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DAILY UPDATE

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June 24, 2016   Download print version

Hundreds arrested for $900 million worth of healthcare fraud

U.S. spurns AstraZeneca's nasal spray flu vaccine as ineffective

Check endoscopes for safety with the Now! Test

Report: Some SPF 50 sunscreens really SPF 8

The US healthcare sector emits more greenhouse gas than the entire UK

Cardiac surgery patients who received omega-3 supplementation experience reduced hospital stays

Americans spent $30.2 billion out-of-pocket on complementary health approaches

Mark Zuckerberg covers his laptop camera. You should consider it, too.

 



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July 2016

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Hundreds arrested for $900 million worth of healthcare fraud

The Justice Department announced it is charging hundreds of individuals across the country with committing Medicare fraud worth hundreds of millions of dollars.

It's the largest takedown in history, both in terms of the number of people charged and the loss amount, according to the Justice Department.

The majority of the cases being prosecuted involve separate fraudulent billings to Medicare, Medicaid or both for treatments that were never provided.

In one case, a Detroit clinic that was actually a front for a narcotics diversion scheme billed Medicare for more than $36 million, the Justice Department said. A doctor in Texas has been charged with participating in schemes to bill Medicare for "medically unnecessary home health services that were often not provided."

And in Florida, the owner of several infusion clinics is accused by the federal government of defrauding medicare out of over $8 million for a scheme involving the reimbursement for expensive intravenous drugs that were never actually purchased and never given to patients.

The defendants are charged with numerous crimes, including conspiracy to commit healthcare fraud, violations of anti-kickback statutes, money laundering and aggravated identity theft.

The Justice Department says that 301 people across the country have been charged with about $900 million in false billing - both records for the Medicare Fraud Strike Force, which carried out the "unprecedented nationwide sweep."

Much of the fraud involved home healthcare agencies - and those types of services have been identified as particularly vulnerable to fraud, according to the HHS Department's inspector general.

In conjunction with the arrests, the HHS inspector general released a study saying that more than $10 billion was made in improper payments in home healthcare in the 2015 financial year. It also identified 27 so-called "hotspots" in 12 places where it believes home health care fraud is committed more often.

Visit CNN for the story.

U.S. spurns AstraZeneca's nasal spray flu vaccine as ineffective

U.S. health officials have advised doctors not to use AstraZeneca's FluMist in the upcoming flu season based on three years of U.S. data showing that the nasal spray vaccine is not effective at preventing influenza.

The decision, announced late Wednesday, was based on a review by the Advisory Committee on Immunization Practices (ACIP) - a panel of experts that advises the U.S. Centers for Disease Control and Prevention - showing the vaccine did not offer adequate protection.

As a result of the move, the CDC said it will be working with manufacturers throughout the summer to ensure there is enough alternative vaccine supply.

AstraZeneca said it would take an $80 million writedown on stocks of its FluMist Quadrivalent vaccine as a result of the decision. The loss of the vaccine may be a problem for some pediatric practices that have already ordered supplies for the upcoming flu season.

FluMist is currently the only licensed flu vaccine that does not require a shot, making it a favored choice by parents of young children.

In the past year, among children aged 2 to 17, FluMist was only 3 percent effective, meaning it offered "no protective benefit," the CDC said. That compared with conventional flu shots, which were 63 percent effective against any flu virus among children in this age group.

AstraZeneca said the CDC data contrasted with its own studies as well as preliminary independent findings by public health authorities in other countries suggesting the vaccine was 46 to 58 percent effective overall against flu strains during the 2015-2016 season.

The CDC said FluMist made up about 8 percent of the total projected supply of 176 million doses of flu vaccine for the upcoming flu season, and it comprised a third of all flu vaccine given to children aged 2 to 17.

Visit Reuters for the story.

Check endoscopes for safety with the Now! Test

Healthmark has released the new NOW! Test to enable the verification of the cleaning process for flexible endoscopes which are a challenge to clean and disinfect/sterilize.

Modern machines such as AER’s are effective tools for rendering scopes safe for use on the next patient, but how do you determine if the process was effective? The new NOW! Test is a simple and rapid test that checks for Gram negative bacteria in about 12 hours, helping to ensure that it is safe to use on the next patient.

Utilizing a unique enzyme detection method, the easy to read fluorometer checks for the Gram negative bacterial growth (<10cfu) by reading telltale fluorescence in the recaptured water. If the fluorometer reading is positive for Gram negative bacteria, reprocess the endoscope following manufacturer guidelines prior to use.

Visit Healthmark for more information.

Report: Some SPF 50 sunscreens really SPF 8

That SPF 50 sunscreen that you just put on may actually be an SPF 8. That’s according to Consumer Reports, which recently tested 65 sunscreens and found that 43 percent of them failed to meet the SPF claim on the label.

“Three of them fell far short, with an SPF of less than 15,” the publication notes in its July issue. “That’s not enough protection, and it could leave you vulnerable to sunburn and possible long-term skin damage, such as wrinkles or skin cancer."

Suncreens that were way off from their claimed SPF included CVS Kids Sun Lotion SPF 50 and Banana Boat Kids Tear-Free, Sting-Free Lotion SPF 50, which both tested SPF 8. Yes to Cucumbers Natural SPF 30 tested SPF 14.

Louisville dermatologist Mark Waldman of Advanced Dermatology said he was surprised that some of the sunscreens were so far off the mark in the Consumer Reports testing.

“If someone said they’re a 50 (SPF) and they’re a 40, we can live with that because it’s not terrible; it’s above a 30 (SPF),” Waldman said. “But when someone says they’re a 50 (SPF) and they’re an 8 or a 20...that’s a big, big difference.”

Waldman suggests wearing sunscreens that have a stated SPF of at least 30.

Consumer Reports said it may benefit you to look for sunscreens with higher SPF numbers, such as 40 or more. That way, “even if a product doesn’t deliver its claimed SPF, you’ll have a better chance of getting a minimum level of coverage,” the publication noted.

Chemical sunscreens tend to outperform mineral ones that usually contain only titanium dioxide, zinc oxide or both as active ingredients, Consumer Reports said. "In fact, not a single one (mineral sunscreen) made our list of recommended sunscreens this year (or in years past), in part because only four of 13 met their promised SPF," the publication stated.

To earn a recommendation from the publication, products had to meet their SPF claim, provide excellent or very good UVA and UVB protection and get an overall score higher than 80.

If you have kids, keep in mind that the American Academy of Dermatology generally suggests waiting until a child is age six-months or older before putting sunscreen on them. Until then, protect them with clothing - making sure they don't overheat - and by putting them in the shade.

Visit the Courier-Journal for the story.

The US healthcare sector emits more greenhouse gas than the entire UK

If the U.S. healthcare sector were ranked as a nation, it would be the world's 13th-largest emitter of greenhouse gases, more than all of the UK, a new study finds.

"Unfortunately, in our quest to take care of individual patients, we're causing this undue harm," said coauthor Dr. Jodi Sherman, from Yale School of Medicine in New Haven, Connecticut. While training to become an anesthesiologist, Sherman saw what she described as a disturbing amount of waste in the operating room.

In 2009, when she was a senior resident at Stanford University, she gave a talk on healthcare pollution. The other doctors challenged her about the magnitude of the problem. She looked for data but found none. So she enlisted environmental engineer Matthew Eckelman, and the two began quantifying healthcare pollution.

Their new study, published in PLoS ONE, estimates that damage from pollutants connected to healthcare leads to an annual loss of 405,000 to 470,000 years of healthy life, or so-called disability-adjusted life years. The loss equates to roughly the same number of Americans as die every year from preventable medical errors: 44,000 to 98,000, the researchers say.

Moreover, the pollution is growing. In the past 10 years, greenhouse gas emissions for the U.S. healthcare sector shot up by more than 30 percent, bringing the total to nearly 10 percent of the nation's 2013 emissions, the study found.

Sherman and Eckelman, a professor at Northeastern University in Boston, used an economic model based on federal data to calculate healthcare sector pollutants from 2003 to 2013. They estimated emissions from heating and cooling, electricity and energy-intensive goods and services in hospitals, doctors' offices, nursing homes, pharmaceutical and medical-device manufacturers as well as government programs like Medicaid. Then they assessed public health impacts.

Prior research had calculated that healthcare activities emit 8 percent of the nation's greenhouse gas emissions, the authors write. But other pollutants from the healthcare industry have not been previously reported.

The new study looks beyond the carbon footprint. It found that direct and indirect emissions from healthcare caused 12 percent of acid rain, 10 percent of smog formation and 9 percent of respiratory disease from particulate matter in 2013.

The researchers say there's a "critical knowledge gap" in the medical community about the health consequences of unnecessary waste, and they urge resource-conservation education and leadership.

"Virtually everything is disposable, from linens to unused drugs that were opened and never administered. Probably every physician would agree they see enormous amounts of waste and disposables, and they just don't know what to do about it," Sherman said. "You certainly need to use sterile and disposable goods," she said. "But this trend is just over the top."

Visit Business Insider for the story.

Cardiac surgery patients who received omega-3 supplementation experience reduced hospital stays

A new meta-analysis published in Clinical Nutrition found that cardiac surgery patients who received omega-3 polyunsaturated fatty acids (compared to placebo) in advance of surgery experienced reduced postoperative cardiac arrhythmias and significantly reduced the length of hospital stay by up to 2.4 days. The results are based on 11 RCT's with 1038 patients.

"Omega-3s are well known for their benefits on cardiovascular health, including a reduced risk of arrhythmias and reduced mortality in patients with recent myocardial infarction or cardiac failure," said co-author Dr. Pascal L. Langlois from the Department of Anesthesiology and Reanimation, Faculty of Medicine and Health Sciences at Sherbrooke University. "Furthermore, they exhibit interesting anti-inflammatory properties and modulate the immune system."

This study implies a reduction in hospital utilization and overall healthcare costs, and supports an existing body of research demonstrating the heart health benefits of omega-3s.

The reduced length of hospital stay in this study was likely associated with the tendency of the omega-3 group to experience a reduction in postoperative atrial fibrillation, according to the authors. The exact mechanism associated with this benefit is unknown, but it is widely believed to be due to the omega-3s' anti-inflammatory and anti-arrhythmic properties.

Visit News Medical for the study

Americans spent $30.2 billion out-of-pocket on complementary health approaches

Americans spent $30.2 billion — $28.3 billion for adults and $1.9 billion for children — out-of-pocket on complementary health approaches, according to a nationwide survey. These approaches include a group of diverse medical and health care systems, practices, and products such as herbal supplements, meditation, chiropractic, and yoga. This amount represents 9.2 percent of all out-of-pocket spending by Americans on health care and 1.1 percent of total health care spending.

These findings come from an analysis by the National Center for Complementary and Integrative Health (NCCIH) and the Centers for Disease Control and Prevention, based on data from a special supplement — on use of complementary health approaches — to the 2012 National Health Interview Survey (NHIS). The NHIS is a large survey conducted annually by CDC's National Center for Health Statistics. NCCIH is part of the National Institutes of Health.

“With so many Americans using and spending money on complementary health approaches, it is extremely important for us to provide the public with evidence-based information to help inform decisions,” said Josephine P. Briggs, M.D., director of NCCIH. “This underscores the importance of conducting rigorous research to know whether the products and practices being used are safe and effective.”

The survey showed:

  • Americans spent $14.7 billion out-of-pocket on visits to complementary practitioners such as chiropractors, acupuncturists or massage therapists. That is almost 30 percent of what they spent out-of-pocket on services by conventional physicians. They spent more on visits to complementary practitioners than on natural product supplements or self-care purchases, and the mean annual out-of-pocket expenditure for practitioner visits was $433.

  • Americans spent $12.8 billion out-of-pocket on natural product supplements, which was about one-quarter of what they spent out-of-pocket on prescription drugs. The mean annual out-of-pocket expenditure in this category was about $368.

  • Total spending on purchases related to self-care approaches (for example self-help materials, such as books or CDs, related to complementary health topics) was $2.7 billion, and the mean annual out-of-pocket expenditure per user was $257.

  • As family income went up, out-of-pocket spending on complementary approaches went up significantly. The average per user out-of-pocket expenditure for complementary health approaches was $435 for people with family incomes of less than $25,000, and $590 for those with family incomes of $100,000 or more. Out-of-pocket expenditures for visits to complementary practitioners averaged $314 for people with family incomes of less than $25,000 and $518 for those with family incomes of $100,000 or more.

Visit NIH for the report.

Mark Zuckerberg covers his laptop camera. You should consider it, too.

Mark Zuckerberg is one of the most powerful men in the world because billions of people give Facebook, which he founded, free access to their personal data. In return, users receive carefully curated snapshots of his life: baby photos, mundane office tours and the occasional 5K.

This week, observers were reminded that Mr. Zuckerberg, 32, is not just a normal guy who enjoys running and quiet dinners with friends. In a photo posted to his Facebook account, he celebrated the growing user base of Instagram, which is owned by Facebook. An eagle-eyed Twitter user named Chris Olson noticed that in the image’s background, his laptop camera and microphone jack appeared to be covered with tape.

The taped-over camera and microphone jack are usually a signal that someone is concerned, perhaps only vaguely, about hackers’ gaining access to his or her devices by using remote-access trojans — a process called “ratting.” (Remote access is not limited to ratters: According to a cache of National Security Agency documents leaked by Edward J. Snowden, at least two government-designed programs were devised to take over computer cameras and microphones.)

Security experts supported the taping, for a few good reasons: The first is that  Mr. Zuckerberg is a high-value target; The second is that covering photo, video and audio portals has long been a basic and cheap security safeguard; Third, Mr. Zuckerberg is not immune to security breaches.

 “Covering the camera is a very common security measure,” Lysa Myers, a security researcher at the data security firm ESET, said in an email. “If you were to walk around a security conference, you would have an easier time counting devices that don’t have something over the camera.”

A recent hacking of his Twitter and LinkedIn accounts shows that he most likely committed two basic privacy faux pas: He may have used the same password across several websites and did not use two-factor authentication.

Experts don’t have a good estimate for how often such attacks occur, but according to a 2015 report released by the nonprofit Digital Citizens Alliance, the practice is a growing problem for consumers, especially young women. The report also said that trojans account for some 70 percent of all malware.

Visit the New York Times for the story.