About Covid-19
US renews 'public health emergency' declaration due to Covid-19 pandemic: “US Department of Health and Human Services Secretary Xavier Becerra signed a renewal of the determination that a "public health emergency" exists due to the Covid-19 pandemic.
The determination was last renewed in April and was set to expire -- as it is up for renewal every 90 days. This latest renewal is effective starting Tuesday and will continue for another 90 days.”
More than 91 million live in US counties with high Covid-19 infections. It's time to reset and put masks back on, expert says: “‘We are at a very different point in the pandemic than we were a month ago,’ Dr. Leana Wen told CNN on Tuesday. ‘And therefore, we should follow the example of LA County and say that if there are places where vaccinated and unvaccinated people are mixing, then indoor mask mandates should still apply.’"
COVID-19 Guidance for Safe Schools: The latest recommendation from the American Academy of Pediatrics includes this statement: “All students older than 2 years and all school staff should wear face masks at school (unless medical or developmental conditions prohibit use).”
Growing number of Republicans urge vaccinations amid delta surge: “Senate Minority Leader Mitch McConnell (R-Ky.) was part of the rising chorus on Tuesday, stressing the need for unvaccinated Americans to receive coronavirus shots and warning that the country could reverse its progress in moving on from the pandemic.”
You heard about someone “getting religion,” now some Republicans are “getting science.”
About health insurance
New bill seeks to reverse slide in ACO participation with more shared savings: “New bipartisan House legislation aims to boost the amount of shared savings that accountable care organizations can receive from the federal government to halt a slide in participation that has occurred over the past two years…
The legislation would increase the size of shared savings that an ACO can get. It also will modify the risk adjustment process that determines whether ACOs reach spending thresholds to better reflect factors that providers in the program could encounter such as health or community risk variables.”
This legislation is a bad idea and just delays the demise of many poorly functioning ACOs. The reason these organizations are dropping out is because they cannot handle the move to risk arrangements that they must assume at the end of the shared shavings arrangements. The Medicare Advantage program is risk-based and has proven to be successful over many years- why keep the flawed ACO program alive when we have a better option?
BREAKING NEWS: CMS to Reinstate Inpatient-Only List: “In an unprecedented move, the Centers for Medicare & Medicaid Services (CMS) has proposed in the 2022 Outpatient Prospective Payment System (OPPS) Rule to put back on the inpatient only list all the procedures that they removed from the inpatient-only list starting this calendar year.
The agency has also put a halt to its three year-plan to completely eliminate the inpatient-only list. It appears that its motivation is to protect the safety of Medicare beneficiaries and take a more cautious approach to removing services from the inpatient only list looking at them on an individual basis rather than by class.”
Dignity Health, Anthem end contract: “Anthem claimed in a statement the relationship primarily fizzled out because the insurer refused to agree to rate increases that would continue to make San Francisco-based Dignity more expensive than other systems. The insurer said Dignity is nearly 30 percent more expensive than other California health systems.
An Anthem spokesperson told Becker's that it is still negotiating with Dignity, but has made members aware of alternatives in the interim.”
Mississippi pharmacist pleads guilty to $180M+ insurance fraud scheme: “A pharmacist based in Bolton, Miss., pleaded guilty July 20 for his role in a health insurance fraud scheme totaling more than $180 million, according to the Department of Justice.
David ‘Jason’ Rutland, 42, a pharmacist and co-owner of various compounding pharmacies, admitted to his role in a scheme that defrauded federal and privately-owned insurers by distributing medically unnecessary compounded medications and adjusting prescription formulas to ensure the highest reimbursement without regarding efficacy, according to the Department of Justice.
The scheme also defrauded insurers by soliciting recruiters to procure prescriptions for high-margin compounded medications and paying those recruiters commissions based on the percentage of reimbursements paid by pharmacy benefit managers and healthcare benefit programs. Under the scheme, copayments to be paid by beneficiaries and members were systematically waived and reduced.”
The DoJ has found many similar cases over the years. What takes them so long to find such huge fraud?
About the public’s health
U.S. life expectancy falls to lowest level in almost 20 years due to COVID-19 -CDC: “Life expectancy in the United States fell by a year and a half in 2020 to 77.3 years, the lowest level since 2003, primarily due to the deaths caused by the COVID-19 pandemic, a U.S. health agency said on Wednesday…
Deaths from COVID-19 contributed to nearly three-fourths, or 74%, of the decline and drug overdoses were also a major contributor, the CDC said.”
More than 200 people in U.S. being monitored for possible monkeypox exposure, CDC says: More on this previously-reported story:
”More than 200 people in 27 states are being monitored for possible exposure to monkeypox after they had contact with an individual who contracted the disease in Nigeria before traveling to the United States this month, according to the Centers for Disease Control and Prevention. To date, no additional cases have been detected.”
A Federal Judge Has Blocked An Arkansas Law Banning Most Abortions: “A federal judge on Tuesday blocked an Arkansas law banning nearly all abortions in the state while she hears a challenge to its constitutionality.
U.S. District Judge Kristine Baker issued a preliminary injunction preventing enforcement of the law, which was set to take effect on July 28. The measure was passed this year by the majority-Republican Legislature and signed by GOP Gov. Asa Hutchinson.
The ban allows the procedure to save the life of the mother in a medical emergency and does not provide exceptions for those impregnated in an act of rape or incest.”
About pharma
How an Unproven Alzheimer’s Drug Got Approved: The quick answer is: “Much is still unknown, but an examination by The Times has found that the process leading to approval took several unusual turns, including a decision for the F.D.A. to work far more closely with Biogen than is typical in a regulatory review.”
This article is a well-done review of what happened in the approval process of this controversial drug.
Attorneys General propose a $26 billion global opioid settlement with the 'big three' drug distributors: “A group of states Attorneys General announced a proposed $26 billion global settlement Wednesday that, if approved, will resolve claims against the big three drug distributors McKesson Corporation, Cardinal Health Inc. and Amerisource Bergen Drug Corporation and opioid manufacturer Johnson & Johnson.”
Justice Department Blasts Purdue Pharma's Bankruptcy Plan: “The DOJ's U.S. Trustee program, which serves as a national watchdog over the federal bankruptcy system, said the deal is unconstitutional and illegal.
In a separate brief, the office of the U.S. Attorney for the Southern District of New York said the plan violated the "constitutional right to due process" for those with potential opioid claims.
Under a proposed settlement negotiated over the last year, members of the Sackler family who own the company would contribute roughly $4.3 billion from their private fortunes to help compensate people and communities harmed by Oxycontin.
In exchange, the Sacklers and a long list of their associates who haven't filed for bankruptcy would be granted so-called "third party releases," sheltering them from future opioid lawsuits.”
AstraZeneca closes mega $39B Alexion buyout despite antitrust fears, making a splash in rare diseases: Finally…” AstraZeneca’s mega $39 billion takeover of Alexion Pharmaceuticals has come to a close, delivering the British pharma a lucrative portfolio of immunology medicines and a towering presence in rare diseases.
AZ on Wednesday announced the completion of its Alexion acquisition, a week after securing a pivotal nod from the U.K.’s Competition and Markets Authority (CMA).”
Johnson & Johnson eyes $2.5B in COVID vaccine sales as key immunology, oncology meds trounce expectations: “Johnson & Johnson is forecasting $2.5 billion in full-year sales of its one-shot COVID-19 vaccine, company executives said Wednesday on a call with analysts. The vaccine pulled in $164 million for the second quarter and $264 million during the first six months of the year, chief financial officer Joe Wolk said. With pandemic revenues in the mix, the company anticipates between $93.8 billion and 94.6 billion in total sales for 2021…
Outside of its COVID-19 vaccine, J&J did gangbusters across all of its businesses as the pandemic eased in parts of the world. Total second-quarter sales swelled roughly 27% to 23.3 billion, with growth recorded in pharmaceuticals, consumer health and medical devices. Medical devices specifically posted a 58.7% sales upswing after suffering some serious pandemic blows in 2020.”
Healthcare quality
Clinician Conceptualization of the Benefits of Treatments for Individual Patients: “In this survey study of 542 clinicians, most respondents significantly overestimated the benefits of common therapies. Clinicians who conceptualized a greater chance of benefits of therapy were more likely to treat similar patients in their practice.”
Do Black and White Patients Experience Similar Rates of Adverse Safety Events at the Same Hospital?: From the Urban Institute: “Our evidence shows that Black patients systematically experience higher rates of hospital-acquired illnesses or injuries related to surgical procedures relative to white patients treated in the same hospital.”
What measures can we consistently use to equalize/maximize hospital quality across all patients?
About healthcare professionals
Carbon Health banks another $350M to become 'largest primary care provider in the U.S.': “Over the course of the pandemic, Carbon Health has doubled its full-time staff from 800 to 1,600 employees, opened over 80 clinics in 12 states and expanded its virtual care services to 23 states, the startup said.
While Carbon Health services are currently available to more than three-quarters of those living in the U.S., the company said it’s looking ahead toward a goal line of 1,500 clinics by 2025 ‘to become the largest primary care provider in the U.S.’”