President-elect Biden Announces American Rescue Plan (Emergency Legislative Package to Fund Vaccinations, Provide Immediate, Direct Relief to Families Bearing the Brunt of the COVID-19 Crisis, and Support Struggling Communities) This statement is a clear and well-written short text of the Rescue Plan. It is not that long and is worth reading. The full (198 page) version is here. For updates, check this link.
About health insurance
Biden Administration Plans to Expand COBRA, ACA Premium Subsidies: The Rescue Plan will extend and increase premium subsidies for COBRA and Affordable Care Act enrollees, with an estimated cost of approximately $57.0 billion over the next three years.
Independent Evaluation of Comprehensive Primary Care Plus (CPC+): This third annual report from Mathematica found that: “There were a few small favorable impacts of CPC+ on some measures of service use, quality of care, and patient experience for Medicare fee- for-service (FFS) beneficiaries during the first three years, but with CMS’s enhanced payments, CPC+ increased total Medicare expenditures. It is still too early to draw conclusions about the likely longer- term effects of CPC+.”
Proposed Decision Memo for Screening for Colorectal Cancer - Blood-Based Biomarker Tests (CAG-00454N): This page has the latest coverage criteria for Medicare patients to have a blood biomarker screen for colon cancer.
Optum expects to add 10,000 physicians this year: “Currently, OptumCare employs or is affiliated with 50,000 physicians and 1,400 clinics. OptumCare expects that its employed and affiliated physicians will grow by at least 10,000 during 2021, according to UnitedHealth CEO David Wichmann.”
Medicare Advantage Star Ratings: 30 measures to know for 2022: “CMS ranks Medicare Advantage on a quality scale of one to five stars, with five representing excellent performance and one reflecting poor performance. To assign stars, Medicare analyzes how health plans perform on certain measures. At the contract level, CMS only includes the measure if numeric value scores are available for both the current year and prior years.
The 30 measures that will be used to calculate the 2022 Star Ratings for Medicare Advantage plans are”listed in the article.
In addition to quality indicators, the stars also determine payments to these plans.
Two Women Plead Guilty In $109M Medicare Fraud Scheme: “Two women pled guilty Wednesday for their roles in a multimillion-dollar Medicare fraud scheme that profited by selling patient data and using that information to submit $109 million worth of false claims, according to the U. S. Department of Justice. Jessica Jones, 30, of Colorado, and Elizabeth Putulin, 30, of Florida, both entered guilty pleas to one count of conspiracy to commit health care fraud. The two women were accused of conspiring with Juan Camilo Perez Buitrago to submit more than $109 million in false claims for durable medical equipment such as back or knee braces by creating shell companies…”
Healthcare execs, physicians pardoned by Trump: In addition to yesterday’s post, here are additional execs who were pardoned (all for insurance fraud crimes).
About COVID-19
New data back ability of Pfizer, BioNTech's COVID-19 vaccine to foil UK strain: “Pfizer and BioNTech on Wednesday reported results from another in-vitro study indicating that their COVID-19 vaccine BNT162b2 is likely capable of neutralising the rapidly spreading UK strain of SARS-CoV-2, also known as B.1.1.7. The findings, which were published on the preprint server bioRxiv, follow the release of a similar laboratory study earlier this month showing that antibodies from vaccinated people were able to efficiently neutralise variants of SARS-CoV-2 with a key mutation, dubbed N501Y, found in the UK variant, as well as another highly transmissible strain that has emerged in South Africa.” However, Emerging Coronavirus Variants May Pose Challenges to Vaccines: “People who had survived mild infections with the coronavirus may still be vulnerable to infection with a new variant; and more worryingly, the vaccines may be less effective against the variants.”
The 10 Biden officials to watch on the Covid-19 response: Read the article for details.
Amazon offers Biden help with Covid-19 vaccine distribution: “Amazon has extended an offer to President Joe Biden to assist with the national distribution of Covid-19 vaccines, a move that could expedite the federal effort to combat the pandemic.”
Biden's just-released coronavirus strategy keeps vaccine goals modest: The article is an update on this fast-moving program. Today, President Biden will “sign 10 more executive orders and directives aimed at mitigating various pandemic-caused crises. They include:
Creating a Pandemic Testing Board that can spur a “surge” in the capacity for coronavirus tests.
Fostering research into new treatments for covid-19.
Strengthening the collection and analysis of data to shape the government’s response to the crisis.
Directing the federal occupational safety agency to release and enforce guidelines to protect workers from getting infected.
Directing the Departments of Education and Health and Human Services to provide guidance on safe reopening and operating for schools, child care providers, and institutions of higher education.
Requiring mask-wearing in airports and other modes of public transportation including trains, airplanes, maritime vessels and intercity buses.”
Europe’s growing mask ask: Ditch the cloth ones for medical-grade coverings: “Germany on Tuesday night made it mandatory for people riding on public transport or in supermarkets to wear medical style masks: either N95s, the Chinese or European equivalent KN95 or FFP2s, or a surgical mask.
It follows a stricter regulation from the German state of Bavaria this week that required N95 equivalents in stores and on public transport. Austria will introduce the same measures from Monday…
Meanwhile in France, the country’s health advisory council on Monday discouraged the wearing of inefficient cloth and homemade masks, also arguing they may not offer sufficient protection against the more highly transmissible coronavirusvariants.”
47% of Americans say vaccinations are moving too slowly: “A plurality of Republicans and Independents, and a majority of Democrats, say the rollout is moving too slowly.
Among those who feel it’s going too slowly, however, there’s a sharp partisan divide over who’s at fault: 60% of Democrats say President Trump is to blame, while a plurality of Republicans (36%) say state governments are the problem…”
But perhaps the most significant finding in this Axios-Harris poll is: “(69%) of Americans say they are likely to take the COVID-19 vaccine, the highest percentage other than the first time we asked in April 2020 (when 73% said they would take the vaccine).”
About healthcare IT
Tripathi tapped as Biden's national coordinator for health IT: “An expert on interoperability, privacy, and technology standards, Tripathi most recently served as chief strategy officer at Arcadia, a population health management solutions company. Before joining Arcadia, [he] had been president and CEO of the Massachusetts eHealth Collaborative (MAeHC), a nonprofit health IT advisory and clinical data analytics company. MAeHC was formed in 2005 and played a significant leadership role in advising and leading various interoperability and standards activities, including HL7 and FHIR.”
ONC investing $20M to boost COVID-19 vaccine data sharing efforts: “ONC will award nearly $20 million in funds from the Coronavirus Aid, Relief, and Economic Security (CARES) Act signed by former President Donald Trump in March to support the nation’s vaccination efforts to fight the COVID-19 pandemic.
The new investments will support opportunities to track vaccination progress, help clinicians pinpoint and contact high-risk patients, and coordinate appointments for patients due to receive the second dose of the vaccine, according to a press release.”
About diagnostics
Thermo Fisher Scientific to Acquire Point-of-Care Molecular Diagnostics Provider Mesa Biotech: “Thermo Fisher Scientific Inc… today announced it has entered into a definitive agreement to acquire Mesa Biotech, Inc., a privately held molecular diagnostic company, for approximately $450 million in cash. Under the terms of the agreement, Thermo Fisher will pay up to an additional $100 million in cash upon the completion of certain milestones following the close of the transaction.
Mesa Biotech has developed and commercialized a PCR-based rapid point-of-care testing platform available for detecting infectious diseases including SARS-CoV-2, Influenza A and B, respiratory syncytial virus (RSV) and Strep A.”
In vitro test maker Ortho Clinical Diagnostics files $1.5B Nasdaq IPO: “Ortho Clinical Diagnostics is hoping to pay down a large portion of its debts by riding a wave of COVID-19 and broader in vitro lab testing demands to a $1.5 billion IPO.
The company is offering 70 million shares on the Nasdaq—slated for the ticker OCDX—that are expected to be priced between $20 and $23 apiece in the coming week. Hitting the midpoint of that range would bestow a market value of $4.9 billion…”
Boston Scientific buys wearable heart monitor maker Preventice for $1.2B, as in-hospital sales take hit from pandemic: “Boston Scientific has moved to acquire the remote cardiac monitoring developer Preventice Solutions, a company it has partnered with and invested in since 2015.
On paper, the transaction features a cash payment of $925 million, plus an additional $300 million tied to the achievement of certain commercial milestones. However, Boston Scientific has built up a 22% stake in Preventice, which is expected to lower the net payments to $720 million upfront and about $230 million in milestone money, respectively.”
About pharma
McLaren Health Care Settles with DEA: “The Agreement is the culmination of a multi-year effort with the DEA, which identified prescribing irregularities at the McLaren Port Huron retail pharmacy in 2018, prompting McLaren to terminate a pharmacist who was diverting opioids for his own personal use. A subsequent review included an exhaustive assessment of pharmacy protocols at other McLaren facilities — in some cases stretching over periods of up to 12 years. At the conclusion of its review, the DEA identified irregularities associated with recordkeeping, dispensing and distribution of controlled substances, particularly among retail pharmacies operating under "legacy" pharmacy protocols that had been in place prior to McLaren's acquisition of their operations.”
The penalty is $7.5M, making it the largest settlement ever for alleged drug diversion.