Today's edition: Federal authorities are investigating an alleged $2 billion Medicare fraud scheme. Defense Secretary Lloyd Austin was also taken to the hospital on Sunday after suffering an “emergency bladder issue,” according to the Pentagon. But first…
Medicaid health prescriptions include food and housing in some states
It has been a pillar of the country's social safety net since the 1960s. medicaid is the largest public source of Health insurance. Now it's becoming more than that.
More and more states are expanding their health insurance programs and making them centers of care. meet social needs:help housing and Transportation facilitiesease the past prison life and domestic violenceand the pastor provided cardboard boxes filled with canned goods and fresh produce. carl nichols and his team deliver in two counties: Southeastern North Carolina.
for Biden administrationfocusing on these needs will facilitate mitigation efforts. health inequalitiesIncluding recent things, America's handbook for addressing social determinants of health. of Centers for Medicare and Medicaid Services After more than a year of working with the White House and other government departments, in November guidelines What services can states add under Medicaid, including up to six months of services? rent, Utility fee subsidy and nutritional food.the nation can dedicate 3% or less The government would need to invest national funds into such experiments, which would account for a portion of overall Medicaid spending, and evaluate their effectiveness.
“Obviously, no one is saying Medicaid is here to solve every housing and nutrition need in the country, and we're not here to take over other agencies like Housing and Urban Development or the Agriculture Department.” Ta. Daniel Tsai, Director of Medicaid at CMS. “Does Medicaid play a role in social needs? The answer is yes. …I'm looking forward to it. It's groundbreaking. It's not an open check. ”
“Sync for your social needsThe coalition, announced by the White House in 2022, will bring together health plans, health systems, government agencies, and e-health teams with the common goal of standardizing patient records to indicate whether they have been screened for social risks. Coordinating recording vendors.
last year, Domestic Quality Assurance CommitteeThe organization, which evaluates health plans and health care workers, updated the data tools used by 90 percent of health plans to require them to report whether they assessed patients for housing, transportation, and food insecurity.
and medicarethe federal health system for seniors and people with disabilities, ordered doctors seeking bonuses in the incentive program to ask patients about food insecurity, unstable housing and personal safety.
1 year ago Organizations that certify the U.S. hospital We have started asking some patients if they have unmet health-related social needs and offering advice on how to get help.
This wave of attention to social needs dates back at least 30 years and grew out of the recognition that the social determinants of health, or the conditions in which people live, have a profound impact on their well-being. Research shows that medical care accounts for only 20 percent of the variance in patient health outcomes, and social risk factors account for half to 80 percent.
“if You are trying to provide medical care to improve health, and [a patient] “If you don't have a healthy diet or a place to live, you end up sitting idle.” Seth A. BerkowitzAssociate Professor of Medicine University of North Carolina School of Medicine.
The new CMS guidelines say the services states choose to include must be based on evidence that makes a difference. It remains to be seen whether this will all work out.
“There's incredible enthusiasm and this is going to be a magic pill,” he said. Laura GottliebProfessor of Family and Community Medicine University of California, San Francisco.
But so far, “there is no evidence to support these activities,” said Gottlieb, the association's founding co-director. Social Intervention Research and Evaluation Network, focuses on the intersection of social and medical care. “The research [running] behind the policy makers. ”
2022 Report by Ministry of Health and Human Services It synthesized research on older projects that attempted to assist primarily outside of Medicaid.that concluded that it is safe and stable housing It has been linked to improved health as well as the availability of nutritious foods. Still, the report acknowledges that many studies have limitations, making it difficult to determine whether the service is truly responsible for improved patient health.
You can read Amy's full report here here.
US investigates $2 billion Medicare fraud
of F.B.I. and other agencies are investigating the allegations. medicare Fraud scheme estimated to total an astonishing $2 billion, our colleagues Dan Diamond, lauren webber and Dan Keating I scooped it up. Click here for details.
The months-long case allegedly involved fraudulent insurance claims filed by seven companies, which billed just 14 patients for urinary catheters in 2021 and 2023. ended up billing more than 400,000 patients. Health and welfare services and other agencies said they could neither confirm nor deny the investigation, citing standard practice.
suspicious plan Discovered by the National ACO AssociationThe medical nonprofit organization known as NAACOS represents hundreds of medical groups and hospitals across the United States.
Members of the nonprofit group have noticed a spike in claims for intermittent urinary catheters, tubes that patients insert several times a day to drain the bladder and treat incontinence. Although the companies used actual patient information to submit the bill, NAACOS and its members found no evidence that the patient wanted or received a catheter.
Federal authorities are currently investigating multiple companies suspected of being involved, according to three officials who spoke on condition of anonymity to discuss the investigation and who said the FBI had contacted federal authorities. That's what it means.
One question: Why are urinary catheters a target? Reimbursement rates for each catheter are relatively low. Medicare will pay approximately $8 for each of the two types of devices involved in the alleged fraud: a curved tip catheter and a sterile kit catheter. However, if you order the product in bulk, you will get a good profit.
Also, because urinary catheters (small tubes often made of latex or silicone) can escape some of the scrutiny that comes with expensive equipment, surgery, and other high bills, these products are potentially fraudulent. Fraud experts say it could have been an attractive target for masters.
Austin was admitted to the hospital on Sunday for testing for bladder symptoms.
Secretary of Defense Lloyd Austin Less than a month after spending nearly two weeks in intensive care due to complications from surgery to treat prostate cancer, he suffered an “urgent bladder issue,” the newspaper's Dan LaMose reported. He was taken to the hospital on Sunday, the Pentagon said.
Major General patrick riderA Pentagon spokesperson said in a statement that Austin's security team transported him to his next location. Walter Reed National Military Medical Center Ryder added in a second statement Sunday night that Austin had transferred his duties and duties to the deputy secretary of defense. Kathleen Hicks Ryder said the White House, Congress and Pentagon military chief Gen. Charles Q. Brown Jr. were alerted around 4:55 p.m.
Austin doctors john maddox and Gregory ChestnutIn a statement, Austin said he was taken to Walter Reed National Military Medical Center for “supportive care and close monitoring” after being transported by a security team earlier in the day with symptoms “suggestive of an urgent bladder issue.” He was admitted to the critical care ward. It is unclear how long he will remain in the hospital, but he is expected to make a full recovery from prostate cancer.
The secretive response to Austin's initial health crisis was politically charged for the Pentagon, especially after it was revealed that President Biden did not know about Austin's cancer diagnosis, surgery, and second hospitalization until January 4. It became a problem. The Pentagon first disclosed Austin's hospitalization. Congress and the People January 5th.
Here are some of the events we're watching this week.
upon Thursday: Choosing House Oversight and Responsibility Subcommittee on the coronavirus pandemic A hearing will be held to examine the U.S. vaccine safety system. This is the first of two hearings on the matter.
On the same day, the House Department of Veterans Affairs Technology Modernization Subcommittee will hold a public hearing entitled, “An In-Depth Study of Electronic Health Records Modernization: Can Oracle Pharmacy Software Make It Safe and Effective?”
In association with, AMA National Advocacy Conference It runs from today through Wednesday in DC. Centers for Disease Control and Prevention director Mandy Cohen He is scheduled to address the group on Wednesday.
and post We host live events on Kaizen on Tuesdays women's mental health and cardiovascular care.Speaker includes: Janet WrightDirector of Heart Disease and Stroke Prevention CDC, Martha GulatiDirector of Preventive Cardiology Smit Heart Institute at Cedars-Sinai Medical Centerand alicia chong rodriguezFounder and CEO of bloomer tech.
- Fungal infections are a growing threatbut creating new drugs remains difficult, reports NBC News' Caitlin Sullivan.
- More than half of mental health visits – 55% – Linda Shearing reports that investigations are being conducted remotely, primarily via video conferencing, rather than in-person visits. For The Post.
- Oregon Health Authority confirms first human case of bubonic plague This incident has been happening since 2015, Stephen Sorace reports on Fox News. Officials say no new cases of plague have been found in Deschutes County, Oregon.
'Fleeing under the cover of darkness': How Idaho's abortion ban will change the state's pregnancies | CNN (Meg Tyrrell and John Bonifield | CNN)
She wants therapy. Her mother doesn't really understand. (Michael Elsen-Rooney | Chalkbeat)
'Here we go!': Congressional war over ZYN nicotine pouches (Riley Rogerson | The Daily Beast)
thank you for reading! See you tomorrow.
