Resource recommendation
The Managed Care Digests have been around for 34 years and provide a good source of data about providers, payers and diseases.
About pharma
FDA pulls emergency authorization for hydroxychloroquine as covid-19 treatment: “The Food and Drug Administration has withdrawn its emergency use authorization for hydroxychloroquine to treat coronavirus patients. President Trump had repeatedly promoted the antimalarial drug as a way to prevent or treat covid-19.
The agency said Monday in a statement that ‘it is no longer reasonable to believe’ the drug may be effective against covid-19 or that its benefits outweigh ‘known and potential risks.’”
Promising path found for COVID-19 therapeutics: As the biology of SARS-CoV-2 becomes clearer, a number of new therapies can be investigated. This article explains one of them.
Physicians, nurses and pharmacists among 19 indicted in multimillion-dollar opioid distribution ring: The opioid epidemic is not over as long as theses schemes persist. “The indictment alleges clinic owner John Henry Rankin gave money and illegal benefits to physicians and nurse practitioners who wrote faulty prescriptions for oxycodone, hydrocodone, promethazine with codeine cough syrup and other highly addictive drugs. The court document also accuses Mr. Rankin of recruiting patients into the conspiracy and paying an unlicensed medical worker to issue fraudulent prescriptions while posing as a physician.
The court has accused the distributors of prescribing nearly 2 million illegal doses of Schedule II controlled substances, with the oxycodone and oxymorphone alone holding a conservative street price of more than $41 million.”
About the public’s health
Trump administration revokes transgender health protection:”The Department of Health and Human Services said it will enforce sex discrimination protections ‘according to the plain meaning of the word ‘sex’ as male or female and as determined by biology.’This rewrites an Obama-era regulation that sought a broader understanding shaped by a person’s internal sense of being male, female, neither or a combination.” This announcement preceded today’s ruling by the Supreme Court that sexual orientation could not be the basis of discrimination in the workplace.
Record spikes in new coronavirus cases, hospitalizations sweep parts of U.S.:”New coronavirus cases and hospitalizations in record numbers swept through more U.S. states, including Florida and Texas, as most push ahead with reopening and President Donald Trump plans an indoor rally in Tulsa, Oklahoma…
Nationally, there were over 25,000 new cases reported on Saturday, the highest tally for a Saturday since May 2, in part due to a significant increase in testing over the past six weeks.”
Beijing imposes curbs as coronavirus returns to Chinese capital:”Several districts of the Chinese capital put up security checkpoints, closed schools and ordered people to be tested for the coronavirus on Monday after an unexpected spike of cases linked to the biggest wholesale food market in Asia.
After nearly two months with no new infections, Beijing officials have reported 79 cases over the past four days, the city’s biggest cluster of infections since February.”
How to Use Masks during the Coronavirus Pandemic: A good reminder from Scientific American about how to use a mask effectively.
FDA Approves Merck’s GARDASIL 9 for the Prevention of Certain HPV-Related Head and Neck Cancers: The new version protects against an additional 5 strains of HPV. Those previously immunized will probably receive a course of this vaccine as well.
The $7,000 Covid test: Why states are stepping in to shield consumers: “Insurance regulators from Tennessee to Washington state have stepped up efforts to protect patients from unexpected bills for coronavirus tests, concerned the federal government has failed to shield people from thousands of dollars in out-of-pocket expenses…
The state-by-state guidance and rules come after Congress and the Trump administration this spring assured Americans that coronavirus testing and any necessary trips to doctors and hospitals would be free. But lawmakers didn't limit charges if the testing is done out of network — or prohibit labs or hospitals from billing patients if insurers refuse to pay their posted charges.
Employers and health plans have complained this could lead to staggering costs. One national insurer was billed $6,946 for a coronavirus test in Texas, according to claims data reviewed by POLITICO.”
Coronavirus survival comes with a $1.1 million, 181-page price tag: “The bill is technically an explanation of charges, and because Flor [the patient] has insurance including Medicare, he won’t have to pay the vast majority of it. In fact because he had COVID-19, and not a different disease, he might not have to pay anything…” Recall many insurers have waived out of pocket expenses for COVID-19 related conditions, including testing (see article above).
About healthcare IT
The bipartisan HEALTH Act would make permanent Medicare payments for telehealth services at federally qualified health centers and rural health clinics: The temporary reimbursement changes for telehealth may become more permanent. “U.S. Reps. G.K. Butterfield, D-North Carolina, and Glenn Thompson, R-Pa., introduced new legislation this week that would provide for permanent Medicare payments for telehealth services at federally qualified health centers and rural health clinics.
The Helping Ensure Access to Local TeleHealth, or HEALTH Act, would require the Secretary of Health and Human Services to revise the Code of Federal Regulations to consider telehealth services from an eligible facility to be a ‘visit.’”
FCC Funds 67 More COVID-19 Telehealth Projects, Program Surpasses $100M in Funding: ”The FCC Wireline Competition Bureau has announced the next tranche of approved projects in the COVID-19 telehealth program. The new funding of $20.18 million is for 67 projects. This brings total funding to $104.98 million for 305 providers in 42 states and the District of Columbia. The $200 million COVID-19 telehealth program was created in the CARES Act, which was approved in March.”
10 common reasons for HIPAA violations: “In the past 12 months, there were 393 protected health information breach incidents reported to HHS.” This article is a good summary of the types of infractions with many examples.
Health systems can use PHI to contact former COVID-19 patients on blood, plasma donation without violating HIPAA: 3 details: And here is guidance about what you can do and not violate HIPAA.
Beyond Convenience: Patients’ Perceptions of Physician Interactional Skills and Compassion via Telemedicine:”This [research] supports the notion that clinician-patient relationships can be established in a video-first model, without a previous in-person encounter, and that positive ratings do not seem to be focused solely on prescription receipt.”
About healthcare professionals
Accountable Care Organizations’ Increase In Nonphysician Practitioners May Signal Shift For Health Care Workforce: For the period 2013-2018: “The average proportion of nonphysician practitioners in ACOs grew from 18.1 percent to 38.7 percent, with a commensurate decline in the average share of primary care physicians from 60.0 percent to 42.2 percent. As value-based care models grow in prevalence, their evolving clinician composition may affect workforce patterns in the broader health care delivery system.”
Healthcare Professionals and the Impact of COVID-19: ”Nationally, from March 2019 to March 2020, utilization of professional services decreased 65 percent and professional revenue based on total estimated allowed amounts decreased 45 percent. From April 2019 to April 2020, utilization fell 68 percent and revenue 48 percent.” This article goes into more details and especially highlights specialties that were particularly affected. For example, oral surgery and gastroenterology were the most impacted.