Charlene Frame, the operator of medical firms Royal Physician Network and Envision It Perfect, pleaded guilty to one count of conspiracy, admitting her participation in a telemedicine and health fraud scheme. Authorities said Frame conspired to pay nurse practitioners and physicians in exchange for obtaining orders for durable medical equipment that was sold to DME providers and billed to Medicare later, totaling more than $60 million in payments from the program.
Physician Lee Besen, Kimberly Schmidt, Terri Haines, Amber Harris and Shanelyn Kennedy of Pennsylvania, and physician Yitzachok Kurtzer and his wife, Robin Kurtzer, both of New York, were charged over their alleged roles in conspiracies to receive and pay kickbacks in exchange for ordering genetic tests. Authorities said Besen and Kurtzer accepted monthly cash bribes and kickbacks ranging from $500 to $5,000 in exchange for collecting DNA samples from Medicare patients and sending them for genetic tests to clinical laboratories in Pennsylvania and New Jersey.
EHR alerts from computerized physician order entry systems and clinical decision support programs are contributing to alert overload and burnout among hospital clinicians, researchers reported in a health informatics journal. Hospital performance improved slightly from 2017 to 2018 on fatal and nuisance order alerts, but researchers say some hospitals still alert too much.
Thirty-five senators asked HHS and the CMS to share plans for rolling back or making permanent temporary changes to telehealth rules. In a July 2 letter, the senators urged the agencies to provide a written plan and timeline for creating permanent telehealth administrative changes to Medicare, Medicaid and the Children's Health Insurance Program, and to confirm existing in-office Medicare reimbursement parity for telehealth services will be maintained, among other requests.
Gilead Sciences has begun evaluating an inhalable form of remdesivir for COVID-19 treatment that could be used outside hospital settings, launching early-stage testing in nearly 60 healthy adults. The company also intends to test remdesivir in combination with anti-inflammatory drugs.
India-based Lupin Pharmaceuticals and Granules Pharmaceuticals have recalled their metformin products after the FDA warned that it discovered higher-than-acceptable levels of N-nitrosodimethylamine, a probable human carcinogen, in the drugs. Lupin is pulling all lots of its metformin extended-release tablets, while Granules is recalling 12 lots after discovering higher than allowed levels of NDMA in some batches.
Medigap enrollment climbed to 14 million in December 2018 from 13.5 million in December 2017, and nearly half of fee-for-service Medicare enrollees without additional insurance coverage had Medigap coverage in 2017, according to an AHIP report. Medicare beneficiaries with Medigap coverage were less likely to report having difficulty paying medical bills than enrollees who didn't have the added coverage, according to the report.
Older people, men and those with preexisting health conditions such as obesity and diabetes have a higher risk of dying from COVID-19 compared with their counterparts, according to a study in Nature. The findings, based on data from more than 17 million people in England, also found that nonwhite individuals, particularly Blacks and South Asians, were more likely to die from COVID-19 compared with white patients, and the association remained after adjusting for factors such as medical conditions, sex and age.
Changes in employee health, corporate downsizing and new rules on retirement plan distributions make this a good time for companies to ensure they have a plan for updating beneficiary designations and locating missing participants, experts said. Anne Tyler Hall of Hall Benefits Law said plan sponsors should make sure participants update beneficiary forms and designations yearly, even if a third party is handling the paperwork.
A report from the New Jersey Health Care Quality Institute makes nine recommendations for helping small businesses in the state provide health insurance coverage to employees, expected to be more difficult with the novel coronavirus pandemic. Recommendations include adding state subsidies for some individuals, a tax credit for small businesses that offer certain plans, and measures that make it easier for insurers to offer coverage in this market sector.