About health insurance
3 insurers to pay out $3.1M after health parity violations: “Aetna, Oscar Health and Wellfleet must pay $3.1 million after allegedly violating federal and New York mental health parity and cost-sharing laws.
A review by the New York Financial Services Department announced the payments after reviewing biannual parity reports from the payers, which found that the insurers had policies requiring members to illegally pay copays or coinsurance for mental health and substance use disorder benefits, according to a department news release.
Between fines for parity and data-reporting violations, the payers owe $2.6 million in penalties and must return $473,565 to members.”
Public health emergency end could cause millions to lose Medicaid coverage: “The provision, a requirement under the Families First Coronavirus Response Act, which passed in March 2020, prevented states from removing Medicaid recipients from the program’s rolls. At least 11 million people have enrolled in Medicaid since February 2020.
Up to 15 million people, including nearly 6 million children, could be at risk of losing their Medicaid eligibility when the protection expires [on January 15], according to the Urban Institute, an economic and policy research think tank. The change could have an outsize effect on communities of color, the Urban Institute concluded.
Many are likely to be eligible for other forms of subsidized coverage, the analysis found, but there is a concern that few people will know that they are in danger of losing Medicaid and are eligible for other types of health insurance. “
Although the emergency designation will probably be extended (given the omicron variant expansion of cases), coverage of these people will inevitably be a problem when the pandemic is back under control.
About Covid-19
CDC: Omicron now accounts for 73% of US cases; 1st US death reported: “The omicron coronavirus variant has quickly become the dominant strain in the U.S., accounting for 73.2 percent of new infections for the week ending Dec. 18, genomic surveillance data from the CDC shows.
That's up from just 13 percent Dec. 11, the updated data reflects, underlining the strain's increased transmissibility. Before the data was updated on Dec. 20, the strain was believed to represent 3 percent of cases Dec. 14.”
Moderna steps back from Spikevax patent row with US government: “Moderna, which is locked in a dispute with the US National Institutes of Health (NIH) over who should be listed as co-inventors of its COVID-19 vaccine Spikevax, says it will not pursue issuance of a patent application for the jab's mRNA sequence "at this time." The company indicated that it made the decision in order to allow more time for discussions with the NIH.
Moderna has argued it was justified in listing its own scientists as sole inventors for Spikevax's mRNA sequence, while excluding three collaborators from the NIH who also worked on the vaccine. In its latest statement, Moderna reiterated that it believes company scientists "invented the specific mRNA sequence at the heart of the patent in question," although it "acknowledges that NIH feels equally strongly that its scientists should be listed as co-inventors for their contemporaneous work on the protein sequence."
About healthcare IT
HIPAA Privacy Rule and Disclosures of Protected Health Information for Extreme Risk Protection Orders: Guidance updated yesterday: “On June 7, 2021, the United States Department of Justice published model legislation to provide a framework for states to consider as they determine whether and how to implement their own “extreme risk protection order” (ERPO) laws. An ERPO is a court order that temporarily prevents a person in crisis, who poses a danger to themselves or others, from accessing firearms. ERPO legislation, which can vary in important ways among states, generally specifies certain categories of petitioners (e.g., law enforcement officers, family members, health care providers) who may apply to a court for an ERPO and includes requirements for affidavits or sworn oral statements from the petitioner or witnesses to support the application. This guidance addresses the requirements of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule for covered health care providers in relation to ERPO laws.”
About the public’s health
988 suicide phone hotline getting $282M to ease July launch: “ People in crisis and those trying to help them will have a new phone number — 988 — to reach the national suicide prevention network starting in July. On Monday, federal health officials announced more than $280 million to smooth the transition from the current 10-digit number to three digits.”
About pharma
FDA Approves Second Biosimilar Insulin Product, Rezvoglar (insulin glargine-aglr) : ”The Food and Drug Administration approved the second biosimilar insulin product, Eli Lilly’s Rezvoglar (insulin glargine-aglr). Rezvoglar (insulin glargine-aglr) is biosimilar to Lantus (insulin glargine).
Rezvoglar is a long-acting human insulin analog indicated to improve glycemic control in adults and pediatric patients with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus….
Rezvoglar is the second biosimilar insulin product and the 32nd biosimilar product approved in the U.S.”
More generics in a category causes prices to drop more.
About patient safety
Strategies to Improve Patient Safety: Final Report to Congress Required by the Patient Safety and Quality Improvement Act of 2005: “As required by the Patient Safety and Quality Improvement Act of 2005 (Patient Safety Act),a the Secretary of the Department of Health and Human Services (HHS) has prepared this Final Report to Congress on effective strategies for reducing medical errors and increasing patient safety in consultation with the Director of the Agency for Healthcare Research and Quality (AHRQ). It includes measures determined appropriate by the Secretary to encourage the appropriate use of effective strategies for reducing medical errors and increasing patient safety, including use in federally funded programs. As the Patient Safety Act also required, a draft of this report was made available for public comment and submitted for review to the Institute of Medicine, now the National Academy of Medicine. This Final Report, which is required to be submitted to Congress no later than December 21, 2021, includes updates and additions made to address feedback received from members of the public and the National Academy of Medicine.”
A “must-read” for those in charge of patient safety activities at their institutions.