals Generative AI Guidance
FDA’s four medical product centers jointly published a paper consolidating expectations for digital health technologies used as clinical trial endpoints, telling sponsors that data from wearables and similar tools must be validated and must measure health outcomes meaningful to patients and caregivers. Separately, FDA named the first participants in its Technology-Enabled Meaningful Patient Outcomes (TEMPO) pilot for digital health devices: SonderMind and Limbic in behavioral health, Cadence Solutions in hypertension, and Dexcom in prediabetes and type 2 diabetes. Rick Abramson, director of FDA’s Digital Health Center of Excellence, told STAT the agency is preparing both broad guidance on generative artificial intelligence and narrower specialty guidance for specific applications.
- FDA Weighs in on the Development and Use of Digitally Derived Measures for Clinical Investigations
- FDA Says Digital Tech Use In Trials Should Measure Outcomes Meaningful To Patients
- Participants Selected for TEMPO for Digital Health Devices Pilot
- FDA adds two behavioral health firms to TEMPO pilot
- FDA plans to regulate generative AI
Tags: #DEVICE #DRUG #PROVIDER
CDRH Updates Breakthrough Metrics and Names READI-Home Participants
FDA’s Center for Devices and Radiological Health (CDRH) updated its Breakthrough Devices Program metrics: 1,284 designations granted through March 31, 2026 (1,264 from CDRH, 20 from CBER), with 198 devices receiving marketing authorization for indications consistent with their designation. CDRH separately named the initial participants and devices selected for the interaction phase of its READI-Home Innovation Challenge, which targets devices designed for use in the home. Selection moves those technologies into direct engagement with the center.
Tags: #DEVICE #PROVIDER
Updated Covid Vaccines Approved Into an Unsettled Coverage Landscape
FDA approved updated Covid vaccines on Aug. 27, clearing Moderna, Pfizer and Novavax’s Nuvaxovid, which Sanofi commercializes in the US, for shipment to pharmacies and physician offices within days. Approval is not access. The updated shots are limited to people 65 and older and those at increased risk of severe infection, and ACIP, still in legal limbo, has not said whether insurers must cover them. Some states bar pharmacists from administering shots CDC has not recommended.
The New York Times KFF Health News
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Overton Nomination Moves as FDA Weighs New Deputy Posts and Staffing Keeps Falling
President Trump nominated Heidi Overton, M.D., Ph.D., a trained surgeon and deputy assistant to the president for domestic policy, as FDA commissioner. The post had been vacant roughly three months, since Marty Makary resigned in May 2026. Sen. Bill Cassidy (R-La.), who will oversee her confirmation, says her limited management experience and her role in the administration’s vaccine policy raise concerns. The agency is reportedly weighing whether to create two new deputy commissioner posts beneath the commissioner, one covering technology and artificial intelligence and one covering drugs, though the report notes no final determination has been made. OPM data show FDA and HHS staffing continued to fall in fiscal 2026, a likely line of questioning at the confirmation hearing.
- What to know about Dr. Heidi Overton, Trump’s pick to lead the FDA
- Trump’s FDA pick faces questions about leading the agency
- With Trump’s nominee pick in, FDA weighs new deputy commissioner posts: report
- OPM Data Show Continued Drop In FDA, HHS Staffing
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Also in FDA
Patients and researchers are challenging FDA-approved cancer drug dosages as excessive, arguing lower and less frequent dosing could save billions and prevent some of the worst side effects. BIO and PhRMA are asking FDA to clarify how it will define, certify and oversee qualified research institutions under its Expedited IND Pilot Program, which aims to shorten the path to first-in-human trials.
Tags: #DRUG #PATIENT
Department of Health and Human Services (HHS)
CDC Reorganizes as HHS Expands Political Appointments
CDC launched an enterprise reorganization called CDC Voyager under principal deputy director and chief operating officer Sean Slovenski, with employees uncertain what it means for the agency’s future. Across the department, POLITICO reports HHS has sharply expanded political appointee roles while career staffing continues to fall, despite a hiring push after last year’s downsizing. Three former CDC officials who resigned in protest a year ago write that the problems they left over persist.
- ‘Transformation’ Project Underway at CDC
- RFK Jr.’s Health Department empowers political appointees like never before
- Opinion: We quit the CDC last year. The problems we protested remain
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NIH Open-Access Policy Could Cost Researchers $104 Million a Year
Complying with the NIH Public Access Policy could add as much as $104 million a year in article processing charges for NIH-funded researchers, according to a modeling study published Aug. 24 in JAMA Internal Medicine assessing 93,783 manuscripts tied to NIH grants. NIH updated the policy in July 2025 to require immediate free availability of manuscripts from NIH-funded studies. The cost lands on grantees and institutions, not on the agency.
MedPage Today Becker’s Hospital Review
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MFN Deals Widen as Advocates Press PBMs on Out-of-Pocket Credit
The administration is expected to announce most favored nation (MFN) drug pricing agreements with several mid-sized biopharma companies, extending the framework beyond the largest manufacturers. Separately, HIV and arthritis patient advocates are pressing the pharmacy benefit manager (PBM) lobby to ensure the TrumpRx prices PBMs agreed to post count toward beneficiaries’ deductibles and out-of-pocket obligations. Without that, the posted prices misstate what patients actually pay.
Fierce Pharma Inside Health Policy
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DOJ Guidance Could Give States Cover to Cut Home and Community-Based Services
New Department of Justice guidance upends a 25-year-old interpretation of federal disability law. Advocates warn it could give states cover to cut the services that help disabled Americans live at home rather than in institutions. The article dates the guidance to June 2026.
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ARPA-H Awards $175 Million for Autonomous Stroke Robots
The Advanced Research Projects Agency for Health (ARPA-H) named awardees under its Autonomous Interventions and Robotics (AIR) program, which will distribute up to $175.3 million across several organizations to develop autonomous mechanical thrombectomy robots and get stroke patients treated faster. Philips North America receives up to $33.7 million, Siemens Healthineers up to $31.1 million and Magnendo up to $32 million. The Siemens award runs five years and funds an endovascular robot capable of performing the procedure without direct human input. Philips will develop remote-assisted and increasingly automated endovascular procedures with Johns Hopkins University, Boston University and Weill Cornell Medicine.
- Siemens Healthineers, Philips awarded ARPA-H funds for stroke robots
- Siemens Healthineers receives up to $31M to develop autonomous robot for remote stroke treatments
- Philips selected for ARPA-H program to advance AI-enabled robotic stroke care
Tags: #DEVICE #HOSPITAL #PROVIDER
Also in HHS
HRSA and the OPTN issued an August modernization update describing changes to transplant system policies, oversight, data and governance. The American Cancer Society Cancer Action Network and 128 other groups filed an Aug. 24 comment letter urging the HHS Office of Inspector General to create an anti-kickback safe harbor letting clinical trial sponsors cover participants’ travel and lodging without fraud and abuse liability. And STAT reports that public comments on a pending OMB research funding rule were removed from regulations.gov without explanation.
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Heard on the Hill
Hospitals Mount a Long-Shot Push to Reverse $1 Trillion in Medicaid Cuts
Hospitals and health systems are mounting a campaign to persuade Congress to roll back roughly $1 trillion in enacted Medicaid cuts before the reductions bite. The first installment reports the scramble is most intense in rural states like Maine, which has the nation’s highest share of population living in rural areas. STAT frames the law as cutting $1 trillion from expected Medicaid funding over the next decade and allowing tens of billions in annual insurance subsidies to expire. The lobbying push is a long shot against a law already on the books.
STAT (subscription) STAT (subscription)
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AHA Opposes Cassidy’s 340B Rebate Model and Offers a Claims Data Alternative
The American Hospital Association is opposing Sen. Bill Cassidy’s draft 340B legislation, which would replace manufacturers’ upfront discount obligation to covered entities with a rebate model. AHA argues the shift moves program leverage to drug makers, and has separately urged HRSA to abandon its own 340B rebate model pilot. The bill is the legislative half of a two-track fight running alongside that HRSA pilot notice.
Tags: #HOSPITAL #DRUG #PAYER
ACO Groups Warn the Physician Pay Bill Could Exclude Independent Practices
Two leading accountable care organization (ACO) groups warn that the bipartisan Medicare physician pay bill from the House doctors caucuses could unintentionally prevent independent practices working with ACOs from participating in its new primary care payment model. The drafting problem cuts against the bill’s stated purpose of supporting independent practice.
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Notable Notes
TAVR Evidence Extends to Large Annuli, Redo Procedures and Congenital Anatomy
Four studies this week push transcatheter aortic valve replacement (TAVR) evidence into anatomies and populations the pivotal trials did not cover. New data indicate TAVR is safe in patients with large and extra-large aortic annuli, defined by annular area at or above 575 mm² and 683 mm². Heart failure rehospitalization was more common after TAVR than surgery, and long-term survival was worse, which the authors attribute to a heavier comorbidity burden in the TAVR group. Heart-team discussion still drives the choice. An STS/ACC TVT Registry analysis of more than 400 redo TAVR patients, mean age 78.9 and 63.1% women, all receiving Medtronic supra-annular self-expanding valves (Evolut R, PRO and PRO+), found mortality and stroke rates comparable to native TAVR at both 30 days and one year. Mean STS risk score was 9.6. That speaks directly to the durability question facing patients outliving their first valve. A new risk score aims to identify older patients likely to see minimal functional benefit, going beyond existing tools that predict procedural complications. And a congress abstract in Archives of Cardiovascular Diseases reports on transcatheter aortic valve implantation in adults with complex and geriatric congenital heart disease, a population the pivotal trials did not address; the abstract runs to a single page and its underlying data are not yet published. Separately, an analysis of mitral transcatheter edge-to-edge repair found no significant sex-based differences in timing of care, counter to earlier studies showing women with severe mitral regurgitation waited longer than men; the authors credit multidisciplinary heart teams.
- TAVR is safe for patients with large aortic annuli—heart failure remains a concern
- Redo TAVR with self-expanding valves linked to positive early outcomes
- New TAVR risk score could help predict poor functional outcomes among older patients
- Transcatheter aortic valve implantation in adults with complex and geriatric congenital heart disease
- No significant sex-based differences in timing of care for M-TEER patients
Tags: #DEVICE #PROVIDER #PATIENT
Multi-Society Guidance Lands on Pulmonary Valve Replacement After Tetralogy Repair
The Society of Thoracic Surgeons, the World Society for Pediatric and Congenital Heart Surgery and the European Congenital Heart Surgeons Association published an executive summary on Aug. 19 drawing together three 2026 documents on pulmonary valve replacement in repaired tetralogy of Fallot with clinically significant pulmonary regurgitation: clinical practice guidelines on indications and timing, an expert consensus document on children, and an expert opinion paper on the role of exercise testing. The recommendations turn on symptoms, ventricular volumes and function, and procedural risk rather than a single threshold. The societies name their top research priority in terms that matter to device makers: comparing timing and long-term outcomes for transcatheter versus open surgical pulmonary valve replacement, particularly in pediatric and adolescent patients. On the device side, an animal-model study reports on a self-expanding transcatheter pulmonary valve for right ventricular outflow tract obstruction in tetralogy of Fallot, pulmonary atresia and other conotruncal defects, reporting success in three of five animals.
- Executive Summary, STS/WSPCHS/ECHSA 2026 Pulmonary Valve Replacement Documents (Annals of Thoracic Surgery)
- Transcatheter implantation of a self-expanding pulmonary valve in animal experiment
Tags: #DEVICE #PROVIDER #PATIENT
Two Competing Diagnoses of Rising Health Care Costs
Two analyses this week reach opposite conclusions from the same starting point. A Yale-led preprint estimates a single-payer system paying all providers at Medicare rates would cut hospital and provider revenue by $300 billion a year, while claiming more than 100,000 lives saved and $1 trillion in annual savings. Writing in Forbes, Sally Pipes argues the problem is insufficient competition: hospital prices rose 5.2% last year against a 3.1% decline in prescription drug prices, hospital care accounts for 31% of $5.7 trillion in national health spending, and hospital service prices rose more than 220% between 2000 and 2022, alongside nearly 500 merger and acquisition deals between 2016 and 2024. Her prescriptions are enforced price transparency, site-neutral Medicare payment and repeal of certificate-of-need laws. The disagreement is about whether the lever is a single payer or a working market.
- Single-payer system to cut $300 billion from providers: analysis
- Opinion: Why Hospital Prices Keep Rising – And How Competition Can Help
Tags: #HOSPITAL #PAYER
Proposed $103,265 H-1B Fee Carves Out Academic Hospitals
The administration proposed a $103,265 H-1B visa fee in a regulation set to publish in the Federal Register, after a federal judge vacated the agency guidance implementing last year’s $100,000 payment in June. The fee applies to cap-subject petitions, so the carve-out tracks existing cap-exempt status: institutions of higher education, their affiliated nonprofits, and nonprofit or governmental research organizations. The carve-out is the operative detail for teaching hospital physician recruitment; community and independent hospitals outside academic affiliation would not be covered by it.
The Washington Post (subscription)
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AMA and Emanuel Spar Over Licensing Autonomous AI
AMA CEO John Whyte invited bioethicist Ezekiel Emanuel to meet the association’s artificial intelligence workgroup on how autonomous clinical AI might be licensed. The invitation follows a public dispute over Emanuel’s argument that AI is already approaching or exceeding physician performance on core cognitive tasks, and over where liability would sit if such a system were licensed to act.
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Also Worth Noting
Doximity’s new compensation report, based on nearly 23,000 US physicians, shows cardiologist pay still rising, with increases also recorded in thoracic and vascular surgery. SCAI is asking the American Board of Internal Medicine to drop procedural-volume reporting requirements for PCI, arguing the thresholds no longer reflect interventional practice. And with sudden cardiac arrest the leading cause of death among US student-athletes, the American Heart Association is running a free webinar for youth sports coaches and league leaders on responding to cardiac emergencies.
Tags: #PROVIDER #PATIENT #HOSPITAL