Cell Phone Security–Spying Software Just Became a Lot Smarter or Scarier –SpyBubble–Cell Phone Microphone Doubles as a Bug

One account and unlimited amount of phones that can be spied upon, email and text message and they can map where ever you are.  Scary – phone’s microphone can be used as a “bug” even if the phone is not being used for a phone call!  You have to watch the video below on this one.

Sounds like it’s time for some new HIPAA rules real soon if this gets on a phone with an electronic medical record system being used via the phone, so don’t let those phones out out your site at all and stick a password on. 

If you go to work for a company that issues cell phones, be careful.  As the video states it is completely invisible and there is no way to know it is there, so to be sure if one thinks it is on their phone, time for a hard reboot and wipe.  You might want to start asking about using your own phone for business.  It works on any Smart Phone.  In healthcare you would get some real  interesting comments here too I am guessing as someone could listen to every conversation a physician has in a hospital for example if the phone was using this software.  Company issued cell phones will never be the same and of course there’s the use advertised for the suspected spouse. 

In the case of not getting a phone already pre-set up, the one who wants to do the spying will still that that short amount of time to get someone else’s phone to do the installation, so keep your eyes on your phone at all times from here on.  At $60.00 for a license this could spread fast. 

A big brother type testimonial from the website:

"I hate when someone betrays me, especially if it's someone that I've given a job to. That's why the minute I heard that someone in my company was leaking information to my main competitor, I installed SpyBubble on all of my agents' phones. It turned out to be one of my best salesmen. I immediately fired him and every time a company calls to ask for references, I tell them the truth about him."

Cell phone spying

I can see this though for monitoring children who are small and have phones as it would serve as helping with parental controls such as what is quoted from the website below:

"My only child has always been the reason of my existence. So, when he suddenly became sulky and moody, I got worried. I had heard stories about pill-pushers around the school. However, I was determinate not to let them get my claws on my son. That's why I installed SpyBubble on his phone. The moment one of them contacted him, I denounced him to the police. "

Then the next issue is at what age do you cut it off, never?  The idea of the microphone bugging conversations in a room too without the phone being in use is scary too.  I have read about similar software on the web, but none that claim to do all that this software does and all the spy needs is a computer connected to the internet.  BD   

Move Your Partner, Employee or Child is Making Using Our POWERFUL Cell-Phone Monitoring Technology!"

"SpyBubble Is Powerful Yet Covert Cell-Phone Monitoring Software That Tracks And
Records ALL Information In Real-Time…
…Which Can Then Be Viewed At From ANY Computer In The World!"

SpyBubble - Cell Phone Spy Software | Mobile Spy

Technorati Tags: Smart Phones,HIPAA,spying,big brother,bug,monitoring devices,conversations,employees,software,SpyBubble

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FDA Issues Alert - Pharma Manufacturers–Crospovidone - Excessive Levels of Peroxide From China Based Manufacturer Found

Here’s one more warning on quality for the Chinese pharmaceutical manufacturers with more than the allowed levels found in a very common ingredient used with drug and dietary supplements.  The FDA states it doesn’t see this as having any health issues up front; however, if used in this current form, the potency of some drugs could suffer. 

Drug manufacturers who use or have used the ingredient with manufacturing are requested to contact the FDA.  BD

FDA issued an alert today that it has detected “excessive levels of peroxide in one lot of Crospovidone (cross linked polyvinyl N-pyrrolidone) manufactured by China-based Tianjin Boai NKY International Ltd.” Although there have not been any related adverse-event reports to date and although the level of peroxide found does not pose a major health risk, said the agency in an advisory statement yesterday, there is concern that elevated levels of peroxide can cause “subpotent finished products.”

In fact, the peroxide level found by FDA in the lot was more than four times the maximum level of peroxide (400 ppm) that is recommended in compendial monographs. This particular ingredient, crospovidone, is very common in drugs and dietary supplements.

PharmTech Talk » Potential Contamination in Crospovidone

Technorati Tags: Tianjin Boai,FDA,drugs,peroxide,China,pharma,imports,alerts

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Stem Cell Surgery Restoring Eyesight–New Zealand Surgeon Grows and Re-Implants To Injured Eye From Patient’s Good Eye

This is fascinating with a very tiny biopsy taken from a patient’s good eye and involves less risk.  So far this is working with patients who have lost sight in one eye and it is being restored in the other eye.  They are hoping to advance the procedure to where it can take care of 2 injured eyes.

Some procedures have also required a corneal transplant too, and so far the procedure has been used for those who had their eyes damaged by burns or items piercing the eye.  BD

Even 10 years ago it would have been considered a miracle but, as Adam Dudding discovered, revolutionary stem cell techniques now allow surgeons to restore sight to the blind.

STEM CELLS grown in a laboratory have been used to restore sight to the blind, in a series of cutting-edge operations performed by an Auckland eye surgeon – a New Zealand first.

Over the past nine months Professor Charles McGhee and his colleagues have performed the operation on five subjects, in each case taking healthy stem cells from a patient's uninjured eye and growing them for up to three weeks on amniotic membrane taken from a human placenta, before reimplanting the lab-grown cells back into the injured eye. In two of the five operations, the patients simultaneously received conventional corneal transplants.

McGhee says operations to transfer stem cells between eyes are used when injury has destroyed the "niches" where the corneal stem cells are stored, just on the junction between the white sclera and the transparent cornea.

A simpler operation, where cells are transferred directly, has been done in New Zealand for five or six years, but it is not suitable for all subjects, as it involves moving up to 50% of the corneal stem cells from the uninjured eye, thus putting the "good" eye at risk.

New stem cell surgery helps the blind to see | Stuff.co.nz

Technorati Tags: stem cells,eye surgery,corneal transplant,New Zealand,heatlhcrare,surgery,operations,eyesight,regenerative medicine

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Nose Doctor on the Run Found Living in a Tent at the End of a Glacier in Italy, Admitted Fraud Still Listed on Some MD Referral Sites

As consumers we all want accurate information on the web to search and I came across another couple of listings that show this MD, who has now admitted to fraud and was on the search list by the FBI for a number of years.  The Post Tribune has this update here.  These are screenshots that still show the former address of the practice in Indiana as well as phone numbers to contact.  I think consumers would have been hard pressed to find this MD on the glacier.  I blogged this story myself back in December of 2009.

Nose Doctor on the Run Found Living in a Tent at the End of a Glacier in Italy

Somewhere along the line if sites are going to provide consumers with accurate search information, especially in cases that are pretty old, someone needs to be updating and not just keep passing along aggregated flawed information.  There are a number of doctor and hospital search sties on the web that either create their information or subscribe or buy it from another source so perhaps they can all get together on this?  BD 

HealthGrades And Other MD Rating and Referral Sites List “Dead Doctors” on Their MD Information Pages And Even Include the Insurance Plans the “Dead Doctors” Honor

This is a strange story, but from the story here the doctor had committed fraud with insurance billing, had his license revoked and disappeared while on vacation in Greece.  Boy this is a sad fate having to live at the end of a glacier in a tent after having 2 planes, a nice mansion, yachts and more.  Crime doesn’t pay or not in this case it appears.

The Medical Quack: Nose Doctor on the Run Found Living in a Tent at the End of a Glacier in Italy

Technorati Tags: nose doctor,glacier,healthcare,health insurance,fraud,FBI,plastic surgeon,Doctor ratings,internet searches,patients

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Chicago Suburb Government Offering Cash Incentives For Employees To Opt Out or Downgrade Health Insurance Plans

This looks like a start to move employees to an insurance exchange in time and to shop for their own.  When you stop and think of the administrative time that companies and small governments are beginning to complain about, this township decided to give cash and let the employees do their own thing.  Perhaps there will be more agreements as such with others looking at even larger dollar amounts.  BD

Romeoville will offer incentives to employees who opt out or downgrade their health insurance plan in an effort by the suburb to save money.

The first option, according to village trustees who approved the plan Wednesday, will allow employees to enroll in an HMO plan rather than a PPO plan.

While the HMO benefit is for family coverage only, those who decided to change to an HMO will receive $250 a month for a maximum of $3,000 annually. The plan will begin this November.

The second option will allow employees to waive coverage. Those who had an HMO will receive $333 a month for a family with a maximum of $4,000 annually. Those who had the plan for themselves only will receive $166 a month with a maximum of $2,000 annually.

Village offering cash for employees who opt out of health care — Romeoville news, photos and events — TribLocal.com

Technorati Tags: Health insurance,healthcare,Chicago,Suburb,HMO,PPO,employees

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Thyroid Cancer Patients Setting Off Alarms After Treatment with Radioactive Iodine

The radio active iodine is active for about a week and there have been reports of patients setting off alarms in buses and radiation alarms have been set off at work.  Garbage trucks with radio active alarms have also been set off. 

The answer here is to have patients stay in a hotel for a few days before going home, but you guessed, not covered and patients should not use public transportation for a week.  I certainly was educated on this topic.  BD 

WASHINGTON – Reports of thyroid cancer patients setting off radiation alarms and contaminating hotel rooms are prompting the agency in charge of nuclear safety to consider tighter rules.

A congressional investigation made public Wednesday found that patients sent home after treatment with radioactive iodine have contaminated unsuspecting hotel guests and set off alarms on public transportation.

The Nuclear Regulatory Commission is considering new rules to address the problem, in particular curbs on sending patients to hotels after treatment, a spokesman said Wednesday.

People given high doses may be kept in the hospital, but many patients are sent home with instructions on how to minimize exposure to others over the next few days. Most of the radiation is gone in about a week, says the National Cancer Institute's website for patients.

Alarms over radiation from thyroid cancer patients - Yahoo! News

Technorati Tags: Thyroid cancer,radioactive,nuclear medicine,heatlhcare,health insurance,iodine

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Devon Medical Products Gets FDA Approval To Sell CircuFlow Sequential Pumps - Lymphedema Treatment

Lymphedema is localized fluid retention and tissue swelling when the lymphatic system is compromised.  It cannot be cured and the new pumps approved by the FDA with the CircuFlow devices can help treat and stimulate the correct amount of fluid to avoid build up and infection.  The sleeves release air in the sleeves to stimulate which is good news for those with secondary instances related to breast cancer.  BD

Devon Medical Products, a manufacturer and distributor of creative, safe, and cost-effective medical devices, today announced it has received U.S. Food and Drug Administration (FDA) 510(k) clearance to market its CircuFlow 5100 and 5200 Sequential Pump models that treat venous insufficiency and lymphedema. Devon Medical

Secondary lymphedema can be caused by cancer and cancer treatment surgeries that damage lymph vessels or require the removal of lymph nodes, such as with breast, prostate or testicular, head and neck, bladder or colon cancers. According to the Lymphedema Awareness Foundation (LAF), 15% to 20% of breast cancer related lymphedema in the U.S. has been determined by the American Cancer Society (ACS).

http://www.onlinetmd.com/medical-device-design-manufacturing-circuflow-102210-tmd.aspx

Technorati Tags: Lymphedema,FDA,Devon Medical,healthcare,medical devices,fluid,cancer

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FDA Approves Risk Education and Awareness For Drugs Used to Promote “Awakeness”–Sleep Apnea & Work Shift Disorder Treatments

Ok the title may have caught your attention as it certainly caught mine as I did not know there were drugs to help those who do not get enough sleep due to sleep apnea or shift work disorder.  In short these are medications to keep one more alert if they have one those conditions and a couple others. 

The official name here is the Risk Evaluation and Mitigation Strategies, aka as REMS to ensure patient, doctor education and safety with ensuring that all side effects are known and understood.  From the websites below:

What is NUVIGIL?

NUVIGIL is a prescription medicine used to improve wakefulness in adults who experience excessive sleepiness (ES) due to one of the following diagnosed sleep disorders: obstructive sleep apnea (OSA), shift work sleep disorder, or narcolepsy.

In patients with OSA, NUVIGIL is used along with other medical treatments for this sleep disorder. NUVIGIL is not a replacement for your current treatment. Consult your doctor about the importance of continuing your current OSA treatment while taking NUVIGIL.

NUVIGIL is a federally controlled substance (C-IV) because it has the potential to be abused or lead to dependence. Please use NUVIGIL only as directed and keep in a safe place to prevent misuse and abuse.

What is PROVIGIL (modafinil), and what does it do?

PROVIGIL is a prescription medicine used to improve wakefulness in adults who experience excessive sleepiness (ES) due to one of the following diagnosed sleep disorders: obstructive sleep apnea (OSA), shift work sleep disorder, also known as shift work disorder, or narcolepsy.

In patients with OSA, PROVIGIL is used along with other medical treatments for this sleep disorder. PROVIGIL is not a replacement for your current treatment. Consult your doctor about the importance of continuing your current OSA treatment while taking PROVIGIL.

These are Schedule IV drugs so I can see why they want to ensure they are used properly and everyone knows the potential side effects.  I found this a bit odd as both websites state they are controlled substances and both could be addictive and yet we have a coupon here for a 7 day starter voucher?  This just struck me as being very odd for a drug that is a Class IV and is federally controlled.  Here we go again with marketing……BD

FRAZER, Pa., Oct. 22 /PRNewswire-FirstCall/ -- Cephalon, Inc. (Nasdaq: CEPH) today announced that Risk Evaluation and Mitigation Strategies (REMS) for its medications NUVIGIL® (armodafinil) Tablets [C-IV] and PROVIGIL® (modafinil) Tablets [C-IV] have been approved by the U.S. Food and Drug Administration (FDA).  Both the NUVIGIL and PROVIGIL REMS consist of a Medication Guide to inform patients about the potential risks associated with the use of these medications, a communication plan and a timetable for submission of assessments of the REMS.  The communication plan includes a Dear Healthcare Professional Letter, a Prescriber Brochure, a Pharmacist Action Letter and a dedicated REMS Internet Site. The introduction of the NUVIGIL and PROVIGIL REMS programs is consistent with the company's commitment to safe and appropriate use of its medications.

The goal of each REMS is to inform healthcare providers, patients and caregivers about the risks associated with these medications, including serious skin rash and hypersensitivity reactions.  The current product labeling for both medications contains a bolded warning that includes these risks. Neither medication is approved for use in the pediatric population for any indication.  In accordance with the approved REMS, the company is currently updating NUVIGIL and PROVIGIL labeling to include the Medication Guide.

Cephalon Announces FDA Approval of Risk Evaluation and Mitigation Strategies for NUVIGIL and... -- FRAZER, Pa., Oct. 22 /PRNewswire-FirstCall/ --

Technorati Tags: FDA,Nuvigl,Provigl,REMS,education of Defense,Cephalon,Class IV,drugs,pharma,side effects

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Dr. David Brailer–US Health Czar Talks About “Getting” Your Personal Health Records & Physician/Hospital Medical Records

The point of the personal health records is to benefit the patient and the prime example he points to here are those with cancer or chronic diseases.  Dr. David Brailer also talks about the slow process of getting their records together without a PHR.   As a reminder I have a full section with over 300 posts that cover Personal Health Records on the Medical Quack.  I have been covering since they came to life. 

As you watch the video there’s many screenshots here with both HealthVault and Google Health, the originators of PHRs.  We still need a lot of help and training to bring consumers up to date as everyone is at different levels with consumer digital literacy today. 

You can always find links to personal health records here under the resources column.  I have my 86 year old mother’s records who is in a different state and we have everything in there from her advanced directive to pathology reports.  What I have said many times over here though is that we are still lacking any role models with our leaders, Congress etc. as this is not “just for those guys over there”.  

This is one area where our leaders keep losing it.   Long and short of all of this is that we have government officials that live in “tech denial” and don’t participate, so we get “Magpie” healthcare so at the highest levels of leadership with highly viewable people in decision making areas that don’t do squat themselves or never find time to try to set any type of example.   If some became participants we would have to spend less on some studies as they would be familiar and know the topics simply by participating. 

HHS National Plan to Improve Health Literacy – Not Going To Happen Until We Focus on Using Technology (The Tool for Literacy) Which Includes Role Models at HHS And Other Places in Government

People he states that are sick seem to be better users and it is much more than just “nice to know” as it can be a lifesaver.  Privacy is mentioned and he says that is a big deal too, and as I always suggest, ask to where your records are being stored.

The goal is not for the consumer to put more information online but rather it is for patients to “get it”.   Once again I do chuckle a bit when the conversation rolls around to the slow adaptation and I covered that above, no roll models.  Speaking of “getting information” this is a good spot to mention the Blue Button Initiative that allows Medicare and VA recipients “to get” their information,it is there. The two links below describe how Medicare and VA recipients can “ get” their information. BD

Medicare.Gov Blue Button Download For Personal Health Record Information for Those Covered by Medicare

VA Can Now Use the “Blue Button” to Download Their Data from Their PHR (Personal Health Record)

WSJ's Jeanette Borzo talks with Dr. David Brailer, America's first digital-health czar, about consumers' efforts to computerize their own health records.

Video - Dr. David Brailer Discusses Challenges to Online Medical Records - WSJ.com

Technorati Tags: PHR,Personal Health Records,EHR,doctors,hospitals,patients,cancer,treatments,Mapgpie Healthcare,non participants,VA,Medicare,Blue Button,White House

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HP Tablet Slate 500 Releases–$799 and Aimed for the Business Client–Windows 7 Pro OS

At 1.5 pounds this is an improvement and you can watch the video for a short walk through from Engadget.  The screen is 8.9 and has digitizer capabilities which after many years of using a tablet, I would be lost without.  It has an integrated VGA camera on the front for video conferencing and is Wi-Fi for WLAN. 

They are certainly making room for all the open real estate here and getting about as slim as slim can get.  The big advantage here is the ability to run corporate software and again a smaller unit to carry around.  BD 

Nope, you're not dreaming, but feel free to pinch yourself, rub your eyes or take a cold shower! You've read right -- the HP Slate is finally official, and after all the teasing, back and forth, and (very recent) leaks, the Atom-powered, Windows 7 Slate will finally see the light of day -- though in a different way than originally intended. While the first videos released by HP may have made it seem like it would be for consumers, HP's tactfully changed its tune (don't forget it's got Palm / WebOS tablets on the way) and is now aiming the Slate at the enterprise and business market. Still, it will be available on HP's site for $799 to anyone who wishes to purchase one.

HP Slate 500 finally (finally!) official, rings up at $799 -- Engadget

Technorati Tags: HP,Tablet PCs,Wi-Fi,mobility,touch screen,Windows 7,digitizer

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Tax Cannabis–California Proposition 19 On the Ballot–The New Leaf To Help the Economy

This is an interesting video and goes over how it would work if passed.  Tax Revenue from the sale would help reduce some of the Mexican gang crimes and put street dealers out of business it says.  The video also says it will create jobs too so when you watch the video promotion it looks to serve a lot of problems.  We have commercials already for medical marijuana so we might as well get educated from all angles.

Medical Marijuana News in California–First TV Ad Airs in California And Workers At Marijuana Factory Join the Teamsters

I am not a user so I’m not qualified to say anything in one direction or another from that end and we do have a growing use of medical marijuana in California and this could ease up some of the problems and issues that has but at this point if it is a way out and an avenue to rebuild what we have lost then it’s fine with me.  BD

Proposition 19 - The New Leaf from ISHOTHIM on Vimeo.

This video just came out – on Nov 2, Californians will be voting on Proposition 19, also known as the Regulate, Control and Tax Cannabis Act of 2010. And just in time for that, a cute video by I Shot Him Because I Loved Him has come out with strong arguments on why you need to vote for Prop 19. What do you think? Will this pass?

http://thisisawesome.com/prop-19-new-legalize-pot-video/

Technorati Tags: Marijuana,heatlhcare,California,factory,teamsters,advertising,healthcare,Marjyn Investments,New Leaf,Proposition 19,budgets

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Dead Doctors and Inaccurate MD Listings On the Web Can Be a Real Hunting Ground of Information to Mine For Crooks Relative to Fraudulent Medical Billing

Nobody likes fraud and me included but with having information floating around out there that includes “dead doctors” and other erroneous information, this is scouting ground for crooks to look around and figure out where fake and fraudulent claims can be sent.  If someone is already working in the medical billing area then they can figure out how to get the NPI numbers and other relative information for starters.

Now when you see a deceased MD on the web along with the type of insurance they honor, dead ringer here as the crooks figure out the information has not been updated in a long time and off we could go with fraudulent medical billing Bingo.  This is just one example but what’s to stop a real crook that wants to make some serious money, and we hear in the news about those folks who go for year until caught.

HealthGrades And Other MD Rating and Referral Sites List “Dead Doctors” on Their MD Information Pages And Even Include the Insurance Plans the “Dead Doctors” Honor

Crooks have to figure out how their billing algorithms are going to have to flow through the system so they don’t get caught, so they do algos too.  In the example below 3 people billing their ass of with fraudulent medical claims.   This is one more reason why software is not going to catch all the crooks as they work hard at it as they have only one focus and are not seeing patients. 

Biggest Prescriber of Medicaid Drugs In New Jersey Charged with Fraud–Only Had 3 Employees

Here’s an example, those anti fraud algorithms didn’t catch these folks at the link below, the FBI did and reported it to the anti fraud company to start checking for these issues, gee is that not what they thought they were paying for? 

Two Florida Business Men–Medicare Fraud For Billing for Penis Pumps for Female and Male Patients–Lot of Transaction Money Made And Who’s Running the Algorithms for Profit?

Case in point here, all algorithms can be created differently and how they actually deter and find fraud is different.  More often than not we have false positives and this is where the providers go through a ton of time and have to show proof on everything and the patient get drug in here too.  The case below goes back a couple years ago to when HealthNet agreed to pay their out of network claims at 14% over the Ingenix rates in the software.  No fraud here but just underpaid doctors. 

HealthNet Algorithms – When Do they Prevent Fraud and When Do They Cross the Line and Not Pay Out – Court Case Where the MDs Win

There still are tons of lawsuits filed all over the US over that situation too with all carriers who licensed it from United/Ingenix. 

Ingenix Data Base Has Some Long Reaching Legal Tentacles with Aetna, Blue Cross, Blue Shield, Humana

Ok so back on course here if all this information is floating around out there and you have crooks constantly sniffing, this proves to be a source of information to where potential billing fraud can occur as in the case of my former doctor, nobody had touched that listing in a long time and was in error from the day it was put out there as she had been dead longer than the websites have existed.  The research sites get their information from State boards and insurance companies so again the crooks can analyze and get an idea too of who’s watching the shop and they could use the Social Security Death Index too, so with everyone else mining data, these folks are no exception when there’s big potential for fraudulent billing. 

Gee I wonder why more inroads are not being made with fraud?  This oncologist got caught in Orange County, was slapped on the wrist and continued to send fraudulent billings for a number of years before they finally caught him for good and by the way he is rated as a 5 Star Doctor as of today on HealthGrades even though his license is gone and he’s going to jail.  This all took place in April of this year but he’s still on the list for consumers to find. 

Prominent Orange County Oncologist Pleads Guilty to Medicare/Insurance Fraud – Over $1 Million

He’s still on a few other rating sites too and obviously the crooks will stay away from this one as he was his own crook.  It will happen with all the mining that is done today on the web with listings that are not up to date contributing toward the growth of medical billing fraud, and the sooner we recognize, the better with this unintentional consequence associated with not updating information.  BD 

This just goes to show you can’t really believe every thing you read on the web.  I came across this by accident when doing some searches relative to the Medical Quack.  I went to an obgyn doctor for many years and was very happy with her and would still be a patient today except for the fact that she unfortunately passed away from breast cancer. 

The Medical Quack: HealthGrades And Other MD Rating and Referral Sites List “Dead Doctors” on Their MD Information Pages And Even Include the Insurance Plans the “Dead Doctors” Honor

Technorati Tags: HealthGrades,data bases,health insurance,human resources,tech denial,infrastrucure,lazy,employer insurance HealthGrades,employer insurance

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In Coders We Trust: Laurel Ruma Describes Gov 2.0 As A Platform–Become an “Algo Man”

This is a nice presentation on government and technology and what is being done, they need coders to build as the last administration didn’t take this seriously or did not understand the meaning.  The government needs a militia of coders to work to make the government better. 

Software and applications = a group of algorithms

The Sunlight Foundation is mentioned with all their contributions.  We have data and need to make it available.  This is the innovation we need and of course coordinated with private efforts too as there will always be a need for both.  I like the one slide in the image below going back to Kennedy too in 1961 so even way back we had folks with some foresight.  Do you still not believe that algorithms are not one of the key factors today driving all decision making?  If not, think again as everything has a system. The government and their groups are soliciting for those Algo Men and Women to come forward and innovate as there’s a real needs and in order to work with private industry we need this so we can communicate at every level.  

It’s not Superman, Spiderman or even Wonder Woman that creates solutions and become our heroes, it’s the “Algo Men” with all the data, algorithms and wisdom for innovation.  BD 

Government as a Platform

“We’re moving from the Social Web to the Civic Web. IT and geeks matter. What we can do with open data and the internet is very important. If government is a platform, we need people to create apps and others to open up data sets.”-Laurel Ruma, Gov 2.0 Evangelist, O’Reilly Media

In Coders We Trust: Laurel Ruma breaks down Gov 2.0 at Ignite NYC | Gov 2.0

Technorati Tags: Coders,Sunshine Foundation,Algo Man,O'Reilly Media,healthcare,algoirthims,innovation,government,Gov 2.0

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Medical-Data Breach With Keystone Mercy HealthPlan (A Subsidiary of Independence Blue Cross)–Lost or Stolen Flash Drive With Medicaid Patient Information

We still keep hearing stories like this and some folks continue to carry medical information around on flash drives and when they get lost, well there goes protecting any privacy.  Insurers bill themselves as the data experts today and yet where are the breaches coming from in the news of late, insurers.  Someone needs to update the way they do business and storing such information on a secured server and accessing with a VPN sure beats the heck out of carrying around a hardware device. 

From the website:

“Headquartered in Philadelphia, Keystone Mercy Health Plan is a mission driven, health care ministry of the Sisters of Mercy with more than 25 years of experience. Its corporate parent partners are Mercy Health System and Keystone First, a subsidiary of Independence Blue Cross.”

What I found to be odd too is that is was noted that this drive was carried around and used at health fairs?  That is strange and surely someone is asleep at the wheel here as again take a wireless notebook, connect to the secured VPN and access information as needed if that were the case.  We sure have some big problems and education needed with how to secure data according to HIPAA rules and regulations.  This somewhat shows too where priories lie with marketing perhaps trumping the use of technology security rules and laws. 

This is not what we are talking about when it comes to sharing records (grin), and a very unfortunate incident for the patients by all means.  BD

Oct. 21--A computer flash drive containing the names, addresses, and personal health information of 280,000 people is missing -- one of the largest recent security breaches of personal health data in the nation.

"We deeply regret this unfortunate incident," said Jay Feldstein , the president of the two affiliated Philadelphia companies, Keystone Mercy Health Plan and AmeriHealth Mercy Health Plan.

The breach, which involves the records of Medicaid recipients, is the first such Medicaid data breach in Pennsylvania since at least 1997, according to the state's Department of Welfare, which has oversight.

The security failure, one of the several largest in nearly two years, involves nearly two-thirds of the insurers' subscribers. It became known only after The Inquirer requested information Tuesday evening. The insurers said the drive was missing from the corporate offices on Stevens Drive in Southwest Philadelphia. It noted that the same flash drive was used at community health fairs.

Insurance News - Medical-Data Breach Said To Be Major

Technorati Tags: Keystone Mercy Health Plan,data breach,health insurance,Medicaid,healthcare reform,AmeriHealth Mercy Health Plan,Independence Blue Cross,data,HIPAA

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Junk Insurance Lawsuit Filed Against Texas Firm Healthmarkets by LA City Attorney–More Algorithms for Profit Conflicting With Care

This is interesting when you see who the majority owners are here with the investors listed, Goldman and Blackstone and the lawsuit contends they knew upfront of the scheme.  The company has fined Healthmarkets but it makes you wonder where fines and regulation come together?  Do we just keep fining such organizations, they pay the fines and keep operating with “business as usual” here?

If you have read the news of late, there’s a lot of that type of activity going on to where we read “the company admitted no guilt” but racks out the dollars.  It all comes back around to how the plans were marketed and how due to the complications of policies, nobody can figure out what in the heck was covered.  So why is everyone accelerating their marketing, money with no real repercussions other than the chance of paying a fine? 

Why Is Almost Everyone In Healthcare Marketing Their “Ass” Off

I think all of us today just want care and are getting a bit tired of being constantly marketed for so many of those schemes that seem to good to be true and the old saying of “if it’s sounds too good to be true, it probably is” holds true.  Here’s one example of how selling MD and hospital information made millions and yet the accuracy of what is on the web does not hold the owners accountable. 

HealthGrades And Other MD Rating and Referral Sites List “Dead Doctors” on Their MD Information Pages And Even Include the Insurance Plans the “Dead Doctors” Honor

Back to the case at hand, these folks have paid out fines and have just kept rolling along with selling their complicated insurance programs that are calculated with risk management algorithms to make money.  As Wendell Potter has pointed out, paying out claims is considered a “loss” for investors, as patients we consider this care so the 2 obviously do not agree here on what the business of health insurance is all about and the business models and care divide are getting worse. 

Once again we are looking at those “algorithms for profit” and if a little care gets thrown in as consumers we get lucky it appears and when you look at who’s running the algorithms here for writing these policies we are back to the folks using their “Algo Men” to forecast and create policies as such.  They give owners guidance too on how to make money, not take care of patients. 

JUNK INSURANCE IS LEADING TO JUNK HEALTHCARE, NOT TO BLAME THE DOCTORS AND HOSPITALS WHO JUST WANT TO GET PAID – IT’S THE ALGORITHMS FOR PROFIT THAT ARE DETERMINING FACTORS.

Accountability for Algorithms Needed On Wall Street–Financial Regulatory Authority Says & We Need The Same for Healthcare Algos

I said this over a year ago that we need a Department of Algorithms or something like this along the line and perhaps it can work under the US Patent Office but again I saw this over 2 years ago building to this point so please come to terms with the fact that formulas for profit have ruined the system and with or without reform, this was going to happen.  The government is basically stuck working with a group of companies that lack ethics and value for human lives and care and only care about their bottom lines.  BD

“Department of Algorithms – Do We Need One of These to Regulate Upcoming Laws?

What happens when the “secret code” and algorithms are stolen and potential exposure is present, shear panic.  BD

Goldman Stolen Code – Has Algorithmic Fraud Become A Business Model in HealthCare Too?

A national health insurer and its majority owners, Wall Street powerhouses Goldman Sachs Group Inc. and Blackstone Group, were accused in a lawsuit Wednesday of defrauding their California customers with "junk insurance" that provided little or no protection.

The suit filed by the Los Angeles city attorney's office alleges that HealthMarkets Inc. and its affiliates trained sales agents to deceive customers — mostly self-employed individuals and small businesses — into buying confusing policies riddled with exclusions and limitations.

It also contended that Goldman Sachs and Blackstone knew about the alleged insurance scams in California when they bought a majority stake in HealthMarkets in 2006.

The lawsuit is the latest trouble for the Texas company, which conducts business in 41 states. In the last two years, regulators from California and more than 30 other states have fined HealthMarkets or its affiliates nearly $40 million over alleged deceptive business practices.

HealthMarkets sued by L.A. city attorney over 'junk insurance' - latimes.com

Technorati Tags: Lawsuit,healthcare reform,heatlh insurance,Goldman Sachs,Blackstone,junk insurance,Healthmarkets

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Accountability for Algorithms Needed On Wall Street–Financial Regulatory Authority Says & We Need The Same for Healthcare Algos

Healthcare payers and Wall Street are all connected and as you can see now the issues with rogue algorithms and identify are being discussed with having adequate audit trails and accountability.  We should be able to trace every transaction and follow it’ path in audit trail, same applies to healthcare but we never get to see those outside the clinical side where certification and rigid standards are the norm for medical record vendors. 

In making this comparison, we have the same issues too with checking “new” algorithms in healthcare and working from the blind side with payers.   One true fact that holds anywhere is that sometimes we don’t know exactly what some algorithms may do, like under a perfect storm scenario.  Usually in healthcare it leads to a claim rejection or something along that line.  Just as the trading houses are running data over many exchanges, we have the same thing happening in healthcare with data touching many areas and accountability is top concern.  On Wall Street, they want brokers to audit the algorithms and in healthcare, first of all we need to see them, and when it comes right down to it, they should be filed in a digital format so one can watch one operate with some fictitious sample data.  Actually, that’s a good idea for future laws to incorporate some of those.  One state legislature in New Jersey is on to this and has a bill with statutes that would allow health insurance algorithms to be audited as to how they were put together (computer code) as well.

New Jersey Legislature Getting Smart– Bill to Modify Claim Procedures to Include Asking For Insurance Company Algorithms-Bill A3334

Transaction fees roll a lot of money and profits around and  recently I had a conversation with a physician’s group who dumped their automated algorithmic auditing system from a 3rd party and brought it in house with 2 employees doing the work, it got too far out of hand with expenses for the services.  Now the 2 employees are using software of course and we are not talking going back to paper but they work with certain algorithms that analyze and mark claims for further investigation and it seems to be working well, and at least they have an auditing system they can afford. 

This is a top notch IPA too that is not living in the dark ages and has invested in software pretty wisely.  There’s so much money made in those transaction fees that come from checking and auditing claims and you never know if you are really getting your money’s worth.  In just reading about the contract below, it made me wonder too how this will really work with finding enough fraud as the overall company makes money on transactions so to cut too many off, there goes the transaction profits.  You need law officials to also help in the effort with fraud as algorithms are kind to crooks as they are better with numbers as they don’t see patients and have only one focus and that is fraud.

Kentucky Hires Ingenix on a 3 Year Contract to Detect Algorithmic Fraud With Medicaid Medical Claims

Bottom line is that the money has over a number of years has been shifted around and it’s all due to algorithmic controls and queries, whether it be Wall Street or Health Insurance, the same thing has occurred.  As consumers we have swords and daggers while trying to battle those with machine gun technology and thus we are at the point to where those machine guns need to be accountable and the solution is audit tables and our own set of Algos to monitor. 

IT IS ABOUT TIME THAT EVERY MEMBER OF CONGRESS AND OTHER LEADERS IN THE US GET SOME “ALGO MEN” AROUND AS YOU CAN’T DO BUSNESS OR MAKE LAWS WITHOUTH THEIR HELP AND THIS IS A LOT OF OUR PROBLEMS WITH THOSE WHO CANNOT EMBRACE AND COME TO THE REALITY OF WHAT HAS OCCURRED THE LAST FEW YEARS, in other words what I call the “non participants” and those holding on to the paradigm of “its for those guys over there’.

If one is running for office, then get those Algo Men on staff during a campaign so they can advise one as a candidate if your promises can be fulfilled as everything needs an IT infrastructure system and they can do the studies and help project.  It will make campaigns a bit cleaner looking too and get rid of some of the “dumb and dumber” stories we hear in the news today too.  You want to make sure though that you direct your Algo Men to create solutions that present accurate results and not all “desired” results as the 2 are not always the same.  Here’s a good book that touches on a lot of how this goes on and yes there are some dark sides to some of the algorithms written for profit.

“Proofiness–The Dark Side of Mathematical Deception”–Created by Those Algorithms–New Book Coming Out Soon

This somewhat makes me feel good that I said this over a year ago:

“Department of Algorithms – Do We Need One of These to Regulate Upcoming Laws?

I think we need one of those or something close along those lines as algorithms and patents too are running together, software patents are basically just patenting a bunch of algorithms that are packaged.  Bill Gates said that one. For all those who don’t get this, there’s always the simple Facebook algorithms to entertain and waste a ton of time there.  Remember the big stink over the Goldman code, yup, those algorithms that make their money was at potential risk of being exposed. 

Goldman Stolen Code – Has Algorithmic Fraud Become A Business Model in HealthCare Too?

Healthcare needs algorithmic style auditing too and we don’t get that now and are sometimes stuck with getting employees reading script that can’t explain what has happened as the claim may still be stuck in the algorithm pool of transactions and given codes, scores and number analyses that they can’t explain or understand.  We have all had the script reading customer service folks and it’s not their faults as they are just doing what they are told but it doesn’t help when you want care or need questions on a claim that has been denied or changed. 

Are We Ever Going to Get Some Algorithm Centric Laws Passed for Healthcare!

“Not satisfied with milking the taxpayer, Goldman and friends have also escalated the profiteering arms race and are looking to skim everyone in the trading arena - partners, clients and each other. Can regulators keep up with the speed of their innovation and put in place sensible restrictions to protect the rest of us? “

In the news today, two other financial firms are talking about their new algorithms:

Deutsche Bank Launches New sophisticated execution algorithms

Quantitative Brokers Launches Suite of Algorithms for Interest Rate Futures

This is common occurrence as there’s ton of formulas being created every day so again having a sample operating digital format in a law without giving up any intellectual property as a visual would be nice and the algorithmic audit trails or we are never going to know how and when transactions transpired and the dis proportion of money in the US will get worse.  On Wall Street and in Healthcare algorithms are running the show and we need accountability for the SEC with the technology and a full staff of “Algo Men” to enforce.  BD 

Broker-dealers who are sponsoring their customers' direct access to securities markets need to face a "higher level of accountability with respect to the algorithms they use,'' according to their chief regulator.

Richard Ketchum, the chairman and chief executive of the Financial Industry Regulatory Authority, said Tuesday that the higher standard of accountability needs to be applied to algorithms whether they come from the firm itself or a vendor and, most particularly, if the algorithms are "used across a wide range of borses.''

This is not to say that firms will be expected to know exactly how their algo will act with an event that has never happened before, such as the May 6 Flash Crash. Ketchum said regulators realize "each exceptional event" may cause difficulties with an algo.

"I think the appropriate place to focus now is to increase the auditing that firms do when they introduce new algorithms and particularly when their customers introduce new algorithms,'' he said.

FINRA: Accountability for Algorithms Needed - On Wall Street

Technorati Tags: Health Insurance,confusion,healthcare reform,profits,education,Wall Street,audit trails,algorithms,brokers,regulation

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Wendell Potter Reporting From the NAIC (National Association of Insurance Commissioners) Who Congress Gave Power On How To Implement Healthcare Reform

This is an extremely good article written here by Wendell Potter who worked many years on the other side before he retired and saw the real picture of what is happening in healthcare.  He states there are 28 people representing consumers and at least a thousand lobbyists there for insurance firms.  He says everyone is waiting in the hallways as the meetings are locked up and no press and lobbyists inside.

Wendell Potter Tell All Book–Deadly Spin–One to Put On My List as “He Knows Algorithms and How they Create Profits”

“It is at these closed-door meetings that some of the most important discussions are taking place, and decisions are being made.”  These are the results that bring out the champagne on Wall Street, when you reduce the amount you spend on medical care and make your customers pay more. “

The NAIC has to figure out which company functions qualify for the medical loss ratios so every administrative function does not get added in.  I can see a whole lot of topics on that one and one I wrote about before was their venture capital arms and we should be sure that those gambles are not under the area of patient care, even if it is medical technology, it’s still an investment and not a direct action.  Blue Cross for example invested in those add supported tablets in doctor’s offices but again this is an investment and not actual care like getting a shot.

BlueCross BlueShield Venture Capital Firm invests in Phreesia

Wendell Potter says they are trying to get just close to everything under the sun covered and perhaps this kind of pressure is why the CEO of Aetna is retiring as Wall Street and the way the algorithms of profit work is that they want the least amount of money spent on care and as he states here, they consider money spent on care to be a loss!

And Now A Word From Wendell Potter About Healthcare Reform and Medical Loss Ratios..

Mr. Potter continues on to describe the flurry of lobbyists that were sent out all over the country prior to this meeting too.  Coming full circle here he further states that the big profits from United may actually help the consumers and give the insurers less of a leg to stand on. 

You know this is really ugly and again one reason health insurers should not be traded on the open market and should go back to being non profits as this really sucks.  Even being represented here being outnumbered as consumers with only 28 and over 1000 lobbyists is nowhere near being fair.  I glad I read this one today and use the link at the end to see the entire article, good stuff.  BD

Health Insurers Sending Big Dollars to the GOP–The Folks Who Largely Lack General Consumer Digital Literacy And Health IT Literacy As Relates to the Power of Algorithmic Formulas

Here’s a related video that goes over some of what is happening. 

Insurance Lawyers Finding More Loopholes

ORLANDO -- If you are hopeful that the consumer protections in the health care reform law actually wind up benefiting consumers more than the insurance industry, please send a thank-you note to executives at UnitedHealth Group, the largest U.S. health insurer.

United announced Tuesday morning that its third-quarter profit jumped 23% -- much more than investors and analysts had expected -- largely because it spent far less of its customers' premiums on medical care than it did this time last year. When an insurance company spends less of every premium dollar it takes in on medical care, it has more left over to reward shareholders and a handful of senior managers who already are among the highest-paid executives on the planet.

United's announcement is cause for joy because maybe, just maybe, the nation's state insurance commissioners -- whom Congress gave the responsibility of determining how major parts of the new law will be implemented -- will finally realize that they don't need to give the big insurers the truck-sized loopholes they have been lobbying so hard for over the past several weeks.

It could turn out that UnitedHealth will help consumers the same way the nation's second largest insurer, WellPoint, did several months ago when it announced that it was hiking premiums as much as 37% for many of its customers in California. The news coverage of that proposed increase so outraged members of Congress that they mustered the gumption to finally pass a reform bill that, until then, seemed to be on life support.

The more they can get the commissioners to write the often obscure but critically important rules in their favor -- even if those rules violate the health care reform statute -- the happier it will make Wall Street. That is what is really going on here. It is as simple as that.

Wendell Potter: Thank You, UnitedHealth Group. Your Jaw-Dropping Profit Announcement May Be Just What the Doctor Ordered.

Technorati Tags: Wendell Potter,NAIC,health insurance,healthcare reform,medical loss ratios,lobbyists,algorithms,United Healthcare,politics

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