About health insurance
Cuts to 340B payments are legal, appeals court rules:”An HHS policy that will cut Medicare outpatient drug payments by nearly 30 percent at 340B hospitals in the U.S. is legal, an appellate court panel ruled July 31. The ruling overturns a lower court decision.
Under the 340B program, eligible hospitals can buy outpatient drugs at a discount. A hospital typically pays 20 percent to 50 percent below the average sales price for the drugs….HHS argued that Medicare should not reimburse hospitals more than they paid to acquire the drugs.”
Health Care Spending and the Medicare Program (July 2020):Perhaps the best comprehensive explanation of annual Medicare spending. It is prepared by MedPAC.
Texas, Other States Lose $479 Million in Obamacare Provider Fees: “The Fifth Circuit Friday upheld the Obamacare provider fee that states pay to the IRS on behalf of Medicaid Managed Care Organizations in order to receive federal reimbursement for MCO payments.
The fee is a valid federal tax that doesn’t violate the U.S. Constitution’s spending clause, it said.”
Florida physician charged in $681M billing fraud scheme: “Dr. Ligotti allegedly served as the medical director for more than 50 addiction treatment facilities and signed more than 135 standing orders authorizing fraudulent tests. In exchange for his signature on the standing orders, he allegedly required the treatment centers to have their patients treated at Whole Health. Some patients were allegedly charged between $10,000 and $20,000 by Dr. Ligotti and Whole Health for one visit.”
CMS Finalizes $750M Medicare Payment Boost for Nursing Homes in Fiscal 2021: “The federal government on Friday finalized a previously proposed rule that will bring a 2.2% Medicare payment bump to the nation’s skilled nursing facilities.”
CMS finalizes 3 payment rules for 2021: 5 things to know: “CMS finalized three Medicare payment rules July 31, including updates for psychiatric facilities, skilled nursing facilities and hospices.”
About the public’s health
Characteristics and Strength of Evidence of COVID-19 Studies Registered on ClinicalTrials.gov: The quality of research studies on COVID-19 has been generally poor. This research was a cross-sectional study using ClinicalTrials.gov information. The researchers “found that despite the marked rise in COVID-19 studies, only 29.1% of those registered in ClinicalTrials.gov have the potential to result in OCEBM [2011 Oxford Centre for Evidence-Based Medicine] level 2 evidence. Of the RCTs, only 29.3% are placebo-controlled, blinded studies. Global decline in new cases could also stall enrollment. Even before results are known, most studies likely will not yield meaningful scientific evidence at a time when rapid generation of high-quality knowledge is critical.”
SARS-CoV-2-reactive T cells in healthy donors and patients with COVID-19: Researchers “detected SARS-CoV-2 S-reactive CD4+ T cells in 83% of patients with COVID-19 but also in 35% of HD [healthy donors].” Meaning that T cell immunity (not just antibody- producing B cell immunity) plays an important part in fighting COVID-19. It is another potential mechanism for vaccine development. Also, the 35% mentioned means healthy people can have cross reactivity and possible protection from previous exposure to other similar viruses.
6 reasons why COVID-19 medical liability shield critics are wrong: One of the differences between Democratic and Republican proposals for COVOD-19 relief is whether there is a liability exemption for employers whose employees become ill. (The former want the liability, the latter want the exemption.) This article from the AMA is a thoughtful analysis of the issue.
COVID-19 Hospital Data System That Bypasses CDC Plagued By Delays, Inaccuracies: This article is a great summary of how the new reporting system is in trouble. In a related article: CDC director says he wasn't involved in decision to reroute COVID-19 hospitalization data
‘The Biggest Monster’ Is Spreading. And It’s Not the Coronavirus: TB is “the biggest infectious-disease killer worldwide, claiming 1.5 million lives each year.” The point of the article is that TB, HIV infection and malaria, all on the decline, have been making a comeback as resources and attention have been focused on COVID-19.
Here are some updates on COVID-19 testing that offer faster/better or easier testing:
Sorrento Licenses COVID-19 Saliva Test;
90 minute COVID-19 tests: [UK]Government orders 5.8 million DnaNudge kits;
Oxford researchers say new artificial intelligence test could identify coronavirus within one hour;
NIH picks seven COVID-19 diagnostic tests in 'Shark Tank' competition, unlocking $248.7M in scale-up funding; and
FDA authorizes first tests for measuring COVID-19 antibody amounts
Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study: “Compared with the general community, front-line health-care workers were at increased risk for reporting a positive COVID-19 test (adjusted HR 11·61, 95% CI 10·93–12·33). To account for differences in testing frequency between front-line health-care workers and the general community and possible selection bias, an inverse probability-weighted model was used to adjust for the likelihood of receiving a COVID-19 test (adjusted HR 3·40, 95% CI 3·37–3·43). Secondary and post-hoc analyses suggested adequacy of PPE, clinical setting, and ethnic background were also important factors.”
About pharma
Ohio pharmacy board reverses hydroxychloroquine ban: Politics wins out over science: “Ohio's board of pharmacy has reversed its ban on hydroxychloroquine for use in COVID-19 patients and said it will reexamine the issue — just a day after announcing its plan to ban the drug — following a request from Gov. Mike DeWine.
The board had announced July 29 a plan to ban medical institutions from prescribing hydroxychloroquine for use in COVID-19 patients as of July 30, saying it was a "patient safety issue." The drug would still have been allowed in clinical trials.”
The day the music died? FDA fields request to ban background music in DTC ads:”While the petition is lengthy, its argument is simple. Music played in the background during the reading of risks distracts consumers and makes it more difficult to understand and remember those risks.”
About hospitals and health systems
Hospitals must start paying back billions borrowed from government during pandemic: Unlike many PPP “loans,” hospitals received advances on Medicare payments which they will need to start paying back soon. This article is a good discussion of the details and issues behind this upcoming major stress.
About healthcare IT
Healthcare groups cheer House move to overturn ban on nationwide patient identifier: Now if the Senate can agree…
”On Thursday, the U.S. House of Representatives passed the six-bill FY2021 minibus package that includes the Labor-Health and Human Services appropriations bill. As part of the bill, the House approved by voice vote the bipartisan Foster-Kelly Amendment, which strikes Section 510 of the Labor-HHS bill and removes the ban on using federal funding to create patient identifiers.”
Allscripts sells EPSi business to Strata Decision Technology for $365M: “EPSi is a provider of financial decision support and planning tools for hospitals and health systems.”