The October 29, 2020 Federal Rule requires that insurers offer patients a tool to research their financial responsibility and both in-network and out-of-network negotiated rates. The MDsave tool, available now, enables 24/7, consumer-friendly price research and allows patients to purchase their care upfront without fear of surprise bills.
BRENTWOOD, Tenn., Oct. 30, 2020 (GLOBE NEWSWIRE) — MDsave, the leading health technology company in transparent, shoppable medical care, announces its ecommerce solution to help insurers meet new transparency requirements issued in an October 29th Final Rule. The Rule, issued jointly by the Departments of Health and Human Services, Labor, and the Treasury, mandates the creation of “an internet-based, self-service tool” that provides “personalized out-of-pocket cost information, and the underlying negotiated rates, for all covered health care items and services,” according to the Transparency in Coverage Final Rule Fact Sheet.
The MDsave transparency tool provides a user-friendly, ecommerce interface that allows patients to instantly purchase a procedure of their choice directly from the website, in addition to enabling personalized cost searches for the required 500 shoppable services and hosting machine-readable files containing all negotiated charges.
Because each procedure on the MDsave platform includes the most commonly related services and their fees, patients can pay for the entire episode of care upfront without fear of surprise bills.
“Our ecommerce transparency platform is already being implemented for hospitals meeting the January 1, 2021 transparency deadline, so the technology is ready for insurers who want to provide a great patient experience but don’t want to build a tool from the ground up,” explains Greg Born, MDsave President and COO. “We have the platform, the searchability and the transaction capability. All insurers need to provide is the data.”
Insurers must launch their online self-service transparency tools for plan years starting January 1, 2023 for the federally specified 500 shoppable services and plan years starting January 1, 2024 for any remaining services or items.
To learn more, visit MDsave.com/price-transparency.
Co-located in Brentwood, Tenn. and San Francisco, Calif., MDsave is the world’s first online healthcare marketplace, bringing together patients seeking affordable, reliable care with providers offering high-quality services at fair prices. Using cutting-edge technology, MDsave simplifies the healthcare billing process for patients and providers alike through negotiated rates, bundled pricing and upfront payment. The MDsave marketplace also helps employers and payers offer more value to employees and policyholders with out-of-pocket deductible costs. For more information, visit http://www.mdsave.com.
CONTACT: Kate Steurer MDsave 615-814-6260 firstname.lastname@example.org
A Kansas nursing home has lost its federal Medicare funding after an investigation revealed faulty practices led to widespread coronavirus infection and 10 deaths.
An onsite investigation at Andbe Home, Inc. in Norton, Kansas, revealed noncompliance with federal requirements for long-term care facilities, according to Centers for Medicare and Medicaid Services (CMS) documents obtained by Fox News.
The survey investigation by the Kansas Department for Aging and Disability Services cited “widespread immediate jeopardy” to resident health and safety, according to the documents. The facility was also slammed with a $14,860 federal civil money penalty while it worked to correct noncompliance back in May.
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Stephen Crystal, director of the Center for Health Services Research at the Rutgers Institute for Health, told Fox News that the move marks CMS’ “ultimate penalty; decertifying a facility.”
“Most of the time, they try very hard do other things before they go to that step [like civil monetary penalties],” he said, adding “CMS actually doesn’t do this very often, and one could argue that they haven’t moved quickly enough on other facilities that had out of control spread,” referencing New Jersey and New York as examples.
In the case of the Kansas facility, staff identified two symptomatic patients on Oct. 5 and confirmed positive test results two days later but failed to separate them from the rest of the residents.
‘ALARMING RATE’ OF CORONAVIRUS INFECTION AMONG GROCERY STORE WORKERS, STUDY FINDS
“During this time, COVID-19 positive residents cohorted with COVID-19 negative residents, with only a curtain between them, against [Centers for Disease and Prevention Control] guidelines and best practice to prevent the spread of highly contagious COVID-19,” said the documents obtained by Fox News. The facility also allowed communal dining for two days after they discovered the symptomatic patients.
These failures, among others described in the report, ultimately exposed all 61 residents to the virus, every single one testing positive, which led to one hospitalization and 10 deaths. By Oct. 19, 37 staff members tested positive.
Crystal wasn’t privy to all the details but upon a brief account said, “It sounds pretty egregious.”
The facility’s administrator, Megan Mapes, received a notice of a 23-day involuntary termination of the Medicare provider agreement: “We have determined that Andbe Home, Inc. no longer meets the requirements for participation as a skilled nursing facility in the Medicare program under Title XVIII of the Social Security Act.”
The termination will go into effect Nov. 18, 2020.
CMS informed Mapes that the Medicare program won’t pay for covered services to patients admitted to the facility on or after Oct. 27, 2020. Medicare will cover patients admitted before that date for up to 30 days “to ensure residents are successfully relocated.”
The facility was
Nursing home VP says federal inspection diverted resources to COVID response during nation’s first outbreak
The executive in charge of the nursing home where the first known outbreak of coronavirus patients erupted in the U.S. says a federal inspection diverted precious time from her staff’s desperate efforts to care for critically ill residents. Bill Whitaker and his team were the first reporters allowed inside the Life Care Center in Kirkland, Washington, since the outbreak there last February. His report reveals the details of the early stages of a medical emergency that soon grew into a pandemic and the federal government’s bungled response to it. The report will be broadcast on 60 Minutes, Sunday, November 1at 7 p.m. ET/PT on CBS.
Nancy Butner, a vice president at Life Care Centers of America who ran the Kirkland facility for 14 years, was desperate for more staff. Forty of them, including the medical director, could no longer come to work because they had COVID-19 symptoms. She asked the federal government for an emergency team of doctors and nurses. A team of doctors and nurses did come five days later, but not before the federal government sent a team in to inspect Life Care Center of Kirkland in the middle of the outbreak. “It was infuriating– they didn’t truly understand COVID or what the facility was going through,” Butner tells Whitaker. “Hours of staff time were averted to managing a survey process instead of managing a crisis in the facility and patient care.”
Life Care Center says inspectors from the Centers for Medicare and Medicaid Services interviewed staff and demanded documentation, diverting 400 hours of staff time away from patient care. “They knew how many staff were lost. They knew how many patients were hospitalized. They knew there was a lot of patients that were sick and it was an unknown virus,” says Butner. “I explained that to them. But I can’t… tell them to leave.”
60 Minutes searched hundreds of public documents and turned up emails that show state health officials pressed the governor’s office to call off the inspection. Dr. Jeffery Duchin, the head of outbreak response at Public Health Seattle-King County called the inspection “Not an appropriate use of precious time.” He tells Whitaker he believes the government knew its investigation was taking place during a public health emergency at a critical time. “I don’t have any reason to believe it. That it was a mix-up. I believe it was an intentional decision to conduct a survey at that time.”
Says Butner, “I think they wanted a scapegoat for what happened at Life Care Center Kirkland. I think that they wanted someone to blame for COVID-19 spreading. We had nothing to do with the spread across the nation.”
60 Minutes wanted to ask Seema Verma, the federal administrator in charge of the inspection, about the timing of the inspection and the findings, but her office declined multiple requests for an on-camera interview.
Life Care was fined more than $600,000 by the federal government and state inspectors working with federal investigators working with federal investigators found the
States say they lack federal funds to distribute coronavirus vaccines as CDC tells them to be ready by Nov. 15
State officials have been planning in earnest in recent weeks to get shots into arms even though no one knows which vaccine will be authorized by the Food and Drug Administration, what special storage and handling may be required and how many doses each state will receive.
Despite those uncertainties, the Centers for Disease Control and Prevention is asking states to be prepared to “preposition” doses in key locations throughout the country. Officials want to move quickly once the FDA authorizes a vaccine and a CDC advisory panel issues recommendations on which populations should be vaccinated, according to a letter the CDC sent Monday to state preparedness and immunization officials.
As part of that effort, the CDC is asking states to provide by Tuesday critical information, including a list of each jurisdiction’s top five sites capable of receiving and administering a vaccine that must be stored at ultracold temperatures of minus-70 Celsius (minus-94 Fahrenheit). The letter refers to the vaccine only as Vaccine A, but industry and health officials have identified it as Pfizer’s candidate.
Pfizer chief executive Albert Bourla said Tuesday that “hundreds of thousands” of doses had already been produced and that a first look at the data would occur soon. Pfizer will not apply for any authorization of its vaccine sooner than the third week of November, when it will have sufficient safety data.
“We acknowledge that you are being asked to do unprecedented work,” wrote Nancy Messonnier, director of CDC’s National Center for Immunization and Respiratory Diseases, which is leading the CDC’s role in vaccine distribution. She added: “This is a new planning ask.”
State officials say they have been trying to raise the issue with federal officials but have received little response.
“It is absolutely ridiculous that the administration, after spending $10 billion for a Warp Speed effort to develop a vaccine, has no interest in a similar investment in a Warp Speed campaign to get the vaccine to every American as quickly as possible after it is approved,” said Michael Fraser, executive director of the Association of State and Territorial Health Officials.
Operation Warp Speed is the federal initiative, funded by more than $10 billion of taxpayer money, to fast-track development of coronavirus countermeasures.
“The now accelerated timeline underscores the need to address the issue of funding for state and territorial health agencies to make this all work,” Fraser said. “There are many other costs that have no clear way to be paid for at this point.”
Local officials still need to recruit thousands of people to staff vaccine clinics and enroll and train providers. They also have to ramp up information technology and data systems to track vaccine inventory and ordering to ensure people get the correct doses at the right times — most vaccines will require two shots — and to monitor for adverse events. They will need to develop locally tailored vaccination communications campaigns, too.
“States have received some funding, but it’s not nearly enough” to support the scale, scope and
Nicolas Asfouri/AFP via Getty Images
Some U.S. hospitals have been hit by coordinated ransomware attacks designed to infect systems for financial gain, federal agencies and a private-sector cybersecurity company warned on Wednesday.
A joint advisory by the Cybersecurity and Infrastructure Security Agency, the Department of Health and Human Services and the FBI says there is “credible information of an increased and imminent cybercrime threat” to U.S. hospitals and healthcare providers.
They are urging institutions to take necessary precautions to protect their networks.
The agencies said hackers are using Ryuk ransomware — malicious software used to encrypt data and keep it locked up — and the Trickbot network of infected computers to steal data, disrupt healthcare services and extort money from healthcare facilities. Such data hijacking often cripples online systems, forcing many to pay up to millions of dollars to restore their services.
The agencies warned healthcare providers to step up protections of their networks, including regularly updating software, backing up data and monitoring who is accessing their systems.
Beyond healthcare facilities, the FBI says ransomware attacks have been on the rise for several years against hospitals, school districts, state and local governments and even law enforcement.
Officials do not recommend paying ransoms, as it does not guarantee data will be recovered and could “embolden” hackers to carry out further attacks.
CNN reports that an unnamed Trump administration official said several hospitals have been targeted in the attacks over the past two days. The official said the incidents may be connected and that the federal government is investigating the attacks.
Experts at the cybersecurity firm FireEye said the latest spate of attacks were carried out by cyberattackers in Eastern Europe seeking financial gain.
“We are experiencing the most significant cybersecurity threat we’ve ever seen in the United States,” said Charles Carmakal, FireEye’s strategic services chief technology officer, describing the group as “one of most brazen, heartless and disruptive threat actors I’ve observed over my career.”
A FireEye report on Wednesday said the same group has this year “actively targeted hospitals, retirement communities, and medical centers, even in the midst of a global health crisis, demonstrating a clear disregard for human life.”
FireEye said the attacks typically start as emails masquerading as corporate communications containing Google Docs and PDFs with malicious links.
The Centers for Medicare and Medicaid Services said it will pay for any Covid-19 vaccine that is authorized or approved by the US Food and Drug Administration to allow for “broad vaccine access and coverage for all Americans.”
The agency also announced it will help cover a larger portion of the cost of new Covid-19 treatments that may be coming down the pipeline for Medicare recipients.
“There are several vaccines in Phase 3 trials, production and distribution plans are well underway, and CMS is doing its part by laying the essential groundwork for coverage and payment when a vaccine does arise. It’ll be widely available and accessible to seniors and every American,” CMS administrator Seema Verma said during a briefing Wednesday.
She said that while the federal government is paying for the vaccine, insurers including Medicare, Medicaid and private plans must cover the cost of administering it.
For Medicare recipients, any future vaccine would be covered by Medicare Part B as a preventative vaccine at no cost to beneficiaries. Medicare Part B covers doctor visits and outpatient services such as lab tests, diagnostic screenings and medical equipment.
“The rule removes any existing ambiguity surrounding Medicare’s coverage of the Covid-19 vaccine and allows us to focus on the paramount goal of ensuring that all of Medicare’s 62 million beneficiaries, including those enrolled in a Medicare Advantage plan, can receive the vaccine at their provider, their choice, again, at no cost,” said Verma.
She estimated that if “literally every senior got immunized,” it would cost “likely around $2.6 billion — that’s if everybody got vaccinated in the Medicare program.”
The new CMS rule requires most private health insurance plans, including individual health insurance and employer health plans — representing about 200 million Americans, according to Verma — to provide both in-network and out-of-network coverage of the vaccine, at no cost to their members.
The agency said that as a condition of receiving free Covid-19 vaccines from the federal government, providers may not charge people for administration of the vaccine.
“Providers who receive free Covid-19 vaccines from the federal government will be prohibited from charging consumers any additional costs for the administration of the vaccine beyond what their insurance covers. Surprise or balanced billing for vaccine costs is strictly prohibited,” she said.
The 68 million beneficiaries on Medicaid and the Children’s Health Insurance Programs will also be covered for their Covid-19 vaccines during the public health emergency; the Provider Relief Fund will cover the cost for those without insurance coverage.
In addition to covering the cost of a vaccine, the new CMS rule also outlines how Medicare plans to cover the “new generation of Covid-19
The U.S. government’s policy of separating migrant children from their families at the southern border is “cruel, inhuman,” and “rises to the level of torture,” according to a new academic article authored by a slate of doctors throughout the country.
The paper, published Tuesday in the medical journal Pediatrics, found that the controversial anti-immigration practice meets the UN’s three criteria to be defined as torture for children: It causes “severe pain and suffering,” it’s purposeful and it’s state-sponsored.… Read More
Congressman Calls For Federal Crackdown On Unproven Coronavirus Treatment : Coronavirus Updates : NPR
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A member of Congress, who has led efforts to investigate alleged coronavirus scams, is calling for the federal government to crack down on an unproven treatment for COVID-19. Widespread sales of that purported treatment – a drug known as thymosin alpha-1 – were first identified by an NPR investigation earlier this month. More than 30 doctors in more than a dozen states around the country have marketed the drug as a treatment for the coronavirus, despite the fact that it has never been approved by the Food and Drug Administration for any condition and such claims are, in the words of the FDA, “not supported by competent and reliable scientific evidence.”
The congressman, Rep. Raja Krishnamoorthi (D-Ill.), leads the House Subcommittee on Economic and Consumer Policy. He is now calling for the FDA and the Federal Trade Commission to take action against one prominent doctor who has marketed the drug: Dr. Dominique Fradin-Read of Los Angeles.
Fradin-Read is known for her work with the actor Gwyneth Paltrow’s wellness brand Goop. Fradin-Read helped formulate a dietary supplement called “Madame Ovary” for the brand. She also runs the practice VitaLifeMD, and had falsely marketed thymosin alpha-1 as an “FDA approved” drug, which she claimed was “one of the best ways to prevent and fight COVID-19.”
“Such false claims appear to be illegal and ought to be subject to strict enforcement by FDA and FTC,” Krishnamoorthi wrote in his letter to the leaders of those agencies. “I ask you to open an investigation into VitaLifeMD, and to take all appropriate action against VitaLifeMD and its principals.”
Fradin-Read did not respond to messages from NPR for this story. But she has previously defended prescriptions of the drug, saying she had prescribed it to members of her staff, her mother, and had even taken it herself without any negative effects.
The FTC and FDA are responsible for enforcing laws against false and misleading advertising. A spokesperson for the FTC declined to comment, and the FDA did not respond to a message NPR.
Earlier on in the pandemic, Krishnamoorthi called on the Trump Administration to take action against conspiracy theorist Alex Jones of InfoWars for marketing colloidal silver-infused toothpastes as a supposed COVID-19 prevention measure. (The National Institutes of Health say colloidal silver is not safe or effective for treating any condition, and can even permanently turn a person’s skin blue at high doses.) The FDA then warned Jones that such claims were misleading and could violate federal law.
The first hint that the novel coronavirus was tearing through the nursing home in rural Kansas arrived in a Facebook post this month. The Andbe Home was in the grips of “a full COVID outbreak,” administrator Megan Mapes wrote, “despite the precautions we have been taking since March.”
But behind the walls of the facility, nursing home officials had failed to take the most basic measures to prevent the spread of the highly contagious virus after learning two residents were infected, according to a blistering report released Tuesday by the Centers for Medicare and Medicaid Services, which resulted in severe penalties.
By the time the viral firestorm had finished sweeping through the nursing home, all 63 residents were infected and at least 10 had died. Medicare moved Monday to terminate the Andbe Home from its program, cutting it off from federal dollars and imposing thousands of dollars in fines.
Government inspectors found that infected residents were separated from their healthy roommates by little more than a privacy sheet. Communal dining continued for two days. Multiple staff members failed to wear masks — even after the outbreak took hold.
In an email Tuesday to The Washington Post, the nursing home administrator disputed some of the findings outlined in the report and stood by the response to the outbreak, saying the facility had immediately quarantined infected residents and that staff wore full personal protective equipment, including goggles, masks and gloves.
“This is a terrible virus, but I am proud of how our staff has battled COVID-19 over the course of the pandemic, coming to work every day under extenuating circumstances, and caring for all of our residents,” Mapes wrote. “I am also proud of and thankful for the mutual support between Andbe Home and our community during trying times for everyone.”
The Medicare report, however, said the facility’s failures had “placed all residents in immediate jeopardy by the spread of Covid-19 to all residents.”
The virus’s rampage through the nursing home came amid a surge of infections in Kansas’s Norton County, which led the nation in per capita case increases between Oct. 12 and Oct. 19 and ranked second this week, according to a Post analysis. Before Oct. 13, the county near the Nebraska border had been spared virus-related deaths.
Now, there are clusters of cases at the nursing home, where 55 of 70 staff members tested positive for the virus, as well as at a correctional facility and a bank. City offices are closed to the public, municipal court is postponed and multiple businesses have temporarily shut their doors. The funeral home has posted a wave of obituaries for people who lived at the Andbe Home: a stained glass artist with pieces displayed around town, a onetime staffer turned resident, a skilled home cook known
A federal judge on Tuesday dismissed a lawsuit against Gov. Gavin Newsom and San Joaquin County and Lodi officials that had been filed by the owner of three Sacramento-area gyms after officials ordered the shutdown of fitness centers last spring because of COVID-19.
After a Zoom hearing in Sacramento federal court, U.S. District Judge John A. Mendez agreed to requests by the defendants that the lawsuit be dismissed and found that the coronavirus pandemic was so dangerous that officials were within their authority when they first ordered the closures.
The orders were “a constitutional response to an unprecedented pandemic,” Mendez said.
Attorney John Killeen argued for the state that since Newsom’s original stay-at-home orders the state has loosened restrictions on fitness centers, including allowing some outdoor exercising and indoor workouts in San Joaquin County at 10% of capacity.
“A number of restrictions have been lifted,” Mendez said.
“I just don’t see any basis for allowing this lawsuit to go forward in the district court,” he added.
The suit was brought by Sean Covell, owner of Fitness System gyms in Land Park, West Sacramento and Lodi, and argued that the shutdown orders violated the Constitution and were costing his operations huge amounts of revenues and lost memberships.
The lawsuit was one of numerous complaints filed by fitness centers, churches and businesses against orders Newsom and health officials issued to combat the spread of COVID-19.
The lawsuits have largely been unsuccessful, although some are pending and yet another involving gyms in Dixon and Sacramento was filed in federal court in Sacramento on Monday.