DCMedical News: Friday, February 28, 2020
DCMedical News-DCMN
Washington, D.C.
Friday, February 28, 2020
DCMedical News is published every day both the House and the Senate are in session.
THE BIG STORY IN HEALTH CARE
Coronavirus News
Public Health: Johns Hopkins, Centers for Disease Control and Prevention (CDC) and National Institutes of Health (NIH) Resources
Tracking by Johns Hopkins shows on 2-27 at 9:00 p.m. EST worldwide 83,342 confirmed cases, 2,856 deaths, 36,488 patients recovered. CDC information page here. NIH information page here.
Public Officials, Responses:
This morning (Friday) members of the House will have a coronavirus briefing from FDA Commissioner Stephen Hahn and Director of National Institute of Allergies and Infectious Diseases for the NIH Anthony Fauci. A Washington Post story (here) reports that U.S. workers without protective gear assisted coronavirus evacuees. This according to an HHS whistleblower, who filed suit. The Hill reports that “Vice President Pence on Thursday tapped longtime health official and ambassador-at-large Debbie Birx to serve as the White House coronavirus response coordinator. Birx has worked for decades in the medical field, largely focusing on combating and preventing the spread of HIV/AIDS. The staffing move is likely intended to appease calls from many lawmakers for the Trump administration to appoint a ‘czar’ to oversee the federal response to the coronavirus.” California Governor Newsom said Thursday that 33 people in California have tested positive for coronavirus, with officials monitoring more than 8,400 people for the virus. Five people who tested positive have since moved out of the state.
Commerce, Trade and Finance:
The Dow Jones Industrial Average plunged another 4% Thursday, nearly 1,200 points. The S&P 500 is down 12% since February 20; among the few winners, Regeneron and Gilead (treatment, vaccine), Clorox (disinfectants), Netflix (self-quarantine). The Financial Times reports (here) that China has issued a record number of “force majeure” certificates, “in an attempt to exempt local exporters from fulfilling contractual agreements with overseas buyers as the country struggles with the fallout from the coronavirus outbreak. Companies that have already been issued with the legal ‘exemption’ papers include steelworks, electronics companies, carmakers and auto parts suppliers.”
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Fraud, The Year in Review
Attorneys from law firm K&L Gates analyze fraudulent claims against the government (here) for 2019, and the prospects for 2020. For 2019, “the False Claims Act remained the federal government’s primary method of civil fraud enforcement. While the more than $3 billion in civil fraud recoveries in Fiscal Year 2019 resulted from Government enforcement across a number of industries, health care continued to represent the most fertile ground for recoveries. Indeed, as in prior years, the lion’s share of the Government’s civil fraud-related recoveries came in health care, which accounted for approximately eighty-five percent (85%) of recoveries in 2019.”
Recoveries in 2019 were “significantly bolstered during the year by major settlements with hospital systems and pharmaceutical companies, which primarily related to alleged improper relationships with health care practitioners and as a civil outgrowth of efforts to address the nation’s opioid epidemic.”
For the coming year, “The Government and relators alike may specifically target health care providers for alleged violations of the Stark Law under the practice ‘loss’ theory in 2020. The practice loss theory suggests that hospitals would not compensate a physician above fair market value unless the hospital expected the physician to make up the difference in referrals. As a result, proponents of the practice loss theory believe that compensation agreements out of line with fair market value must include improper remuneration for physician referrals.”
MEDICARE, MEDICAID, COMMERCIAL HEALTH INSURANCE
Who Pays the Most?
A RAND group (report here, news release here), studied the totality of all payments for health care by U.S. households and their employers, including premiums, out-of-pocket payments, federal and state taxes and other health care payments. They found “that higher-income households pay the most to finance health care in dollar amounts, but the burden of payments as a share of income is greater among lower-income households.”
DRUGS AND DEVICES
Drugs, China and Coronavirus:
The Regulatory Affairs Professionals Society reports (here) that the FDA has identified 20 drugs that are made in or produced solely from active pharmaceutical ingredients sourced from China. The story notes that the agency has been in contact with the companies that make the 20 products and that none of these firms has reported any shortage to date. [Also] the “FDA has been in contact with more than 180 manufacturers to remind them of their responsibility to notify the agency of anticipated supply disruptions and ask that they review their supply chains for API and other components sourced from China. At this time, no firm has reported a shortage is anticipated for any drug due to COVID-19. The statement came after a report from Axios on Sunday alleged that FDA had compiled a list of about 150 drugs that are at risk of shortage.”
READINGS AND REFERENCES
Research Methods Homework
JAMA Surgery publishes a series of short essays with examples and references on research methods. Today (here) a “Practical Guide to Mixed Methods.” An excerpt, “Mixed methods refers to a relatively new research methodology seeking to capitalize on the strengths of quantitative and qualitative data within a single study by integrating the 2 data types . . . methods should be combined in a way that creates complementary strengths and nonoverlapping weaknesses through data integration at 1 or more study phases . . . The use of mixed methods in the health sciences has rapidly expanded as investigators have looked to explain patient or clinician behavior, determine the determinants to best practice, or evaluate the implementation of evidenced-based interventions. The 3 main reasons to consider mixed methods are to (1) obtain convergence or corroboration of main findings, (2) eliminate or minimize alternative explanations from the conclusions drawn from the data, and (3) explain divergent aspects of a phenomenon.”
U.S. House of Representatives:
Members at https://www.house.gov/representatives
Committees and Members at https://www.house.gov/committees
U. S. Senate:
Committees and Members at https://www.senate.gov/committees
CQ 2020 Calendar of Regularly Scheduled Sessions, here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
March 2, 3, 4, 5, 9, 10, 11, 12, 23, 24, 25, 26, 27, 30, 31
April 1, 2, 3, 20, 21, 22, 27, 28, 29, 30
May 12, 13, 14, 15, 18, 19, 20, 21
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.