About Covid-19
WHO-Backed Advisory Group Supports Omicron COVID-19 Booster “A World Health Organization (WHO) advisory panel has recommended an Omicron-adapted COVID-19 booster dose for those who have already received primary COVID-19 vaccine doses…
The group also advised that an Omicron-specific monovalent vaccine for a primary series is not recommended due to insufficient information regarding its efficacy against other variants of concern.”
About health insurance
MEDICARE AND BENEFICIARIES PAIDSUBSTANTIALLY MORE TO PROVIDER- BASED FACILITIES IN EIGHT SELECTED STATES IN CALENDAR YEARS 2010 THROUGH 2017 THAN THEY PAID TO FREESTANDING FACILITIES IN THE SAME STATES FOR THE SAME TYPE OF SERVICES From the HHS OIG. The headline is the message. The recommendation is: “… that CMS pursue legislative or regulatory changes to lower costs for both the Medicare program and beneficiaries, by equalizing payments as appropriate between provider- based facilities and freestanding facilities for E&M services.”
UnitedHealth Rejected by High Court on Medicare Overpayments “The US Supreme Court rejected an appeal by UnitedHealth Group Inc., leaving in place a federal rule designed to allow the government to recoup billions of dollars in overpayments from insurers that participate in the Medicare Advantage program.UnitedHealth and its allies argued unsuccessfully that the 2014 Centers for Medicare & Medicaid Services rule will gut the popular program, forcing insurers to reduce coverage and benefits or raise premiums for many of the 26 million seniors who are enrolled.”
Molina settles claims of MassHealth fraud, improper licensure of healthcare staff for $4.6M “The Justice Department said Molina Healthcare and former subsidiary Pathways of Massachusetts have agreed to pay a settlement of $4.625 million over allegations of False Claims Act violations and improper licensure and supervision of healthcare employees.
Between November 2015 and March 2018, Molina owned and operated Pathways, a group of mental health centers, in Springfield and Worcester, Mass. Federal and state officials allege that the two entities improperly submitted reimbursement claims to the state's Medicaid program, MassHealth, and associated organizations…
Additionally, the government claims that the payer failed to properly license and supervise Pathways employees, including social workers and psychological associates…”
Optum launches new solution aimed at driving down unnecessary testing “The laboratory benefit management tool will assist insurers in aligning lab tests with clinical guidance and will automate large parts of lab benefit administration, Optum said in an announcement provided first to Fierce Healthcare.
The company estimates that insurers could save between $12 to $36 per member per year, or about $3 billion.”
About hospitals and healthcare systems
The unintended consequences of the $178 billion bailout to keep hospitals and doctors afloat “…data show that the money indeed served as a lifeline for many hospitals that might not have withstood the onslaught of the coronavirus — but the funds also exacerbated the gap between the industry’s haves and have-nots, disproportionately rewarding wealthy hospitals that did not need the money as urgently. Many institutions reported strong profits and pursued growth strategies without pause.”
About pharma
Estimates of Probabilities of Successful Development of Pain Medications: An Analysis of Pharmaceutical Clinical Development Programs from 2000 to 2020 “The overall probability of successful development of all pain medications from phase 1 to approval is 10.4% (standard error, 1.5%). Medications to treat nociceptive and neuropathic pain have a probability of successful development of 13.3% (standard error, 2.3%) and 7.1% (standard error, 1.9%), respectively. The probability of successful development of medications with high abuse potential and low abuse potential are 27.8% (standard error, 4.6%) and 4.7% (standard error, 1.2%), respectively.”
Express Scripts’ ‘refill pill mill’ bilked government, suit alleges “Express Scripts delivered unnecessary prescription drugs to military personnel, bilking the federal government and vendors out of billions of dollars, a whistleblower alleges in a False Claims Act lawsuit.
The St. Louis-based pharmacy benefit manager allegedly enrolled as many Tricare beneficiaries as possible in automatic delivery, which was set up to provide an extra nine-month supply of drugs over the course of a year, according to a qui tam lawsuit filed in a California federal court in mid-2019 and unsealed Friday. Express Scripts inflated drug costs for payers and patients through its ‘refill pill mill’ that systematically overcharged the military’s health insurance program for unnecessary medication from October 2009 to March 2018, the suit alleges.”
Purdue Pharma launches no-profit treatment to reverse opioid overdose effects “Five months after the FDA approved Purdue Pharma's opioid antagonist injection, nalmefene hydrochloride, the no-profit treatment is now available for use, according to a June 21 press release.”
Novartis plots Precision attack on sickle cell, paying $75M and putting up $1.4B in biobucks to form in vivo gene editing pact “One year after Intellia’s landmark data, Novartis is making a play for the in vivo gene editing market. The move sees the Swiss pharma pay Precision BioSciences $75 million upfront in a combination of cash and equity investment along with up to $1.4 billion in milestones to secure rights to a potential treatment for sickle cell disease and beta thalassemia.”
About the public’s health
Healthiest Communities Rankings 2022 From U.S.News
The Senate’s newly released gun deal A great review of the terms of the deal.
UK signs £1bn deal with Moderna for new vaccine centre “The UK government is collaborating with Boston-based Moderna to build the country’s first manufacturing centre for messenger RNA vaccines in a deal worth £1bn as it seeks to be a leader in responding to pandemics. The government is aiming to secure homegrown supplies of the mRNA technology that has proved a crucial weapon in the fight against Covid-19 and offers the prospect of transforming treatment for other conditions such as cancer.”
About healthcare IT
New class action lawsuit claims Meta's discreet patient data tracker was active across 664 provider websites “The case was filed on Friday in the Northern District of California by an anonymous patient of Baltimore’s Medstar Health System on the behalf of “millions of other Americans whose medical privacy has been violated by Facebook’s Pixel tracking tool.”
The filing came just days after the publication of an investigation by The Markup detailing how the tech company’s analytics tool was found on roughly a third of the country’s top hospitals’ websites.
Both the report and the lawsuit detailed the tracker’s collection of identifiable information such as IP addresses alongside other potentially sensitive information including doctor names and recent web activity related to their health conditions.”
State by state, some patients are losing telehealth access to doctors “A year ago, 26 states still had pandemic-era waivers that allowed residents to have virtual visits with doctors who were based in other states, according to the Federation of State Medical Boards, which represents the licensing boards in U.S. states and territories.
Now, only 12 states still have their pandemic-era waivers, according to the federation. California, New Jersey and some of the other remaining states are scheduled to let their emergency waivers expire soon, the federation said. Nineteen more states have some long-term rules for interstate telemedicine, although they vary.”
VA hits pause on future rollouts of EHR until 2023 while lawmakers raise fresh concerns about patient safety risks “The VA acknowledged in a statement that there have been ‘unanticipated outages and system degradations’ from the onset of the new Oracle Cerner electronic medical record system rollout. The EHR system has been rolled out to three VA facilities to date.”