About Covid-19
Fully vaccinated people may travel, CDC says: “But the Centers for Disease Control and Prevention said that even though fully vaccinated individuals are at lower risk of infection, travel is still not recommended due to the rising number of cases in the United States and globally.”
Emergent plant that ruined Johnson & Johnson vaccine doses had prior FDA violations: “In April last year, an investigator from the Food and Drug Administration reported problems he had discovered at a Baltimore plant operated by Emergent BioSolutions, a major supplier of vaccines to the federal government.
Some employees had not been properly trained. Records were not adequately secured. Established testing procedures were not being followed. And a measure intended to “prevent contamination or mix-ups” was found to be deficient.
Soon after the inspection, Emergent’s Baltimore plant was given an important role in Operation Warp Speed, the government’s program to rapidly produce vaccines to fight the coronavirus pandemic. Emergent was awarded $628 million by the government and also secured deals totaling more than $740 million with Johnson & Johnson and AstraZeneca to produce coronavirus vaccines for both companies at the Baltimore site.”
Updated data show 91% efficacy for Pfizer, BioNTech COVID-19 vaccine at six months: “Pfizer and BioNTech on Thursday said updated topline results from a pivotal Phase III study of their COVID-19 vaccine BNT162b2 show it was 91.3% effective at preventing the disease up to six months after the second dose. The new analysis of 46,307 participants in the trial is based on 927 confirmed symptomatic cases of COVID-19 observed through March 13…”
The effectiveness percentage just confirms previous data, but the 6 month duration is great news.
COVID-19 tracker: U.S. may not need AZ vaccine, Fauci says; FDA tweaks Moderna shot authorization: “NIAID Director Dr. Anthony Fauci said the United States may not need the AstraZeneca COVID-19 vaccine because contracts with other suppliers are sufficient to vaccinate the entire population and perhaps provide booster shots in the fall…
The FDA has tweaked its emergency use authorization for Moderna’s COVID-19 vaccine, allowing it to sit longer at room temperatures and for it to be delivered in larger vials.”
State of COVID-19: What you should know about the CDC's 5 variants of concern: A good, concise review of what we know about the variants.
‘Where the magic happens’ — inside BioNTech’s innovative vaccine plant: Why does an mRNA vaccine take so long to produce? “It takes up to 13 days to formulate a batch. The more time-consuming part is testing: each batch needs a few weeks of analysis and quality control.”
About health insurance
Repayment of COVID-19 Accelerated and Advance Payments Began on March 30, 2021: CMS explains how it will recoup the advanced payments it made to providers to keep them fiscally sound.
Billing errors resulted in $23.6M in overpayments to HCA hospital, inspector general finds: “Las Vegas-based Sunrise Hospital and Medical Center, owned by Nashville, Tenn.-based HCA Healthcare, failed to comply with Medicare billing requirements for 54 of 100 inpatient and outpatient claims reviewed by the HHS Office of Inspector General, according to an inspector general's report released March 31.
The billing errors, 50 of which were in inpatient claims and four of which were in outpatient claims, resulted in overpayments of $999,950 for the audit period of January 2017 to December 2018, according to the report.
Based on review of the 100-claim sample, the report estimates that the Las Vegas hospital received overpayments of at least $23.6 million.”
Doctors Accuse UnitedHealthcare of Stifling Competition: “A multistate group of anesthesiologists filed cases in Texas and Colorado, accusing the insurance giant of squeezing them like a ‘boa constrictor.’”
United responded that the group was trying to demand unreasonable rates.
This conflict is very typical of payer-provider reimbursement issues.
New ACA subsidies go into effect as HHS announces $50M boost to outreach funding: “The Department of Health and Human Services (HHS) announced the availability of the lower subsidies, which were passed as part of the American Rescue Plan Act, on Thursday. HHS also announced an additional $50 million for outreach for the latest special enrollment period that ends Aug. 15.”
As previously mentioned, premium support and open re-enrollment just provide access. Out-of-pocket expense help is needed to guarantee affordability.
New Data Show the Highest Prevalence of Medical Liability Premium Increases in 15 Years: From the AMA: “The main and most significant finding in this year's PRP is that more premiums increased than in any year since 2005. The proportion of premiums that went up in 2018 almost doubled in 2019— from 13.7% to 26.5%. Then in 2020, this share grew again, as 31.1% of premiums increased from the previous year. This appears to be the beginning of an upward trend in increases in premiums—a trend not seen in over 20 years.”
Tort reform will not be addressed by Democrats at any level of government because of the significant lawyer-lobby contributions.
MedPAC’s Public Meeting April 1-2, 2021: Check here for its agenda and briefs about what it will recommend to CMS. Among these recommendations are:
1. Streamlining the (too) many alternative payments methods (see the book starting on page 614) and
2. Changing the Medicare Advantage benchmark process (see the book starting on page 299 for an explanation of the MA competitive bidding process).
About pharma
Prescriptions to cost more than £10 in just four years: Obviously a British article, complains about the rising cost of pharmaceuticals. The pound closed today at $1.38.
I hope one day we can make a similar complaint.
Bristol Myers Squibb Settles Medicaid Rebate Suit For $75M: “Bristol Myers Squibb has agreed to pay $75 million to settle a whistleblower's False Claims Act suit over claims it shorted its payments to government insurance programs, Deputy U. S. Attorney Louis Lappen announced from Philadelphia Thursday. The settlement ends claims that Bristol Myers paid less than it owed for dozens of drugs under the Medicaid Drug Rebate Program, where a drugmaker pays states incentives for their Medicaid programs to cover its products, by reducing what it told the state and federal governments the average prices were for the covered drugs.”
About diagnostics
Illumina Agrees To Delay $8B Grail Deal During FTC Challenge: “ Illumina Inc. has agreed to delay closing its planned $8 billion acquisition of cancer detection firm Grail Inc. until as late as September while the Federal Trade Commission challenges the deal in D. C. federal court.”