About the public’s health
Western States Join California’s Scientific Safety Review Workgroup to Ensure Safety of COVID-19 Vaccine: “Washington, Oregon and Nevada have joined California’s COVID-19 Scientific Safety Review Workgroup, which will independently review the safety and efficacy of any vaccine approved by the FDA for distribution.”
Coronavirus antibodies decline after infection, study finds, raising questions about herd immunity: “Researchers from Imperial College London screened 365,000 people in England over three rounds of testing between June 20 and Sept. 28.
Analysis of finger-prick tests carried out at home found that rather than people building immunity over time, the number of people with antibodies that can fight Covid-19 declined roughly 26%.”
U.S. Preventive Services Task Force Issues Draft Recommendation on Screening for Colorectal Cancer:”For the first time, the Task Force is recommending that screening start at age 45. This is a B recommendation. The Task Force continues to strongly recommend screening people who are 50 to 75 years old. This is an A recommendation.” (Emphases in original.)
COVID-19 Mitigation Behaviors by Age Group — United States, April–June 2020:”Self-reported engagement in mitigation behaviors (mask wearing, handwashing, physical distancing, crowd and restaurant avoidance, and cancellation of social activities) differed significantly by adult age group. During April–June 2020, the prevalence of these behaviors was lowest among adults aged 18–29 years and highest among those aged >60 years. Whereas mask wearing increased over time, other reported mitigation behaviors decreased or remained unchanged.”
About health insurance
Anthem Reports Third Quarter Results, Reaffirms Commitment to Stakeholders During COVID-19 Pandemic: Anthem sustained an operating loss decline of 86.8% for the 3rd quarter compared to the previous year’s period. For the 9 months so far, both revenue and profit are up about 17.5%.
New CMS Proposals Streamline Medicare Coverage, Payment, and Coding for Innovative New Technologies and Provide Beneficiaries with Diabetes Access to More Therapy Choices: “The proposed rule would expand the interpretation regarding when external infusion pumps are appropriate for use in the home and can be covered as DME under Medicare Part B, increasing access to drug infusion therapy services in the home. The proposed rule also drastically reduces administrative burdens – such as complicated government coverage, payment and coding processes – that block innovators from getting their products to Medicare beneficiaries in a timely manner…
If finalized, today’s proposed rule will also expand Medicare coverage and payment for continuous glucose monitors (CGMs)…”
2019 Quality Payment Program (QPP) Performance Results: From CMS: “We’re pleased to share that the maximum MIPS payment adjustment for exceptional performance during the 2019 reporting year will be the highest since the program began. Clinicians with a final score equal to or above 75.00 points will receive a positive payment adjustment in 2021 of up to 1.79%…
Some other clinicians, however, may see lower than expected positive payment adjustments. This is because the Quality Payment Program is required by law to be budget neutral, and more clinicians who may have faced maximum negative adjustments qualified for reporting exceptions under the MIPS Extreme and Uncontrollable Circumstances policy. As a result, there is a smaller pool of dollars from negative payment adjustments that can be redistributed and used for the positive payment adjustments.”
Anthem to pay $594M share in pending Blues plan antitrust settlement: “Anthem is paying a substantial portion of Blues plans' tentative antitrust settlement, which is estimated to be nearly $3 billion, executives said on a call with investors on Wednesday morning.
Anthem has penciled in $594 million for its contribution to the $2.7 billion settlement. The Blue Cross and Blue Shield Association reportedly agreed to the settlement in a lengthy class action suit late last month…
In the suit, filed in 2012, Blues plans were accused of conspiring to split up geographic regions to avoid competing against one another directly. That lack of competition drove up costs, the plaintiffs allege.”
About healthcare IT
Aetna Pays $1,000,000 to Settle Three HIPAA Breaches: Read the OCR announcement for further details. The events occurred in 2017.
Healthcare technology
Exact Sciences snaps up liquid biopsy company Thrive in $2.15B deal:”Exact Sciences is adding early cancer detection to its pipeline through its buyout of Thrive Earlier Detection for up to $2.15 billion in cash and stock. The deal comes just three months after Thrive raised $257 million in venture dollars to push its liquid biopsy test into a registrational trial.”
About pharma
Eli Lilly nabs $375M deal to supply COVID-19 antibody to U.S. government despite trial failure: “Eli Lilly may have deep-sixed trials of its COVID-19 antibody treatment in hospitalized patients for lack of efficacy, but that’s not stopping the U.S. government from placing a huge bet on the drug’s success in other settings.
The government struck a $375 million deal with the company for 300,000 vials of the antibody treatment, bamlanivimab (LY-CoV555), provided it wins an emergency use authorization from the FDA…”