About health insurance
Covid-19 Vaccination Costs to Strain State Medicaid Programs: “Getting millions of Covid-19 vaccine doses to the poorest adults in the country will require budget-conscious Medicaid plans to get creative with dwindling resources and a patchy health-care system not designed for mass inoculation.”
Many Private Insurers Offer Financial Relief for COVID-19 Treatment, but Cost-Sharing Waivers Are Expiring:”About 88% – nearly nine in ten – enrollees in the individual and fully-insured group markets are covered by plans that have taken action to limit out-of-pocket costs for patients undergoing treatment for COVID-19 since the start of the pandemic. However, after accounting for waivers that have already expired (20%) or are scheduled to expire by the end of September (16%), just over half of enrollees in these plans will still be eligible for waived cost-sharing in October and beyond.
The estimates do not include the 61% of group market enrollees in self-insured plans through their employers.”
UC Health settles Medicare fraud allegations: “Cincinnati-based UC Health has agreed to pay $3.1 million to settle Medicare fraud allegations, according to The Cincinnati Enquirer.
The settlement, announced Aug. 20, resolves allegations brought in 2018 by Donald Lynch, MD, an interventional cardiologist employed by the health system. He alleged the system illegally billed Medicare for trascatheter aortic valve replacements. UC Health needed to have performed at least 50 of the surgeries the year prior to bill for the procedures, and it had allegedly performed about half that amount, a lawyer representing Dr. Lynch told The Cincinnati Enquirer.
UC Health did not admit to the allegations as part of the settlement.”
Centene underpaid physicians affiliated with TeamHealth, court says:”Under the verdict, a six-person jury in the U.S. District Court for the Eastern District of Arkansas found Centene and its subsidiaries breached their contract with Southeastern Emergency Physicians by underpaying ER claims and delaying reimbursement. The jury found Centene and its affiliates are liable for $9.4 million in underpayments to the ER physicians.”
About the public’s health
For Joe Biden, it's all about fixing the coronavirus pandemic: A good summary of his acceptance speech last night.
What if We Worried Less About the Accuracy of Coronavirus Tests?: Nothing new in this article but it is a good explanation of the advantage of testing pooled samples.
Ultraviolet UVC sanitizers can be dangerous and have limited use against coronavirus, warns FDA: “‘The effectiveness of UVC lamps in inactivating the SARS-CoV-2 virus is unknown because there is limited published data about the wavelength, dose, and duration of UVC radiation required to inactivate the SARS-CoV-2 virus,’ the FDA said in a newly posted statement.”
Trump administration bars FDA from regulating some laboratory tests, including for coronavirus:”The new policy stunned many health experts and laboratories because of its timing, several months into a pandemic. Some public health experts warned the shift could result in unreliable coronavirus tests on the market, potentially worsening the testing crisis that has dogged the United States if more people get erroneous results. They argued the change is unlikely to solve current testing problems, which at this point are largely due to shortages of supplies such as swabs and chemical reagents.”
About healthcare IT
HHS denies report COVID-19 hospital data going back to CDC:”The Department of Health and Human Services is denying a report by the Wall Street Journal which stated that hospitals would return to the practice of sending critical COVID-19 data to the Centers for Disease Control and Prevention. Data collection was moved to HHS in July.
‘HHS made repeated attempts to explain to the Wall Street Journal that the process for COVID-19 data reporting has not and is not changing,’ said Michael Caputo, HHS Assistant Secretary for Public Affairs in a statement to TEGNA. ‘This false reporting will sow more confusion and only undermines the public health response.’”
About hospitals and health systems
Two systems report financial results:
Mayo Clinic's operating income drops 48.7%: “Rochester, Minn.-based Mayo Clinic recorded a net operating income of $154 million in the second quarter of 2020, a decrease of 48.7 percent compared to the same period last year, according to recently released financial documents.”
Sutter Health posts net income in second quarter after $1B first-quarter loss:”Sacramento, Calif.-based Sutter Health saw its financial picture improve in the second quarter of 2020, after posting a $1.1 billion loss in the first quarter, according to recently released financial documents.
Sutter Health recorded a net income of $220 million in the second quarter of 2020. This compares to a net income of $113 million in the same quarter one year prior.”
About healthcare technology
Agile mobile robotic platform for contactless vital signs monitoring: “To eliminate the need for in-person contact for vital signs measurement in the hospital setting, we developed Dr. Spot, an agile quadruped robotic system that comprises a set of contactless monitoring systems for measuring vital signs and a tablet computer to enable face-to-face medical interviewing. Dr. Spot is teleoperated by trained clinical staff to facilitate enhanced telemedicine. Specifically, it has the potential to simultaneously measure skin temperature, respiratory rate, heart rate, and blood oxygen saturation simultaneously while maintaining social distancing from the patients.”
Bayer to pay $1.6 billion to resolve U.S. claims for Essure birth-control device: “…Bayer said on Thursday it will pay around $1.6 billion to settle the majority of U.S. claims involving its Essure birth-control device…
Bayer said the Essure settlement is for around 90% of the nearly 39,000 claims by women alleging injury from the devices and that it was in discussion with counsel for the remaining plaintiffs.”
About pharma
Efficacy of Remdesivir in COVID-19: A JAMA editorial that is a good summary of the topic. Conclusion: “First, the optimal patient population is unclear. Second, the optimal duration of therapy is unclear. Third, the effect on discrete clinical outcomes is unclear. Fourth, the relative effect of the drug if given in the presence of dexamethasone or other corticosteroids is unclear. Some of the RCT findings suggest remdesivir could improve recovery for many millions of individuals around the world who may be hospitalized with COVID-19. However, the costs to produce and distribute remdesivir at such scale are considerable, and, most importantly, whether remdesivir offers incremental benefit over corticosteroids, which are widely available and inexpensive, is unknown. It therefore seems prudent to urgently conduct further evaluations of remdesivir in large-scale RCTs designed to address the residual uncertainties and inform optimal use.”