About health insurance
FAQs About Families First Coronavirus Response Act and Coronavirus Aid, Relief, and Economic Security Act Implementation- Part 42: This document is from CMS and has a lot of information for payers. A few key issues:
These laws apply to all payers including ERISA plans
Testing cannot have any out of pocket expenses for the patient or have utilization criteria applied except medical necessity (e.g., must have a physician’s order).
The rates insurers pay testing entities must be their contracted rates or the rates the entities are required to publish, e.g., online. Such published rates need not be reasonable, however.
See the document for answers to what is a covered visit.
Bundled-Payment Models Around the World: How They Work and What Their Impact Has Been: This study, from the Commonwealth Fund, found that: “Of the 35 studies retrieved, 32 reported effects on quality of care and 32 reported effects on medical spending. Twenty of 32 studies reported modest savings or a modest reduction in spending growth, while two studies (both based on the same initiative) demonstrated increased spending in the early years of the bundled-payment model’s implementation. Eighteen of 32 studies reported quality improvements for most evaluated measures, while other studies showed no difference in measured quality. Our study provides evidence that bundled-payment models have the potential to reduce medical spending growth while having either a positive impact or no impact on quality of care.”
About the public’s health
Coronavirus Resources & Tools (COVID-19): This resource site is sponsored by Walters Kluwer. Click on “Agency Guidance” or go here to compare state and federal regulations and laws.
Towards aerodynamically equivalent COVID19 1.5 m social distancing for walking and running: In Europe, the recommended social distance is 1.5 meters (almost 5 feet). This Belgian study, widely quoted in the media today, says that “this social distance has been defined for persons that are standing still. It does not take into account the potential aerodynamic effects introduced by person movement, such as walking fast, running and cycling. This aerodynamics study investigates whether a first person moving nearby a second person at 1.5 m distance or beyond could cause droplet transfer to this second person.” The result of the study is that: “In the absence of head wind, tail wind and cross-wind, for walking fast at 4 km/h this [safe] distance is about 5 m [16.4 feet] and for running at 14.4 km/h this distance is about 10 m [32.8 feet].” Another recommendation is running or cycling to the side of the person in front. The article has some interesting graphics on slipstream dynamics.
Aerosol and Surface Distribution of Severe Acute Respiratory Syndrome Coronavirus 2 in Hospital Wards, Wuhan, China, 2020: In a related article from the CDC: “To determine distribution of severe acute respiratory syndrome coronavirus 2 in hospital wards in Wuhan, China, we tested air and surface samples. Contamination was greater in intensive care units than general wards. Virus was widely distributed on floors, computer mice, trash cans, and sickbed handrails and was detected in air ≈4 m from patients.” The 6 feet rule may not be sufficient in hospital settings.
Coronavirus Tests Are Being Fast-Tracked by the FDA, but It’s Unclear How Accurate They Are: The headline is self-explanatory.
Diagnostic Testing for Severe Acute Respiratory Syndrome–Related Coronavirus-2: A Narrative Review: In a related article, this open-access review from the Annals of Internal Medicine is a good review of the topic.
Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A good update on the subject from JAMA (open access). Bottom line: “No therapies have been shown effective to date.”
Small Chloroquine Study Halted Over Risk of Fatal Heart Complications: “A small study in Brazil was halted early for safety reasons after coronavirus patients taking a higher dose of chloroquine developed irregular heart rates that increased their risk of a potentially fatal heart arrhythmia.”
Vital Signs: Newly Reported Acute and Chronic Hepatitis C Cases ― United States, 2009–2018: “The annual rate of reported acute hepatitis C tripled from 2009 to 2018 and was highest among persons aged 20–39 years. In 2018, the largest proportion of chronic hepatitis C cases occurred among persons aged 20–39 years and 50–69 years. Only 61% of adults with hepatitis C knew that they were infected…
All adults and pregnant women should be screened for hepatitis C according to CDC’s new screening recommendations.”
Weekly U.S. Influenza Surveillance Report: “Nationally, the percent of laboratory specimens testing positive for influenza at clinical laboratories continued to decrease and is now low… CDC estimates that so far this season there have been at least 39 million flu illnesses, 410,000 hospitalizations and 24,000 deaths from flu.” Reporting (from care-seeking) has increased because of heightened awareness of COVID-19.
FDA OKs on-site decontamination systems for reusing millions of N95 respirator masks: “The FDA greenlighted its second and third systems for decontaminating N95 respirators, both previously used on-site at many health systems nationwide. Together, the agency estimates this will allow nearly 5 million masks to be processed and reused per day.”
FDA quickly authorizes its second blood filtering device for COVID-19: ”Shortly after granting an emergency authorization to Terumo BCT’s blood filtering device for COVID-19, the FDA did the same for CytoSorbents’ system. Both are designed to strip out the immune system proteins that fuel the deadly cytokine-storm reactions associated with the disease.”
WHO investigating reports of coronavirus patients testing positive again: “The World Health Organization (WHO) confirmed on Saturday it is investigating reports of some recovered coronavirus patients testing positive for the illness after initially testing negative.
The move is in response to a report from South Korea on Friday that 91 patients who had been cleared of COVID-19 and were being prepared for discharge tested positive again. Officials say that, rather than being reinfected, patients may be suffering from a ‘reactivated’ coronavirus. “
America's new opioid crisis:”A yearslong crackdown on opioid production is having an unintended consequence during the coronavirus crisis: Many of these same drugs are essential for people on ventilators, and now there’s a shortage.”