To readers: For some reason, yesterday’s blog, while sent, was lost.
It is duplicated first below
TODAY'S NEWS AND COMMENTARY
February 14, 2022
About Covid-19
Federal vaccination mandate begins for healthcare workers in 24 states: “Healthcare facilities in 24 states face their first deadline Feb. 14 to comply with the Biden administration's COVID-19 vaccination mandate.”
Almost 1 in 3 older adults develop new conditions after covid-19 infection: “Almost a third (32 of every 100) of older adults infected with covid-19 in 2020 developed at least one new condition that required medical attention in the months after initial infection, 11 more than those who did not have covid-19, finds a US study published by The BMJ today.
Conditions involved a range of major organs and systems, including the heart, kidneys, lungs and liver as well as mental health complications.”
CDC recommends people with weakened immune systems get booster doses after three months instead of five: “The Centers for Disease Control and Prevention updated its guidance on Friday for some people with weakened immune systems, recommending they get a booster dose of the coronavirus vaccine three months after completing the initial series of the Pfizer-BioNTech or Moderna shots, rather than the current interval of five months.
The guidance also said immunocompromised people who received the one-shot Johnson & Johnson vaccine should get an additional dose. That means two doses, at least 28 days apart, followed by a booster dose of one of the mRNA vaccines.”
About health insurance
UnitedHealth was 2021's most profitable payer. Here's a look at what its competitors earned: A quick look at financial performance for the industry’s top players.
Medical Director Convicted in $110 Million Addiction Treatment Fraud Scheme: “According to court documents and evidence presented at trial, Mark Agresti, M.D., 59, of Palm Beach, unlawfully billed approximately $110 million of urinalysis (UA) drug testing services that were medically unnecessary for patients at a sober living facility, Good Decisions Sober Living (GDSL). GDSL was paid kickbacks for providing patients to addiction treatment facilities in the West Palm Beach area, in violation of Florida state law.”
Association Between High-Deductible Health Plans [HDHPs] and Hernia Acuity: “In this cohort study that included 83 281 patients from a large commercial insurance claims database, the study team found that those enrolled in individual HDHP coverage were at 6% higher odds of presenting with an incarcerated or strangulated hernia.
Meaning Among patients with groin and ventral hernias, enrollment in an HDHP may be associated with delays in surgical care that may result in complex disease presentation.”
About hospitals and healthcare systems
CMS claws back Medicare payments from hospitals that own nursing schools: For nearly a decade, the federal government has overpaid hospitals that own nursing schools an estimated $310 million, and now the Centers for Medicare and Medicaid Services want that money back. CMS posted a notice online in late 2020 stating that due to an agency error, nursing schools were overpaid by Medicare from 2008 through 2018 and needed to return that money. For many of the providers, that money will come due this summer unless a congressional effort to forgive the debts is successful.”
CMS delays hospital star ratings update until July: “CMS is postponing its next Overall Hospital Quality Star Ratings update from April to July to fix a calculation error…
The error involved calculations using 2021 hospital data for the OP-10 outpatient imaging efficiency measure.”
Mass General Brigham's operating income falls to $10M in Q1: “Although Boston-based Mass General Brigham reported higher revenue in the first quarter of fiscal year 2022, its operating income fell, according to recently released financial documents…”
’We are continuing to address longstanding capacity challenges for our patients, severely exacerbated by deferred care and a staffing crisis during the latest COVID-19 surge,’ Mass General said.”
Catholic Medical Center Agrees To Pay $3.8M For Kickback-Related False Claims: “According to the settlement agreement, the United States asserted that CMC, a hospital in Manchester, paid its own cardiologists to cover for, and to be available to provide medical services for, another cardiologist’s patients when she was on vacation or otherwise unavailable. The United States further alleged that CMC provided these call coverage services at no charge. The cardiologist who received the free call coverage referred millions of dollars in medical procedures and services to CMC over the decade in which the free services were provided. Because CMC submitted claims for payment to Medicare, Medicaid, and other federal health care programs for the services referred by the cardiologist, the United States alleged that these claims were the result of unlawful kickbacks.”
Kaiser Permanente Broke Its Own Profit Record In 2021: “Kaiser Permanente had its most profitable year yet in 2021, drawing $8.1 billion in net income.
Oakland, California-based Kaiser once again benefited from strong investment returns last year, beefing up its nonoperating income even as its operating income grew slimmer. The integrated health system’s net income grew 27.2% year-over-year, from an already strong $6.4 billion in 2020.”
About healthcare IT
WHO: It’s Time to Eliminate Ageism in Artificial Intelligence: “As caregivers examine how artificial intelligence (AI) can improve healthcare for seniors, a policy brief by the World Health Organization shows that potential issues can be eliminated by taking various steps, including optimal design and data collection, providing resources, and maintaining good moral codes.
The most common uses of healthcare-focused AI for seniors are remote patient monitoring, which is used as a method of community care, and the production of drugs for aging patients. The report… also stated that optimizing AI capabilities can increase hospital capacity, as beds can be reserved for cases requiring hands-on care.”
Healthcare clearinghouse to pay $1.12M to settle data breach: “nmediata Health Group agreed to pay $1.12 million to resolve allegations it put patients at risk during a 2019 data breach that affected 1.5 million people, Top Class Actions reported.
Inmediata is a Puerto Rico-based healthcare clearinghouse. It ensures providers' medical claims are error-free so payers can accurately process them.”
Doximity brings in record profit in Q3, snaps up Amion to add physician scheduling to its platform: “Doximity, a digital platform for medical professionals, brought in $98 million in revenue in the third quarter, a 67% jump from a year ago. The health tech company also boasted a record profit of $56 million during the quarter, up from $17.2 million just one year ago.
Doximity, which went public in June, operates like a LinkedIn for doctors and provides a digital platform for U.S. medical professionals, including telehealth and scheduling tools. The company has over 1.8 million medical professional members as of March 31, 2021, and claims to have more than 80% of doctors on its network.”
About healthcare personnel
‘A real crisis’: License backlogs in some states are preventing health care workers from seeing patients: “In some states, though, licensing delays and their impacts are clear. NBC News spoke to the leaders of nine health care professional organizations in three states who said wait times for licenses are worse than they’ve ever been. Licensing agencies that were already slow and understaffed were put under additional pressure by the pandemic. They’ve dealt with an influx of applicants, had to adapt antiquated paper-based application systems to remote work and built emergency licensing processes nearly overnight. In 2021 and 2022, they’ve lost staff to the Great Resignation.”
HERE IS TODAY’S POST
About Covid-19
Moderna, Pfizer stocks fall as omicron Covid wave subsides in U.S.: “Shares of the major Covid vaccine makers fell on Monday, as the unprecedented wave of omicron infections eased, with new cases rapidly dropping across the country.
Moderna plunged more than 11%, the biggest decline in the S&P 500 Monday. Pfizer tumbled nearly 2% and its partner BioNTech slid more than 9%, while Novavax was off more than 11% and Johnson & Johnson fell over 1%.
White House chief medical advisor Dr. Anthony Fauci told The Financial Times last week that the U.S. is exiting the ‘full-blown pandemic phase of Covid-19.’”
CDC recommends people with weakened immune systems get booster doses after three months instead of five: “The Centers for Disease Control and Prevention updated its guidance on Friday for some people with weakened immune systems, recommending they get a booster dose of the coronavirus vaccine three months after completing the initial series of the Pfizer-BioNTech or Moderna shots, rather than the current interval of five months.
The guidance also said immunocompromised people who received the one-shot Johnson & Johnson vaccine should get an additional dose. That means two doses, at least 28 days apart, followed by a booster dose of one of the mRNA vaccines.”
Almost 1 in 3 older adults develop new conditions after covid-19 infection: “Almost a third (32 of every 100) of older adults infected with covid-19 in 2020 developed at least one new condition that required medical attention in the months after initial infection, 11 more than those who did not have covid-19, finds a US study published by The BMJ today.
Conditions involved a range of major organs and systems, including the heart, kidneys, lungs and liver as well as mental health complications.”
Stroke risk among older adults highest in first 3 days after COVID-19 diagnosis: “Research Highlights:
The risk of stroke among older adults diagnosed with COVID-19 was greatest within the first three days of being diagnosed with the virus.
The risk of stroke was higher among adults ages 65-74 years old, compared to those 85 and older, and among those without a history of stroke.”
Eagerly awaited COVID lifesavers molnupiravir, Paxlovid now wait for patients: “Supplies of the eagerly awaited oral COVID-19 antiviral prescription medications are slowly arriving at US pharmacies, but despite strong evidence that they can help reduce symptoms and prevent severe illness, federal data and experts suggest that many patients don't know about them or don't want to take them.
Two oral COVID-19 antiviral medications, molnupiravir (Merck) and Paxlovid (nirmatrelvir and ritonavir, Pfizer), have been proven to be safe, effective, and convenient treatments to take at home.”
About health insurance
Why Millions on Medicaid Are at Risk of Losing Coverage in the Months Ahead: “Before the public health crisis, states regularly reviewed whether people still qualified for the safety-net program, based on their income or perhaps their age or disability status. While those routines have been suspended for the past two years, enrollment climbed to record highs. As of July, 76.7 million people, or nearly 1 in 4 Americans, were enrolled, according to the Centers for Medicare & Medicaid Services.
When the public health emergency ends, state Medicaid officials face a huge job of reevaluating each person’s eligibility and connecting with people whose jobs, income, and housing might have been upended in the pandemic. People could lose their coverage if they earn too much or don’t provide the information their state needs to verify their income or residency.”
Medical Director Convicted in $110 Million Addiction Treatment Fraud Scheme: “According to court documents and evidence presented at trial, Mark Agresti, M.D., 59, of Palm Beach, unlawfully billed approximately $110 million of urinalysis (UA) drug testing services that were medically unnecessary for patients at a sober living facility, Good Decisions Sober Living (GDSL). GDSL was paid kickbacks for providing patients to addiction treatment facilities in the West Palm Beach area, in violation of Florida state law.”
Provider groups scramble to convince lawmakers, CMMI to continue Direct Contracting mode: “The major efforts by several provider groups come in response to concerns from progressive lawmakers in Congress wanting to get rid of the model due to concerns it could fuel privatization of Medicare. Providers say such concerns are unfounded, and the model is needed to shift healthcare from fee-for-service to value.”
About hospitals and healthcare systems
Evaluation of Unreimbursed Medicaid Costs Among Nonprofit and For-Profit US Hospitals: “In this economic evaluation, nonprofit and for-profit hospitals had similar unreimbursed Medicaid costs as a share of expenses. In half of the 45 states in which both nonprofit and for-profit hospitals operate, nonprofit hospitals had a lower weighted mean unreimbursed Medicaid cost to expense ratio than for-profit hospitals—but only nonprofit hospitals receive a sizeable tax subsidy. Thus, our results suggest that the largest component of community benefit supposedly provided by nonprofit hospitals (ie, unreimbursed Medicaid costs, net of supplemental payments) is poorly aligned with the (effectively automatic) tax subsidy that these institutions receive. Prior research suggested similar results for the provision of charity care by nonprofit vs for-profit hospitals.”
CMS claws back Medicare payments from hospitals that own nursing schools: “For nearly a decade, the federal government has overpaid hospitals that own nursing schools an estimated $310 million, and now the Centers for Medicare and Medicaid Services want that money back. CMS posted a notice online in late 2020 stating that due to an agency error, nursing schools were overpaid by Medicare from 2008 through 2018 and needed to return that money. For many of the providers, that money will come due this summer unless a congressional effort to forgive the debts is successful.”
Nonprofit Hospital CEO Compensation: How Much Is Enough?: “Within this set of more than 1,000 nonprofit hospitals, we found that hospital executives on average made eight times the wages of workers without advanced degrees in 2018. However, this ratio varied widely. Some hospital CEOs were paid at twice the rate of other workers, while the highest paid received 60 times the hourly pay of general workers.”
About pharma
Robert Califf confirmed to lead FDA for second time: “The US Senate on Tuesday voted 50 to 46 in favour of confirming President Joe Biden nominee Robert Califf as commissioner of the FDA, a position he previously held under the Obama administration. The cardiologist will replace acting Commissioner Janet Woodcock, who stepped into the role from her position as long-time director of the FDA's Center for Drug Evaluation and Research (CDER), when Biden took office in January 2021.”
A Woman Is Cured of H.I.V. Using a Novel Treatment: “The woman, who also had leukemia, received cord blood to treat her cancer. It came from a partially matched donor, instead of the typical practice of finding a bone marrow donor of similar race and ethnicity to the patient’s. She also received blood from a close relative to give her body temporary immune defenses while the transplant took.”
FTC to vote on pharmacy benefit manager competition probe: “The Federal Trade Commission will vote Feb. 17 whether to investigate the anticompetitive impacts of pharmacy benefit managers on independent pharmacies.”
The top 10 M&A targets in biotech for 2022: FYI
GSK becomes 13th drugmaker to restrict 340B discounts to safety net hospitals: “GlaxoSmithKline will limit 340B drug discounts for safety net hospitals' contract pharmacies, the drugmaker said in a Feb. 14 letter to hospitals.
Effective April 1, GSK will provide 340B discounts only to locations registered as a 340B covered entity or child site location affiliated with that covered entity.”
Wearables play an increasingly pivotal role in clinical trials: “Wearable device sales are increasing worldwide. The global wearable devices market is expected to reach $62.82 billion by 2025. With wearables, patients, physicians and clinical trialists can collect data without the need for frequent office or health centre visits. FirstWord interviewed four experts in wearable technology and drug development about the use of wearables in clinical trials.
According to ClinicalTrials.gov, there have been approximately 1400 trials conducted using wearable devices. Through wearables, clinical trial researchers have captured and analysed information on various biometric data points such as heart rate, respiratory rate, blood oxygen saturation, body temperature, sleep pattern, glucose monitoring, haptics, ultraviolet tracking, pressure sensors, sweat analysis and electro-stimulation. This information can be used alone or combined with other information like patient-reported outcomes, hospitalisation rates and physical activity.
The experts said wearables are beneficial for clinical trials because they reduce the burden of data collection – automatically collating data and sending it back to pharma companies or clinical research organisations for analysis – and generate reliable, accurate information. In addition, wearables provide objective, high-frequency data from patients daily, rather than subjective data gathered from patient surveys or site visits.”
"Amazing" Nanoparticles from Maize: A Potent and Economical Anti-Cancer Therapeutic: Fascinating new nano technology: “Researchers from Tokyo University of Science have recently developed novel corn-derived bionanoparticles for targeting cancer cells directly, via an immune mechanism. The results are encouraging, and the technique has demonstrated efficacy in treating tumor-bearing laboratory mice. Moreover, no serious adverse effects have been reported in mice so far.”
About the public’s health
Why Health Affairs can't promote its latest issue: “Health Affairs' entire February issue is devoted to the topic of racism and health, but Google and Twitter are blocking its paid media ads to promote the content, flagging racism as ‘sensitive content…’
The two platforms' automated systems flagged the term "racism" as sensitive content and withheld approval for the paid ads, effectively placing them in digital limbo.”
Endo Opioid Saga 'Like A John Grisham Movie,' Judge Says: “A Tennessee judge who found Endo Pharmaceuticals liable by default for opioid abuse in the state told Law360 on Monday that his extraordinary ruling stemmed from "the worst case of document hiding" he has ever encountered, likening the situation to the plot of a Hollywood legal thriller. In a Monday afternoon interview, Circuit Court Judge Jonathan Lee Young outlined the basis for his default judgment in favor of various Tennessee counties, which have alleged in a sweeping lawsuit that Endo "knowingly participates in the illegal drug market for opioids" through its past sales and marketing of prescription narcotics.”
About healthcare IT
US warns organizations to brace for potential Russian cyberattacks: “The Cybersecurity and Infrastructure Security Agency issued a recommendation that all U.S. organizations should increase cybersecurity to shield up against potential threats from Russia.
The CISA warning, posted Feb. 14, came after the State Department advisory that urged Americans to leave Ukraine because of increased threats by the Russian military.”
South Shore Hospital breach leaves 116,000 patients' data vulnerable: “Chicago-based South Shore Hospital notified current and former patients about a cybersecurity incident that left 115,670 patients' protected information vulnerable…
The investigation found the attacker gained access to files that contained patients' and employees' first and last names, addresses, dates of birth, Social Security numbers, financial information, health insurance information, medical information, diagnoses, health insurance policy numbers, and Medicare and Medicaid information.”
Doximity brings in record profit in Q3, snaps up Amion to add physician scheduling to its platform: “Doximity, a digital platform for medical professionals, brought in $98 million in revenue in the third quarter, a 67% jump from a year ago. The health tech company also boasted a record profit of $56 million during the quarter, up from $17.2 million just one year ago.
Doximity, which went public in June, operates like a LinkedIn for doctors and provides a digital platform for U.S. medical professionals, including telehealth and scheduling tools. The company has over 1.8 million medical professional members as of March 31, 2021, and claims to have more than 80% of doctors on its network.”
About healthcare personnel
As state medical boards try to stamp out COVID misinformation, some in GOP push back: “Although doctors have leeway to decide which treatments to provide, the medical boards that oversee them have broad authority over licensing and discipline for misconduct. Often, doctors are investigated for violating guidelines on prescribing high-powered drugs. But physicians are sometimes punished for other types of ‘unprofessional conduct.’”
The article explains the situation in Tennessee as an example.
