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Healthcare Industry Is Not Alone with Hackers, NASDAQ Has Intruders Using Algorithms to Break In-FBI Investigation

2/05/2011 09:39:00 PM  , ,  

More and more we keep hearing about hackers getting into servers and websites and as this article states, motives can be varied.  The article from the Wall Street Journal states this has been going on for a year or so without being able to find the source of who or where the hacking is coming from. So far, no damage has been done and transactions and software compiled code is ok, so the algorithms that run imageeverything are fine.  What the invaders seemed to have an interest in were the communication files, used via a secured server program called “Directors Desk” as this is where high level email and communication takes place with only the elite higher ups being able to have access, about 10,000 individuals. The owner of Directors Desk is NASDAQ OMX so what I tell all is true, the get the best coders and tech folks in the world and pay well for them, and then they market their software to other companies for some bonus dollars here.

Does the SEC know about this software <grin>.   If they don’t here’s one more area of catch up for the agency and something to get on very quickly.  Maybe it’s time to call in some “white hats” from the “black hats” official hacking community.  The government is using them at Homeland Security.  It’s called the Defcon society and since this has gone to the White House too, he’s probably already in there. 

Homeland Security Appoints Black Hat Founder to Advisory Council

“It is a technological arms race in financial markets and the regulators are a bit caught unaware of how quickly the technology has evolved”

With the nature of shared on Directors Desk, the list of potential hackers could include foreign governments wanting corporate secrets or criminal hackers seeking access to confidential information for insider trading purposes.  Gee we are back to that topic again, “inside trading”.  I could certainly see a hacker looking around for information and not touching a thing as when you think about it, damaging any of the systems would in fact ruin their opportunities to trade if in fact they did secure any information.  Is this the next wikileaks <grin>. 

You can bet the  "Director’s Desk” software programmers are in the middle of this heated investigation for sure and for good reason they want to be there.  imageCompanies like SonoSite, a healthcare company use Director’s Desk.  Why?  Well when you are about ready to announce a new FDA approved product, you don’t want any top secret information out in the world until it’s time, insider trading potential again.  Here’s an example from a short while back of a new FDA approved product from 2009 and again no unauthorized information should be floating around out there and thus the need for software like Director’s Desk. 

SonoSite Introduces New Smaller FDA Approved Mobile Ultra Sound Device and Software

Hackers have repeatedly penetrated the computer network of the company that runs the Nasdaq Stock Market during the past year, and federal investigators are trying to identify the perpetrators and their purpose, according to people familiar with the matter.  I worry too about some of the other strange things they do with stock exchanges and high frequency servers, like over clocking their processors.  This is dangerous and ask a hospital CTO or CIO about over clocking processors and you would have to pick them up off the floor, as you don’t do it.  You can have a car that can go 100 mph but do you push it and run it as 125 mph all the time?   That’s what over clocking does and it brings up some real potential safety issues, like frying the brains or processors of the server if something goes wrong.

Gamers Are Not the Only Ones to Over Clock Processors-Turns Out It’s Done on Wall Street To Run Those Algorithms at Rocket Speed

It's very much algorithmic warfare, with no real thought given to collateral damage.

I still like to go back to the 2009 flash crash and think about what really may have occurred with exchanges at the time in the process of upgrading processors to new Xeons with a whole lot more cache and memory disambiguation and wonder if that did in fact blow out the load balancers on the servers as some still had slower speed chips, and delayed a server fail over, as all posted as the transactions too place when self healing took place.  Not many delve into the possible processor end of this but I did some training for Intel a while back and took advantage as best I could to read up on as much as I could as far as cores, the software on the chips and how they all came together at the time with the front side buses, and by today’s terms, much of that has changed and accelerated quite a bit, but the principles of the mechanisms are still there.  I did my speculating like all the other geeks out there and wrote up my thoughts back in 2009, link below. 

Was a Server Fail Over Taking Place on Wall Street During a “Perfect Storm” of Heavy Transactions?

One thing I have to say is thank goodness the exchanges don’t run 24/7 as the IT folks would be pulling their hair out without the time in between to do their maintenance and other software/hardware work.  Back on track here NASDAQ OMX might be fielding a number of inquiries now from their clients as well since it has now been established that hacking was possible.  Clients may wonder how safe is the software they created? 

In Los Angeles we had an intrusion that we watched kind of helplessly a couple years ago to where the internet comes in and they were seen and they came on and quietly went away, that was big and something that drew a lot attention.  Hackers today I don’t believe are in it for the glory so much as they were before as if they get caught, it’s right off to jail and by just looking around and gaining information , they can use it elsewhere and remain anonymous as this is what could have been occurring here.  Hackers write algorithms to get in to systems so there’s a good side and a dark side of computer code. 

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

We have an SEC that better get some serious ALGO MEN on hand and get in to the 20th century here if their regulation methodologies are going to be effective.  Perhaps regulation in some areas now may not look so bad and if the SEC in turn via upgraded technologies and audit trails has information to also stay on top of minding their business, all might be able to get along when it comes to wars on security an unauthorized access.  BD 

The exchange's trading platform—the part of the system that executes trades—wasn't compromised, these people said. However, it couldn't be determined which other parts of Nasdaq's computer network were accessed.Investigators are considering a range of possible motives, including unlawful financial gain, theft of trade secrets and a national-security threat designed to damage the exchange.

Hackers Penetrate Nasdaq's Computers - WSJ.com

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HHS Creates 'Most Wanted' List Website for Healthcare Fraud - Office of the Inspector General

2/05/2011 01:26:00 PM  ,  

This is pretty hot stuff and is updated as to when the folks on the list get captured.  imageThere’s even a place on the site where you can report information about any of those listed on the “Most Wanted List” for healthcare fraud.  To report one can either fill in the form on the website or call the hotline, toll-free, 1-888-476-4453.

I did some looking around and there’s all types on this list to include some former doctors who are apparently on the run.  The site also shows their reported accomplices along with pictures.  The rap sheets vary and some are those convicted of fraud that took off and are in hiding.  There’s quite a few from Florida and California has a few too. 

Here’s one example who happens to be a registered nurse:

“Along with her co-conspirators, Susan Bendigo, who was born in the Philippines, is accused in a Federal indictment of billing Medi‑Cal, California's Medicaid program, for $17.1 million, collecting $10 million, about half of which came from the claims she submitted for services she provided with unlicensed staff.

A registered nurse, Bendigo was director of nursing for a company that provided nurses for home health agencies. Investigators say that from May 2004 through May 2007, she sent unlicensed nurses to treat patients under Medi‑Cal, even though she knew that Medi‑Cal required licensed nurses to perform the work.”

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Fraud costs everyone money and this latest effort certainly can’t hurt at all.  Medicare has been such a huge target for fraud and with combined efforts through new technology from HHS to be able to analyze claims hopefully this will make a dent as the law enforcement agencies have made the biggest dent in this area.  Contractors don’t really have much incentive to fight fraud as they have subsidiaries that make profits from other areas of their entire operation.  In one such area the Office of the Inspector General found some big interest being made by holding Medicare funds over 45 days. 

Insurers Made $450 Million with Interest Income by Holding Medicare Funds for Around 46 Days Before Releasing Payment

Finally some business intelligence is coming to CMS and other areas of HHS, which has been longer needed.  This will help identify some of the claims that perhaps fall out of the normal parameters and cue them for a second look and law enforcement agencies will all have access as well and it will enrich the information they need to work their cases too with some algorithms to identify fraud.  BD

Medicare Federal Investigators Getting Algorithms to Analyze And Find Fraud-Good Move as Contractors Efforts Are Weak With Risking Loss Of Transaction Revenue

Office of Inspector General to Monitor Upgrade of CMS Computer and Data Systems and Stimulus Incentives for EHRs

WASHINGTON – Taking a cue from the FBI, the Health and Human Services Department has released an online list of its "Most Wanted" fugitives charged with committing healthcare fraud.

The Most Wanted Fugitives List is the government's latest attempt to focus public attention on individuals sought by authorities on charges of bilking federal healthcare programs and fleeing with the money.

The list includes photos and profiles of each featured fugitive, an online tip form and the Office of Inspector General hotline number to report information in either English or Spanish. The website will be updated if a fugitive is apprehended.

Government creates 'Most Wanted' list for healthcare fraud | Healthcare Finance News

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Hotmail Making It Simple and Easy to Create “Junker Email” Aliases

2/05/2011 12:36:00 PM  , ,  

By now everyone who is on the web is more than likely using a Junker email for one purpose or another.  This is cool with being able to add an “alias” so you can imageactually pre-sort an separate emails sent to the alias address.  As I read here you can have up to 5 aliases and when complete an individual will be able to have as many as 15. It’s pretty simple to add on and took me a couple of minutes to do. 

You can delete the alias too at any time, so when presented the screen, choose create a new email live address and you can add it on. One other item to think about too is to at least create a new folder and set up a sorting rule for all those emails containing that address to go to a separate folder.  You don’t have to do this but it will keep all such emails from entering into your main email box and makes it simpler to find the “alias mail”.  Also when providing an email address on the web, again you have everything in one place as we may not always want to use our good email address that we use for work and personal correspondence with web applications such as social networks.  BD 

Today, Hotmail is getting a new feature aimed at "e-mail enthusiasts," which lets anyone create multiple e-mail accounts that can be read, replied to, and managed from their everyday e-mail inbox. These additional e-mail addresses can be had in the same manner as signing up for new accounts, but they require no extra log-ins or upkeep.

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The solution Microsoft's Hotmail team came up with was to make use of some of its existing technologies like account sign-up, message filtering, and multiple e-mail address integration to give users these aliases within the same account. Each user can create up to five aliases, any of which can be deleted and replaced with another at any time. Over time, Microsoft will increase that limit to 15 aliases per account, making it so that the true heavy users won't need to juggle between two or more Hotmail accounts.

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The solution Microsoft's Hotmail team came up with was to make use of some of its existing technologies like account sign-up, message filtering, and multiple e-mail address integration to give users these aliases within the same account. Each user can create up to five aliases, any of which can be deleted and replaced with another at any time. Over time, Microsoft will increase that limit to 15 aliases per account, making it so that the true heavy users won't need to juggle between two or more Hotmail accounts.

Hotmail launches accounts you can throw away | Microsoft - CNET News

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'Cuckoo's Nest' Mental Hospital Discovers Cremated Remains of 3500 Patients In a Storage Room

2/05/2011 11:49:00 AM  ,  

Well all remember the hospital with Jack Nicholson in the movie “One Flew Over the imageCuckoo’s Nest”, that is if you are old enough, or there are several areas on the web where you can also probably find the movie.  The hospital soon will no longer be in use as patients are being moved to into Oregon's new 620-bed mental institution this month.  This is an old hospital going back to 1914 and the remains are said to be from that era up to the 1970s. 

The hospital is placing information on the website in hopes that everyone will be identified and all patient ashes can be delivered to their families.  So far there are only 4 canisters of cremated ashes that remain unidentified   Actually the discover was made back in 2004 and now the information and news of the find is now just getting out.  There’s plenty on the web about this hospital and actual abuses did take place and the reasoning behind the canisters being locked away is due to the fact that many years back were embarrassed by family members who were in mental hospitals and thus sadly they were forgotten.  BD 

A mental hospital in the US state of Oregon is trying to identify the cremated remains of 3,500 patients that were hidden in a storage room imagefor decades.

They were discovered in 2004 in what was called "the room for lost souls".

The hospital has published the names and birthdates of patients who died between 1917 and the 1970s online in an attempt to locate family members.

All but four canisters of the remains have been identified.

The hospital also came under fire in 2008 after authorities discovered mice, toxic paint, asbestos, outbreaks of scabies and pneumonia, and 400 patient-against-patient assaults in one year.

BBC News - 'Cuckoo's Nest' mental hospital finds unknown remains

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FDA Clears IPhone/IPad Application For Doctors and Hospitals to View and Exchange Medical Images- Mobile Health IT

2/05/2011 11:15:00 AM  , ,  

The FDA stated this is not a replacement for a full workstation but can be used imagewhen mobility is needed for patient care. As an example the physician can view and make a diagnosis at the bedside without having to leave the room and run back to a workstation.  The application is already available in 30 countries.  Mobile MIM has several services they offer to include server capabilities to connect to the hospital PACS system and operates both on Apple and PC systems.  It’s amazing as to what is being developed for the Ipad and recently a hospital in Israel is using a PC program to port applications to the Ipad which also brings imaging to the bedside.  We seem to have many choices out there developing quickly.  BD   

iPad Helping Hospital In Israel Treat Patients With Connecting via Chameleon to Run Their Windows Based Programs (Video)

A mobile medical-imaging application won approval from U.S. regulators imageto let doctors examine pictures from patient scans on Apple Inc.’s iPhone and iPad.

The technology, known as Mobile MIM, is the first portable- device application for common medical images cleared by the Food and Drug Administration, the agency said today in a statement. The uses are for computerized tomography, magnetic resonance imaging and positron imageemission tomography scans.

The application, made by closely held MIM Software Inc. in Cleveland, enables hospitals and doctors’ offices to send images to physicians’ mobile devices over a secure network. The software isn’t intended to replace full workstations, and should only be used when a doctor doesn’t have access to the larger equipment, the FDA said.

IPhone App for Doctors to View Medical Scans is First Cleared by U.S. FDA - Bloomberg

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eMix Medical Information Exchange Using Virtualization Via VMware To Securely Transfer Patient Data to EHRS and PHRs With PACS Image Company DR Systems

2/05/2011 09:53:00 AM  ,  

eMix is yet one more way to use a secure web based cloud product to exchange imagemedical records and their emphasis seems to be with medical images.  There are a few others who have entered this field of late.

The service reminds me of one that I used to send documents in a secure method via email called You Send it, which works well and I can set up expiration dates, etc. so the data is gone after a designated amount of time.  Basically with e-Mix you have the same type of scenario except with images you are talking about large files and it appears cloud services with virtualization is the technology that is utilized.  The service also has a pay per use model so you don’t pay until you use the service.  Sending images in this fashion certainly beats waiting for someone to burn a DVD to supply the information.  BD   

SAN DIEGO--(BUSINESS WIRE)--Behind the data center infrastructure of eMix™, the leading cloud computing service for sharing medical imaging studies and reports, is an alliance between the largest independent PACS company and the world’s leading virtualization and cloud infrastructure company.

“We are pleased to expand our partnership with eMix”

image

In developing this new electronic medical imaging exchange service, the eMix technology team selected an infrastructure solution from VMware. The choice was based on VMware’s ability to quickly deliver a comprehensive solution for cloud computing.

The result: Using VMware’s comprehensive portfolio cloud computing technologies, eMix accelerated the reliable delivery of its medical exam-sharing service. eMix also achieved greater infrastructure flexibility and lowered its IT, energy and real estate costs.

eMix Medical Info Exchange Built on VMware Virtualization Software | Business Wire

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Hospitals And Police Agency Budgets Battle Over Arrests When Suspects Need Medical Care-Unarrest and Re-arrest

2/05/2011 09:29:00 AM  ,  

We have yet one more battle of budgets with suspects or individuals being arrested needing medical care before they can be brought to a police station and we come back around to money.  Apparently at least in California, if someone who is arrestedimage needs care and the patient is “unarrested” during the hospital visit, then the police agency is not responsible for the bill at the hospital; however if they they continue to be legally arrested, then the bill goes to the police agency for the care of the arrested suspect.

This is happening at Scripps in San Diego and in 2010 they had this occurrence happen over 400 times, which depending on the care administered, becomes a big potential dollar item.  According to this article, the handcuffs are removed, the patient is treated while the police officers wait and then when care is finished, the suspect gets re-arrested. If the patient doesn’t have insurance then I guess the hospital has to go through other routes in order to collect.  I wonder how that would work if a conviction in court later is deemed and the patient serves time? It sounds like this is yet one more fine line in the healthcare system that has some open holes and you can see both sides of this one with the police agency not wanting to be a funding source for ER treatment, but on the other hand it puts the hospital in an odd spot too with uncertainty with payment at times.  BD

LA JOLLA - There's a growing problem facing local hospitals.

According to hospital administrators, law enforcement officers are letting go arrested suspects at emergency rooms; waiting for them to get better - - only to arrest them again.

Chris Van Gorder, CEO of Scripps Health sees more and more law enforcement officers dropping off injured or sick people they've just arrested at the hospital's doorstep.

Vna Gorder said, "I've seen police officers bring in a patient in handcuffs. Take the handcuffs off. Wait around till the emergency care was delivered then rearrests the patient, and take them to jail."

Hospitals See Growing Problem of Police Leaving People They've Just Arrested - San Diego 6

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Extormity Giving Away iPad for Most Compelling Case Study Of An EHR Vendor Annoyance/Frustration Story at HIMSS

2/04/2011 12:07:00 PM  , ,  

You have one week from today to get your entry in!  I like these folks as they make us all laugh at ourselves and bring us back to earth when it comes to electronic medical records.  We have had many in positions to where they see one side of the story only and sometimes forget about the end users, the doctors so in their humorous way they keep up on track.  They also said at HIMSS this year they will be uncovered so we will find out who they are, can’t wait for that!   Read the full press release below and there’s a link to submit your story and all names and vendors will be changed to protect both the innocent and the guilty.  By the way, I have to once more include their testimony video from a couple weeks ago, this is a riot!  BD

“You want a PHR…I’m entitled to one…my existence profits from stock

Seedie Testimony
options says Jack…I have that luxury….we use words like implementation fees, custom integration, software licensing as a way of defending our cost structure….I’d rather you just wrote me a check and went on your way (EMR Vendor speaking)…Jack has spoken.”

Extormity EHR Testimony at Health IT Hearing (Spoof-Video)

Press Release:

Recognizing that hundreds of Extormity Alert subscribers have experienced their share of expense, exasperation and exhaustion associated with an EHR implementation, Extormity is soliciting case studies from its followers.

“When people sign up for Extormity Alerts, they usually include comments indicating frustration with their EHR vendor,” stated Extormity imageCEO Brantley Whittington. “While we take great pride in over-promising and under-delivering, it appears that many of our competitors are taking a page from the Extormity playbook.”

“We are inviting our fans to submit their true-life encounters with these ne’er do well wannabes, and we will promptly replace the name of the offending vendor with Extormity so we can take credit for fostering disappointment while extracting our pound of CIO flesh,” added Whittington. “We plan to publish the most compelling case studies at extormity.com. The individual who submits the best entry will win an iPad, which is now the de-facto giveaway item for healthcare IT companies.”

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Extormity will announce the winner at a press event at the upcoming HIMSS11 conference in Orlando.

Click Here to submit your Extormity case study. All submissions due by Friday, February 11, 2011.

Extormity is an electronic health records mega-corporation dedicated to offering highly proprietary, difficult to customize and prohibitively expensive healthcare IT solutions. Our flagship product, the Extormity EMR Software Suite, was recently voted “Most Complex” by readers of a leading healthcare industry publication. Learn more at www.extormity.com

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Trademarkia Data Base Opens for Business- Trademarks, Business Intelligence Information-Algorithm To Search With Chatter From Social Networks

2/04/2011 10:39:00 AM  , ,  

This is very cool if you have trademarks or are wanting to file one for sure.  I can’t imagehelp but think in the pharma end of healthcare that Trademarkia will perhaps be used quite a bit.  All the trademarks issued in the US since 1870 claim to be listed.  I just went to the general page and they have a section for the “latest” trademarks and found one of my old clients in Irvine, California “Newport Scents” listed a recent file.  You get to see trademark images and all the additional information on file.

From the Website:

“Trademarkia is the largest search engine for U.S. trademarks. Each month hundreds of trademarks around the world are filed by licensed attorneys in the Trademarkia network! You can register your trademark in 55+ countries in the world through Trademarkia Network. Trademarkia.com is a free search engine of publicly available government records. Trademarkia.com is not a law firm and does not represent owners & correspondents listed on this page. “

Now take a look and see how the trademark is being discussed on social networks:

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You can also browse Trademarks by category:

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This gets even better if you need to file a trademark too as it has most countries listed to where you can use the site to file for a trademark and includes the US Patent and Trademark office.  What this tells me is that the filing of trademark stands to become more of an automated process too.  The fee listed for filling is $159.00 and they offer a 100% money back guarantee.  I put the healthcare spin on this but any industry can use it.  Again, I think if one was looking to establish a trademark this would be a good place to go and check out if there’s anything similar or already in place that might create some delays along the way.  There’s also a link to where you can view the latest trademarks filed through the system.  I look this to grow and be a very busy site for obvious reasons.  BD

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Trademarkia scans of all the marks and returns results in a visual grid that’s a lot easier to make sense of than the USPTO’s trademark database. You can search by company, theme, product category, or even filing attorney. Companies can also file a trademark with the U.S. Patent and Trademark Office through the site. And Trademarkia.com offers trademarked logo search that allows users to search inside millions logos for specific features or design elements

Trademark Database Trademarkia Debuts Automatic Activity Notifications

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UnitedHealth Group Sued-Class Action Lawsuit Relative to Purchase of HealthNet in Northeast-Post Auditing With Demands For Providers to Repay Reimbursements

2/04/2011 09:53:00 AM  ,  

The lawsuit has to do with the provisions of ERISA which is the grounds for the imageinsurance carrier demanding the providers repay what they were given.  Here’s a good example of “audit algorithms” and how they are used to get money.  The law suit states they are in violation of ERISA and that retroactive payment demands are not part of the game.  Remember this news making article relative to Wal Mart with ERISA where they were suing the woman who received care?  

“You may have heard the recent story about Wal-Mart suing an employee who suffered severe brain damage when her minivan was hit by a tractor-trailer.
Wal-Mart sought to recover $417,000 it paid for her medical care under its employee health plan. This $417,000 was money the woman desperately needed for life-sustaining nursing care. Due to substantial negative media coverage, Wal-Mart dropped its claim against the woman and dismissed its lawsuit.Under ERISA, an insurance company or HMO can deny coverage without penalty, even if that denial of coverage causes serious harm or even death.”

Healthcare reform has addressed some of these situations but apparently not to the imagepoint to where retroactive audits can still be done to demand payments to be returned in this case it’s the doctors they are going after versus the patients. This is just another “loophole” to where extensive business intelligence algorithms were produced to see if it could generate more profits and revenue, not good for consumers and doctors.  As the article states Untied is not alone and there are similar lawsuits against other insurers.  BD

Once more it’s all about those algorithms for profit. 

NEW YORK, Feb. 2, 2011 (GLOBE NEWSWIRE) -- Pomerantz Haudek Grossman & Gross LLP, one of the country's preeminent class action firms and a leader in combating the abuses of the health insurance industry, filed a class action lawsuit against UnitedHealth Group and Health Net of the Northeast, Inc. on behalf of a putative nationwide class of health care providers, as well as the Ohio State Chiropractic Association. United's acquisition of Health Net of the Northeast's health insurance business closed in December 2009, adding to United's status as the nation's largest private health plan by revenue. The suit challenges the Defendants' abusive practices in using post-payment audits and reviews, and improper repayment demands, to pressure providers to repay substantial sums that had previously been paid as health insurance benefits.
The action alleges that the post-payment audit and review process as applied by the Defendants violates the Employee Retirement Income Security Act of 1974 ("ERISA"), in that its repayment demands are retroactive determinations that particular services are not covered under the terms of the United and Health Net health care plans, but without proper appeal or other protections otherwise available under ERISA for both self-funded and fully insured health care plans offered through private employers.

"ERISA establishes the procedures that insurance companies must follow when making benefit determinations – whether prior to payment or retroactively," says Plaintiffs' counsel, D. Brian Hufford of Pomerantz. "The Defendants here, as is true for many insurance companies, are violating their ERISA obligations in order to recover funds that simply do not belong to them."

Pomerantz and Buttaci & Leardi have pending actions against a number of Blue Cross and Blue Shield entities, as well as Aetna, Inc., asserting similar claims.

Insurance News - UnitedHealth Group Sued

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Glow Caps from Vitality Purchased by Billionaire Investor–Pill Bottle With Compliance Data Trails Built In

2/04/2011 09:30:00 AM  , , ,  

Patrick Soon-Shiong M.D. is the Los Angeles billionaire investor who has scooped up the company.  Overall the product is a good thing as far as the reminder system and keep folks on track.  My only concerns is the privacy factors and the data that it creates for sale.  In today’s world of technology everything that is “good” and helpful seems to have a back door to money and this could prove to be in the same path.  A billionaire is not going to invest to make sure we take our pills, they invest to make money. 

Vitality and AT&T Selling Glow Caps Prescription Bottle on Amazon-Compliance Help and Also Creates Data for Sale

The concept of the pill bottle is good and can be helpful but the side of all of this are the profits that it creates for Health IT companies to sell your data.  It is what it is.  The Colbert Report did a funny video on the Glow Caps a while back too, funny. 

The Colbert Report Takes On Vitality GlowCaps (Video) – Check Out the Privacy Issues Here As Medication Data is Created That Can Be Sold To Health Insurance Companies For Use With Underwriting Algorithms

I am just a realist when it comes to data and try to keep all informed of where the imagedata goes and who uses and sells it for profit.  We all know compliance with taking medications is a priority and want the information used for that purpose and not to create data trails to be used somehow to perhaps deny a medical claim if one were lets say a couple hours late and ended up in the ER room with problems and this is a scenario that could develop. If the data trail showed that one was 2 hours late taking their medications, when the claim arrives for processing would that data trail be held against the patient?  Something to give some thought too as millions are made every day selling our medication data. 

Ingenix, a division of United Healthcare is one such group that makes big profit on selling your medication information for underwriting purposes and who knows what else as they are the bean counters and data arm of the company and this has been going on for years.  We need check and balances throughout our data systems and this is just something to be aware of and that use of such products create a trackable data trail of everything you do with interacting with the product so if you decide to use it, go in with your eyes wide open as there’s no HIPAA coverage here for privacy and HHS has tried many times to establish some rules and regulations here but to no avail so far.  The pill bottle has algorithms built in.  BD

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“HIPAA does not give the Department of Health and Human Services the ability to directly investigate or hold accountable entities, such as pharmacy benefit managers or companies such as Ingenix and Milliman, who are not covered by HIPAA.”

The Pill Bottle That Talks To Your Cell Phone, Creates Data Reports and More…

Vitality, which developed a wireless, Internet-connected pill bottle cap to remind patients to take their medication, has been acquired by Patrick Soon-Shiong M.D.  Soon-Shiong recently sold his second multi-billion dollar pharmaceutical company in three years and was already an investor in Vitality.

Vitality’s main product is the GlowCap, a pill cap with an embedded wireless chip which fits popular prescription bottles. The related home hub illuminates and plays a melody when it’s time to take the medication. If the bottle is not opened two hours after a scheduled dose, the user even gets a phone call reminding him to take his medication.

Wireless pill cap makers bought by pharma billionaire | VentureBeat

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First We Had Spray On Stem Cells and Now The Stem Cell Skin Gun for Wound Care Speeds Healing- Regenerative Medicine

2/04/2011 08:00:00 AM  , ,  

Regenerative medicine is moving so fast as it was just 2 months ago I posted about imagean up and coming trial to where a patient’s own stem cells from their bone marrow is being sprayed.  The video here shows a man who was burned quite badly and when you see how the skin looked in about 4 days, this amazing.  I think stem cells are the future for wound care by a long shot.  The healing process is not only good but the short amount of time it takes is amazing.image 

Spray On Stem Cells for Treating Burns and Open Wounds–Regenerative Medicine

The image at the right represents what the patient’s skin looked like before and the video shows what the condition is today.  The skin gun rocks!  I hope to see this get FDA approval quickly!  BD 

Explorer | How to Build a Beating Heart | Video | The Skin Gun | National Geographic Channel

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Anesthesia Drug Shortages, First It Was Propofol and now Pentothal–Choice #3 Is a Real Old Drug And Less Stable

2/02/2011 09:41:00 PM  ,  

Ok now we are coming full circle and hopefully by this time since November when I posted about the hotline created for propofol that has maybe evened out a little, but I wouldn’t hold my breath.  We do not make any propofol in the US any longer and in 2 years went from 2 companies in the US to zero.  Now the choice of drug #2 for anesthesia is having some political issues.  image

APP Pharmaceuticals Launching Drug Hotline in US–Check Status Of Fresenius Propoven (Propofol)-The Only US FDA Approved Drug

The drug is manufactured in Germany and sold here in the US by APP Pharmaceuticals.  As of today the website states the company is supplying 100 percent of the current market demand for propofol injections, but there seems to be a difference of opinions in the news.  In Phoenix all hospitals are working together to ensure those surgeries that doctors feel are the highest on the list for using this propofol get their supplies. This is a very strange shortage as some hospitals seem to be ok most of the time and others have not been able to get any for over a year or so. 

Teva To Stop Manufacturing Propofol – With No US Manufacturers Left FDA Approved Import From Europe

if you read on the web you can find a few sites where facilities are also talking about how they are sharing the supply.  Perhaps the market demand as it is called is filled, but how about actual orders where hospitals are waiting and having to share?   Pentothal is a bit of a political battle too as the ingredient needed to make it comes from Italy and they won’t supply it unless the US agrees not to use the drug to carry out death penalties. 

Italy will sell it to Hospira who can make the drug in the US only if the firm agreed not to use it as a death penalty drug and Britain has outright banned exports of sodium thiopental to the U.S. for the same reason.  Hospira said no more Pentothal.  BD  image

Choice # 3 below:

Some hospitals and dentists are now using a drug called etomidate. It is an older drug that works  but it is sometimes very painful going in. Anesthesiologists are not real happy with this drug because it is much harder to intubate or use this drug for conscious sedation or general anesthesia safely.  Many younger anesthesiologists have not been trained on using the drug as well.   So I guess until such time we either find another drug for death penalties or go back to the electric chair drug #2 is in short supply. 

This is really bad as we no longer in the US make the very most common 2 drugs that are used for surgical procedures day in and day out, and that includes dentists and veterinarians, so the pets don’t' benefit either.  BD

A death penalty drug shortage may potentially cause prisons to shut down the death penalty all together. Currently, Hospira, the main pharmaceutical company creating the drug Pentothal has halted all production of the drug because they do not have the sufficient ingredient, sodium thiopental, to make Pentothal.

In the hopes of starting production on sodium thiopental sooner, Hospira tried to get the ingredient from overseas. However, Italy will sell it to Hospira only if the firm agreed not to use it as a death penalty drug and Britain has outright banned exports of sodium thiopental to the U.S. for the same reason. Without this key ingredient, Hospira has now chosen not to make Pentothal at all.

Death Penalty Drug Shortage Causes Delays in... | Gather

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TSA Changing Software at Airport Scanners-New Images Look More Like Stickmen Instead of Medical Images

2/02/2011 04:34:00 PM  ,  

The first airport to try out the new software is Las Vegas.  imageAtlanta is another airport that will be testing and travelers can even see their images.  If you forget to take keys or whatever out you will be able to see the detection on the screen.  They look a lot better I must say and definitely are not as revealing and the images won’t be getting anyone excited any longer. 

Below is a reminder of what they look like now.  BD

Federal aviation officials are giving it another try. This time, they are not imagelooking as closely under travelers' clothes.

The Transportation Security Administration on Tuesday began testing a new, more modest body scanning system at three airports. They hope it will assuage critics' concerns that the nearly 500 full-body scanners at 78 airports reveal too much.

http://www.huffingtonpost.com/2011/02/02/tsa-body-scanners_n_817326.html?ir=Technology

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Aetna pulls Out of Individual Health Insurance Policies in Colorado as of August of 2012-Risk and Profit Algorithms At Work

2/02/2011 03:40:00 PM  ,  

Aetna began sending letters out this week so if you are an individual health insurance policy holder in Colorado, you have a little over a year left as policies will renew for one year only and August 1st of 2012 is the cut off date. 

Now the company will still offer employer provided insurance along with specific group policies i.e. a union provided policy, that’s where the big money is usually made.  When 2014 rolls around, Aetna will not be in any exchanged in the state and I wonder if this type of move will spread elsewhere with other carriers too?  Last month Aetna took out re-insurance in the Caymans for coverage in case of expenses that could be out of their control to pay claims, i.e. a natural disaster, etc. but I think they also thought that it would look good for investors too.   

Aetna Takes Out Reinsurance Deal In The Cayman Islands- $150 Million to Kick When Medical Loss Ratio Hits 104%

The company no doubt is using their business intelligence algorithms to zero down on where the profits will be.  BD

Aetna is pulling out of Colorado's individual health-insurance market, affecting 22,400 policyholders statewide.

The Hartford, Conn.-based insurance company sent a letter to Colorado agents saying it "could no longer meet the needs of its customers while remaining competitive in the individual health market."

The company began sending letters to policyholders on Tuesday notifying them of the change. Existing policies will renew for one more term, and the company will have no individual health policies in Colorado as of Aug. 1, 2012.

The change means less competition and likely higher premiums for customers, said Chris Davies of Choice Plus Insurance, 2629 Redwing Road, Fort Collins, who has about 100 Aetna policyholders.

Aetna was one of the lower-priced carriers, Davies said.

"They weren't dramatically lower but lower enough that people would go with them," she said.

Davies sent about 100 letters to her Aetna customers informing them of Aetna's decision.

The company will continue to offer large group, dental and life products, Aetna spokeswoman Anjie Coplin said in an e-mail to the Coloradoan.

Aetna pulls out of state's individual market | coloradoan.com | The Coloradoan

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Microsoft Delivers Encrypted E-mail Using Government “Direct Project” Security Protocols With HealthVault Personal Health Records

2/02/2011 11:02:00 AM  , , ,  

Something we have all been waiting for today is finally open for business, the “Direct Project” from the Office of the National Coordinator for Health IT.  You can read the official press release from the ONC Office here.  I have covered a bit of the progress here to a certain point as a preview of what was to come.  In the announcement Rhode Island and Minnesota are the first operating points to open.  There are a total of 29 Health IT vendors who have committed to coming online.  The Direct Project allows for sharing of clinical information via approved and secure standards.

Office of National Coordinator to Begin Real World Testing of NHIN–Clinical Information Exchange Between Healthcare Providers–The Next Step Beyond the Faximage

Ok, so now if you are a consumer this may not be too exciting but Microsoft at HealthVault has something for you with their work with Quest Diagnostics.  Also, I might make mention that the Medical Quack has over 300 posts on personal health records and you can either use the link above to review or simply use the 2nd search box via keyword to find additional information here.  The Direct Project is all part of the Nationwide Health Information Network..a short summary below. 

Nationwide Health Information Network (NHIN): Background & Scope

“The Nationwide Health Information Network (NHIN) is being developed to provide a secure, nationwide, interoperable health information infrastructure that will connect providers, consumers, and others involved in supporting health and healthcare. This critical part of the national health IT agenda will enable health information to follow the consumer, be available for clinical decision making, and imagesupport appropriate use of healthcare information beyond direct patient care so as to improve health.”

HealthVault, the personal health records from Microsoft will now be able to accept emails direct from providers.  Med Plus and Vision Share Inc. are they 2 key vendors and Med Plus is the technology arm of Quest Diagnostics.  Quest has also been busy with their individual efforts with mobile connections and expanding methodologies for access to lab results and aggregating information with medications for a even higher level of intelligence.   Back in 2009 I spoke with MedPlus about where their technology was moving.

Quest Diagnostics and Health IT – Interview with Rohit Nayak, Vice President of Sales, Clinical Information Solutions Group, MedPlus

You can read at the link below about aggregating lab and medication information below.

Quest Diagnostics and Surescripts To Integrate Lab and Prescription Algorithms To Improve Safety and Outcomes

Back on track here, providers will be able to email information to the patient’s HeatlhVault Account securely.  The Direct Project is a combination private-public effort.  When the patient receives the email with a HealthVault address created, the information is automatically saved to the patient’s record.  This is making it simple as everyone pretty much knows how to do email today and all you need is the patient email address that connects with HeatlhVault.  If you are attending HIMSS this year, Microsoft will be running a demo in their booth to show how it works. 

If you don’t have a HealthVault PHR, there’s always a link here to the site to make it easy for you to find it and get started.  HealthVault is spreading world wide and beyond the US and the link below talks about how Siemens is working with HealthVault in Germany. 

Microsoft HealthVault and Siemens Bringing PHR Platform to Germany – And a Look at a German HER

Besides all of the news today, Sean at HealthVault has promised that Kinect will someday entering the picture, record all your activity to HealthVault too on day, so if you are going to be the plane in World of Warcraft, you might as well see what your activity levels are and how much exercise you and your heart are drilling in to.  BD 

Could HealthVault Develop a Hack For Kinect Like World of Warcraft Has? (Video)

Press Release:

Interoperable e-mail messaging service launched with new version of Microsoft HealthVault enables physicians to share patient health information electronically.

REDMOND, Wash., Feb. 2, 2011 /PRNewswire/ -- During a Health & Human Services event in D.C. today, Microsoft Corp. announced new encrypted e-mail functionality for Microsoft HealthVault, which allows clinical partner solutions to send messages to patients based on security protocols set forth by the Office of the National Coordinator's (ONC's) Direct Project. Through this offering, every HealthVault record will be able to automatically accept mails directly from healthcare providers. Initial partners include MedPlus and VisionShare Inc., which have integrated the new service with their solutions to help clinical users secure messages they send to patients. The three companies are pioneering members of the Direct Project and will demonstrate the capabilities of their solutions in the Interoperability Showcase at the 2011 Annual HIMSS Conference & Exhibit (HIMSS 2011) as part of the Office of the National Coordinator's exhibit.

"The initial goal of the Direct Project is to specify a simple, secure, scalable, standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet," said Wes Rishel, vice president and distinguished analyst, Gartner. "It is exciting to see early, real-world examples of applications based on the Direct Project's security protocols emerging through the efforts of the private sector. Through public-private partnerships such as these we are starting to see the sharing of critical information across the health system."

Through this functionality, an encrypted copy of an individual's clinical information can be electronically transmitted to a patient's new e-mail address created within Microsoft HealthVault, where it is automatically saved to the patient's HealthVault account as part of their longitudinal personal health record. The service may be used to read or download the information. Direct Project messaging with security-enhanced technologies enables clinical solution providers to meet Phase One Meaningful Use requirements for the Medicaid EHR Incentive Program by providing patients with their health information, as well as proposed Phase Two requirements, which call for secure online patient messaging.

"Through the Direct Project, and our work with Microsoft HealthVault, Quest Diagnostics Care360™ EHR is providing the physician community with an effective way to transmit comprehensive clinical information directly to patients and to realize the financial incentives of achieving meaningful use," said Richard A. Mahoney, Quest Diagnostics vice president of Healthcare Information Solutions and president of its MedPlus healthcare information technology subsidiary. "With Care360 EHR, physicians can securely and easily collaborate and share information with the goal of improving patient care."

ONC's Direct Project says it benefits providers and patients by improving the direct transport of structured and unstructured health information, making it secure, fast, inexpensive, and, for some applications, interoperable. Using Direct Project addresses, a care provider can send and receive important clinical information, connecting to other stakeholders across the country.

"This service and our early partnerships are accelerating the ability for patients to become active participants in managing their health," said Sean Nolan, distinguished engineer and chief architect, Microsoft Health Solutions Group. "As one of the first examples of the Direct Project security protocols being utilized to meet Meaningful Use requirements, this interoperability is a step on the road map to the goal of expanding secure online interactions between physicians and patients."

Microsoft is also working with VisionShare, a leader in e-health connectivity, to advance the goals of the Direct Project. Both companies are participating in a Direct Project Pilot Implementation to demonstrate the feasibility of using the Direct Project communication protocols, security model and addressing mechanism to submit immunization data from providers into a state immunization information system with security-enhanced technologies. Information on the pilot, which began sending data on Jan. 12, will be available after the completion of the program.

Demonstrations of Microsoft HealthVault encrypted e-mail can be seen in scenarios presented by MedPlus and VisionShare at the Interoperability Showcase during HIMSS 2011 at the Orange County Convention Center in Orlando, Fla., Feb. 20–24.

About Microsoft in Health

Microsoft is committed to improving health around the world through software innovation. Over the past 13 years, Microsoft has steadily increased its investments in health, with a focus on addressing the challenges of health providers, health and social services organizations, payers, consumers and life sciences companies worldwide. Microsoft closely collaborates with a broad ecosystem of partners and develops its own powerful health solutions, such as Microsoft Amalga, Microsoft HealthVault, and a portfolio of identity and access management technologies acquired from Sentillion Inc. in 2010. Together, Microsoft and its industry partners are working to deliver health solutions for the way people aspire to work and live.

About Microsoft

Founded in 1975, Microsoft (Nasdaq: MSFT) is the worldwide leader in software, services and solutions that help people and businesses realize their full potential.

Microsoft Delivers Online Encrypted E-mail Using Direct Project Security Protocols -- REDMOND, Wash., Feb. 2, 2011 /PRNewswire/ --

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