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FDA Approves First First Wireless Remote Control Device for Back Pain Relief Using TENS Technology–One Device For Over the Counter and Pro Model To Be Available by Prescription–Hollywog

First off you have to kind of like this name as it’s not your typical name for a device company and actually it’s one you can somewhat imageremember as it stands out.  TENS units have been out for a number of years and I remember using one years back and they keep getting better.  The Wi-Touch devices that focus on back pain are exactly that, an improvement.  It has a wireless device to control the unit and it is small enough to wear under clothing.  The battery life is not bad either with 150 30 minute treatments before it needs a re-charge.  It also states that the coverage area is much larger and just looking at the images you do notice that and it has replaceable gel pads. 

The Wi-Touch will be available over the counter for a cost of $150.00 and the Pro version will need a prescription.  The company does manufacture and create standard TENS products as well.  Both the Pro and OTC versions of the product are wireless and it appears the Pro version has a bit higher output than the one over the counter.  This sure look like a treatment that can help to avoid taking a lot of pain medications for patients if their body reacts positively to the treatment.  I would guess that anyone who uses a TENS technology product would be a good candidate for this product.  Right now the company only has 7 employees and they plan to release additional products in the future geared towards pain management.  BD





Hollywog, a seven-person medical equipment startup on Amnicolaimage Highway, starts domestic distribution of its one-of-a-kind back pain relief product next week and will begin worldwide distribution in the next two months.

Government regulators approved the WiTouch and the WiTouch Pro earlier this week, and the devices soon will appear at chiropractor and physical therapy offices and independent drugstores.

The basic WiTouch, usable only on the lower back, will be available over the counter for less than $150. The WiTouch Pro is for use on the lower and upper back and will be covered by some insurance plans, but will require a prescription.  "For a small startup, we have probably the most experienced staff globally for product development and marketing," Thomas said. "I was real fortunate to be able to have them come work directly for Hollywog."

http://www.timesfreepress.com/news/2012/aug/25/chattanooga-companys-device-targets-back-pain/

SCAN Agrees to Pay $320 Million to Resolve Over Payment Allegations to California Medi-Cal Program–Billing and Audit Algorithms Busy Again Shifting Money Back and Forth…

This case was brought about by a whistle blower and goes back to records dating to 1985, a long time back.  California doesn’t get all the money though as the Feds get some too as this is a joint plan between California and the Feds.  As usual no admittance of wrong doing here imagewas admitted; however, the prosecutors didn’t find any wrong doing either so human error with input or the algorithms created this one as it was a coding error with reimbursing SCAN at the wrong levels, as if all patients were under the care of a nursing home which is a higher level.  The whistle blower though says the case was at the fault of SCAN and the case was filed in 2009. 

One more item worth mentioning here was the use of a 3rd party by SCAN that was involved with the billing codes.  So was this gaming the system in fact?  We don’t know for sure but someone will be looking at the algorithms and codes used for risk assessment you can bet.  Here we have yet one more case of the algorithms moving money back and forth.  Mayo Clinic just settled on of these types of cases, again a whistle blower and it’s worth a look too as Mayo refunded the money right away upon finding the error.  Some of the time invested in these cases going way back such as this are software generated. 

Mayo Clinic Agrees to Settle DOJ Legal Suit Dating Back to 2007 Under Whistleblower Provisions–One More Example of Algorithms Shifting Money in Healthcare As Cost of the Lawsuit Had to Far Exceed the End Results With Time and Money–A Waste

I said myself that the Mayo case was a big waste of time to keep it moving as once they saw the error they refunded the money but the legal part of it keeps moving on and on.  I can see where a big case of “real fraud” is definitely worth pursuing for obvious reasons but how many “coding” suits will keep appearing and shifting money?    Again it’s the involvement of the 3rd parties that sell their analytics and coding software based on the promise that they can cut expenditures and save money as well as not leave any money laying on the table at the same time, and the latter is where the coding comes in. 

Bad Algorithms in Healthcare Payment Systems and Risk Assessments–Did the Hospital Bill Fraudulently or Were They Sold Formulas That Did Not Conform

So one does have to wonder as to how much time will be spent on using algorithms and coding errors to keep shifting money back and forth and back and forth?  There will be more forthcoming you can bet and SCAN will look to see where they have opportunities to replace lost revenue as that’s the way business functions today, healthcare or otherwise.  Maybe SCAN will find a little more profitable data to sell?  Who knows.  BD



A Long Beach health plan agreed to pay $320 million to resolve allegations that it was overpaid by the state's Medi-Cal program going back to 1985, government officials said.

Federal officials called the settlement from SCAN Health Plan the largest of its kind from a single provider in Medi-Cal, the state's Medicaid program for the poor and disabled. 


Separately, the United States attorney's office in Los Angeles said SCAN paid an additional $3.8 million to settle a whistle-blower's allegation that the nonprofit company was overpaid by Medicare because of withholding of information about patients' diagnosis codes. 

Medi-Cal is a joint state-federal program. Under the settlement announced Thursday, California will receive $190.5 million and the federal government will get $129.4 million.

http://www.latimes.com/business/la-fi-medi-cal-settlement-20120824,0,4746289.story

Bavarian Nordic In Denmark At Risk of Having to Fire 100s of Workers if the US Doesn’t Place Order for Smallpox Vaccine by January

Normally the order is received around June of every year and HHS soimage far this year has not placed the order.  The vaccine, called Immune is 95% of the company revenue.  There are other vaccines produced that are also a single treatment but vaccines from other companies are not necessarily safe for individuals with compromised immune systems and thus this is where the drug comes in to play.  Again this is the only company that makes the vaccine for those at risk and without an order it could run out of money and go away and we don’t want that.  Other sources of funding I’m sure would also be entertained as well.  BD

imageBy looking at the pipeline you can see there are also some oncology drugs such as the one in trials for prostate cancer as vaccine.  BD




Bavarian Nordic A/S (BAVA)
, the largest vaccine maker in Denmark, will need to fire hundreds of workers and shut down a factory if it doesn’t receive an order for a smallpox vaccine from the U.S. government by January, the company’s chief executive officer said

Bavarian Nordic relies on the vaccine, called Imvamune, for 95 imagepercent of its revenue, said Anders Hedegaard, CEO of the Kvistgaard, Denmark-based biotechnology firm. It was awarded a $500 million U.S. health contract for 20 million doses in 2007. Without the new order, the impact on the company “would be dramatic,” he said. The firm already has begun firing workers and scaling down production.

While government laboratories in the U.S. and Russia hold the only known samples of smallpox, federal agencies stockpile the vaccine amid concerns about bioterrorism. The virus is ranked as one of the greatest potential threats to public health because of its high mortality rate and capacity to spread, according to the Centers for Disease Control and Prevention.

http://www.bloomberg.com/news/2012-08-21/bavarian-nordic-at-risk-as-u-s-weighs-smallpox-order.html

I’ll Take My Licorice Unleaded Please, FDA Alert American Licorice Company Recalling Black Licorice Twists–Discard and Do Not Eat

I love this licorice and hopefully I am not poisoned as I ate a bunch imageof it a couple weeks ago so I assume I’m fine.  The candy has elevated levels of lead and I am curious as to how it got there.  Lead poisoning is hard to detect.   At any rate, don’t eat the stuff and wait until a new batch comes out.  Where’s those bar codes I say to identify them?  Maybe one of these days we might get there.  BD



American Licorice Company is recalling the 16 oz. bags of Red Vines Black Licorice Twists. The recall is due to the discovery of elevated levels of lead contained in the licorice. The one pound bags are affected by this recall. American Licorice is notifying consumers and customers to discard this product and to not consume.

Lead poisoning can be hard to detect — even people who seem healthy can have high blood levels of lead. Signs and symptoms usually don't appear until dangerous amounts have accumulated.

Pregnant women and those with children who may have consumed this candy should consult with their physician or health care provider. This may help determine whether further medical testing is required. For more information about lead poisoning contact your local childhood lead poisoning prevention program or local public health department.

For further questions regarding this product contact American Licorice Consumer Support at 886-442-2783 for further information.

http://www.examiner.com/article/fda-health-hazard-alert-recall-on-black-licorice

State of Louisiana Rejects United Healthcare’s Protest Over Awarding Blue Cross/Blue Shield Contract To Manage State Employee Health Insurance–Battle of the Insurance Algorithms Continues..

Here we go again with contract disputes.  United said they were cheaper and have better costing algorithms.  They can appeal to the insurance commissioner as a next step so it’s wait and see time here with this aware.  Of course this is not as big as the Tri-Care contract to where United sued to get that contract.  So what will they do next if the appeal is not successful, sue?  A few months ago the company hired the former Assistant Attorney General of Minnesota as general counsel so were they anticipating lawsuits over contract disputes?  Actually with the Tri-Care contract it appears that the loss by the Blue Cross subsidiary Tri-West is going to put them out of business in April when United takes over and who knows what subsidiaries of the subsidiary Tri-West United could gobble up and buy between now and then. 

Update: UnitedHealthcare Sues Department of Defense Over Tri-Care Contracts–They Said They Would Do This – Is This A Case Of My Algorithms Are Better Than Yours?

Actually when it comes to contracts United uses their formulas and algorithms for cost to go to battle with and not that the others don’t, they have more of them with the huge daisy chains of companies they have bought and started over the last few years.  As a matter of fact United hired the former HHS executive credited for writing most of the Healthcare reform law and so now he’s a VP at the United Healthcare Optum division.  I kind of look at it this way when someone goes over to the other side today and the same holds true for investment banks is that they all want the information as to what was and is going on with the other side, in this case the government.  By the way United also does own a bank speaking on that topic with over a billion on deposit.

US Health Insurance Regulator Leaving to Take a Job at UnitedHealth Care As Vice President of the Optum Division – Moving to the “For Profit Side” With Business Intelligence Algorithm Dollars To Review


Is this company getting a little too big?  Good question with all the diversified entities they own as they can almost get a cut of healthcare transactions everywhere you turn today as if it’s not analytics it’s from the HMOs and IPAs they bought.  They seem to attack  the competition with their code, algorithms and analytics used and again remember these folks are traded on the stock markets so shareholders, even as the CEO said are of utmost importance, so hopefully patients might fit in here too?  No doubt by getting big contracts as such it allows for subsidiaries to make money and prosper and put more money on the United Corporate bottom line.  
 

United HealthCare Awards Contract to One Blue Cross/Blue Shield Subsidiary to Process Tri-Care Claims While The Other BlueCross BlueShield Company Lost the Over All Tri-Care Bid To United In the West

United has subsidiaries that sell electronic medical records too, I think about 3 of them so they are in that business as well as HIE.  Theoretically if the company and subsidiaries were successful in each avenue of getting a drug to market they could handle it from the beginning with the introduction to the FDA via consulting services all the way down to reimbursement.  So you do wonder at times as you know they maximize their use of data if the data runs between subsidiaries to give leads to other parts of the conglomerate to rush in for a sale?  An example would be contract cuts for doctors and then another division could rush in to sell them software to be more efficient..think that happens out there?   They also just created a new clearinghouse subsidiary to work with Epic medical records. 

 

Subsidiary Watch-Corporate Conglomerate Insurers Reduce Compensation Contracts Using One Subsidiary Then Market Same MDs With Another Subsidiary in Health IT


United Healthcare Preparing to Roll Out New Contracts To Pay Doctors& Hospitals For Meeting Goals and Keeping Costs Down– Plenty of Subsidiaries to Provide Some of the Technology And/Or Products & Generate Income–Subsidiary Watch

So I guess we wait and see if this #37 million dollars worth of business is worth an appeal or maybe yet a lawsuit substantiating they have better algorithms to get the contract.  In Texas Blue Cross is protesting the award to United for the Texas Employee Retirement benefits and it left participants with little or not out of network services with United. The two companies duked it out in Nebraska and I believe it was in Kansas that Blue Cross gave up competing due to the low ball rates proposed by United.  Anyway in some areas where they protest and sue it seems they are getting contracts and one wonders is this fair?  It sure is happening quite frequently today and there’s other examples around but these are the most noticeable at State levels.  BD




BATON ROUGE, La. — The state Office of Group Benefits has rejected United Healthcare's protest concerning the hiring of Blue Cross and Blue Shield of Louisiana to manage state employee health insurance plans. 

United Healthcare's next remedy is to file an appeal with Commissioner of Administration Paul Rainwater, who is Gov. Bobby Jindal's chief budget adviser.

United Healthcare, Blue Cross and Blue Shield, and Humana submitted proposals earlier this year to serve as administrator of state health plans covering more than 200,000 people.

A panel of state officials opted to hire Blue Cross and Blue Shield of Louisiana. The company stands to receive $37.8 million a year.

United Healthcare objected to losing the contract, citing a flawed analysis, objectionable scoring and an alleged favoritism shown Blue Cross and Blue Shield.
http://www.therepublic.com/view/story/c60809fd9a3147ccab6490f121be47d3/LA--Insurance-Flap

Johnson and Johnson Synthes Division Recalls Bone Putty As Product Could Catch on Fire During Surgery

Well J and J didn’t get a break with recalls and this is their new division that was purchased last year, Synthes.  Occasionally there are fires in surgery but we don’t need a product that could contribute and thus the recall and this is a class one so all need to stop using the product immediately. 


Johnson & Johnson Agrees to By Synthes $21.3 Billion

If you go back in history a few years with Synthes they had their subsidiary company Norian where four executives were charged with unlawful clinical trials and this too was a cement issue to where it reacted with blood to cause clots.  I have no idea if this is the same product or not.  BD

At Norian Four Executives Charged in Connection With Unlawful Clinical Trials – 3 Patients Died on the Operating Table

 

The Food and Drug Administration said Johnson & Johnson (JNJ) unit Synthes last month initiated a recall on certain lots of bone putty, saying the medical product could catch fire during surgery.

The FDA gave the recall a Class I designation, its most serious type of recall.

The regulator said Synthes in early July issued a medical device recall letter, asking medical facilities to examine their inventories and immediately stop using specific lots of the putty. The product, called a hemostatic bone putty, is used to stop bone bleeding by creating a physical barrier along the edges of bones that have been damaged by trauma or cut during surgery.

http://www.foxbusiness.com/news/2012/08/21/fda-jj-unit-recalls-potentially-flammable-bone-putty/

President of Ireland With Scathing Critique of US Healthcare System Video–In the US Its All About the Algorithms for Profit–Time for New Leadership With Technology Backgrounds at HHS and at the SEC

The president of Ireland spent some time in the US and this is interesting to hear someone on the outside looking in.  Yup we have very imagepathetic Congress that is so digitally illiterate they can’t see what’s going on either to create better laws.  The head of HHS and SEC by today’s standards are both way over their heads and we need Executives here that have some technology in their background too.  Nothing personal and I like that fact that they are women here, but step aside before things deteriorate more  and leave with a good reputation because the battle is getting worse and it’s a battle of technology in both areas.  We don’t have time for extra briefings, etc. just watch the news every day and we see how far behind we are.  Hillary Clinton’s job is different as her job is diplomacy and human ethics so she’s right where she belongs.  In areas like the SEC and HHS, people with a law degree no longer fit the bill, it’s the hybrids that understand law and can do some area of technology.  So now listen to this video and see what you think..



Also there’s worse problems of digital illiterates in Congress…the news this week was full of it…in more areas than one as consumers we don’t have much of a chance with folks sitting in denial for sure. 

Here We Go Again–Digital Illiteracy With Lawmakers & Those Running for Office–Back to the “Default” Topic of Women’s Health With A Need to Control Something When the Intellect Is Not There…Akin


Here’s a good video on that topic and I guess we need the counter part video at this point on “How idiots shape our world” you think?   Either that or maybe I should be writing about “The Attack of the Digital Illiterates?  (by the way you can find this video front stage on every page of this blog if you scroll a little)  BD


It’s the Attack of the Killer Algorithms that whipping our government in huge lashes at at time.  BD

Attack of the Killer Algorithms–Digest & Links for 35 Chapters–on How Math and Crafty Formulas Today Running on Servers 24/7 Make Life Impacting Decisions About You–Updated 6-24-2012


A two-year old debate between Irish President Michael D. Higgins and conservative broadcaster Michael Graham has found a new lease on life on the Internet and is approaching 500,000 views on YouTube. Give it a listen, and you will understand why:

Higgins' passionate oratory is irresistible, regardless of where you stand on the Affordable Care Act.

"A social floor below which people would not fall, that is the future," he proclaims. "Even the poorest people in the great country that is the United States should be entitled to basic healthcare."

http://www.mddionline.com/article/election/irish-president-critiques-healthcare

Former Executives of ArthroCare Charged With Defrauding Investors by Inflating Revenue and Creating False Shipments and Orders to Meet Wall Street Forecasts

Boy did I see a bunch of this in my past lifetime.  I used to deal imagewith logistics managers who got so frustrated on orders shipped the last day of the month that were not “real” and then they would have the expense of the return of the products once they were refused, so the logistics department paid for this as well.  All of this activity was done to meet the Wall Street forecasts but all of this comes back to bite eventually.  Sometimes if companies are not doing this the use of “blind” shipments can create more areas of unknowns as well with finding true points of origin.  Back in my days as a sale rep these double route shipments did add a few dollars for meeting quota but never enough to where it really mattered as any kind of a dollar maker for sure. 

More Candy From China – Are “Blind” Bills of Lading adding to the confusion and delay in locating the products for recall?


As a side note, being I used to write code I often ponder how much medical software sometimes gets out there ahead of it’s time with devices too, as you can see that device recalls involving software lead the list and what really goes on to meet those Wall Street forecasts?   Some of it might kill you one day with malfunctions.  Part of this is just the business but folks do anything to meet those forecasts at time.  The distributors in this case were paid to accept shipments to show orders of course and they could return the product, just like I stated above as I used to see this a lot.  The consumer electronics business is good for this stuff too.   Shareholders in this case are reported to have lost more than $400 million.  BD


   

AUSTIN (CN) - Two former executives of medical device maker Arthrocare were arrested Wednesday and charged with defrauding investors of more than $400 million, federal prosecutors said.

John Raffle, a former senior vice president of strategic business units, and David Applegate, a former senior vice president of ArthroCare's spine division, were arrested Wednesday morning, Raffle in Morristown, N.J., and Applegate in Orange County, Calif.

The indictment, unsealed Wednesday, claims the men and other senior executives and employees inflated ArthroCare's revenue through several of end-of-quarter transactions involving its distributors, from December 2005 to December 2008.

"Raffle, Applegate, and others then allegedly caused ArthroCare to 'park' millions of dollars worth of ArthroCare's medical devices at its distributors at the end of each relevant quarter. ArthroCare would then report these shipments as sales in its quarterly and annual filings at the time of the shipment, enabling the company to meet or exceed internal and external earnings forecasts."    Shareholders sued Arthrocare and its executives in July 2008, after the company restated its earnings.

http://www.courthousenews.com/2012/08/23/49563.htm

NIH Hospital Used Gene Sequencing (DNA) to Stalk and Identify Deadly Strain of Klebsiella Pneumonia Where 11 Patient Died With Hospital Acquired Infections

The infection began with a patient that was transferred from a New York hospital that had a history of drug resistant infections imageand the infection was linked to three other patients as it spread, even though in an isolation area.  The NIH hospital of course is the model for which other hospitals in the US and world for that matter.  Klebsiella bacteria are a leading cause of infection and can spread through ventilators, catheters and in this case it was found that the bacteria was spread even from sink drains and plumbers took out and replaced the drain pipes.  This is pretty scary in essence to think that plumbing even had to be replaced to get rid of the bacteria. 

Part of the hospital was sectioned off and strict hand washing policies and other policies were established.  To identify the strain, a study with sequencing the strains was performed on 18 samples and this allowed the hospital to follow the route of the infections and determine which patients have the infections upon arrival and which patients end up with the infection with being acquired at the facility.  A total of 11 patients died from the bacteria and six survived.  Researchers were also able to tell which patients actually died from the bacteria and which died from other complications combined with the bacterial infection.  Six patients died from the infection itself and this is amazing that sequencing allowed the identification of the bacteria’s footprint.   

This case is even scarier than MRSA in the fact that if Colistin doesn’t work which is the last straw to use with such infections, there’s nothing left to treat patients with.  The rooms were even blasted by a robot with vapors of Hydrogen peroxide.  If you have not see how this works, the link below has a video that shows how a robot works to disinfect the patient rooms.  The bacteria is evidently pretty resistant as it was found on a ventilator that had been bleached twice. 


Hospital Robot Blasts Bacteria With One UV Swoop to Disinfect Rooms And All the Contents


In essence, one item here somewhat states that in addition to normal bacteria fighting policies, will DNA sequencing become part of the future at hospitals to identify and track such infections?  With this strain of bacteria it certainly sounds like it and where will the money come from? Hospitals with imagea few exceptions across the US are cash strapped and after reading this even someone who is not in healthcare can appreciate the efforts of the investigation and as with all research it will improve and get better.  Also, how about nursing homes which are also known to have issued with bacterial infections.  Every patient now is screened at the NIH facility who is transferred from another facility for super bugs and now this one should be on the list for mandated reports too with CDC. 

Again, this is a stop and think for reporting and responding to hospital acquired infections, especially with this case of having to literally rip out plumbing to eradicate it and it could happen anywhere.  The New York hospital that transferred the patient who brought the infection to the facility was not identified but you can bet after this information and research was made available that they too did a vigorous investigation to ensure that it was no longer living there as well.  BD 



Researchers unraveled a medical mystery that left six patients dead last year at the National Institutes of Health's elite research hospital, demonstrating that gene sequencing can help in the fight against hospital-acquired infections.

The NIH researchers' sleuth work—they stalked a deadly strain of antibiotic-resistant Klebsiella pneumonia through 18 patients at the agency's 243-bed Clinical Center in Bethesda, Md.—was detailed in a study published online Wednesday by Science Translational Medicine. The scientists sequenced the genes of the microbial invader to reveal its exact path from patient to patient until the deadly outbreak was contained in December.

The outbreak began on June 13, 2011, when a 43-year-old female patient with a history of multiple drug-resistant infections was transferred from a New York City hospital. Although the patient was admitted into an isolation area, the Klebsiella colony she had brought with her into the hospital soon leapt to at least three other patients. The NIH did not identify the New York hospital.

At the NIH's Clinical Center, researchers began sequencing the bacteria specimens in mid-August after three patients displayed symptoms. They determined that the third patient to become infected had actually acquired the bacteria from the original New York patient while both were being treated in the ICU, before passing it on to the second patient who showed symptoms.

The researchers determined that the bug was also spreading from sink drains, based on the genetic trail, possibly by splashing upward as people washed their hands. "We didn't test this possibility—we just had the plumbers take out the drain pipes," Dr. Segre said in an email.

http://online.wsj.com/article/SB10000872396390444812704577605473262312862.html

Two Health Insurance Executives in Florida Arrested & Face 13 Felony Charges for Concealing Insolvency of the Firm

In December of 2011, Medicare terminated it’s contract imagewith the firm. The company was based in Tampa, Florida.  Medicare found at this time that they had insufficient funds to assure payment of claims and losses.  The plan has 10,000 members and they all returned to the original Medicare plan. 
Humana picked up the prescription plan with Florida Wal-Mart Preferred which they run and administrate and this action with criminal charges is a result of what happened at the end of last year.  The charges state that the two executives used false or misleading statements and concealed a $5 million dollar asset on a loan from Herald National Bank in New York.  The company was liquidated by the courts in December.  This is interesting to see the involvement of the bank here as well and how did they get that loan could be a good question.  BD



Two executives from a Tampa health insurance company have been accused of intentionally filing misleading information with the state to cover the firm’s fiscal instability.
Sabiha Haider Khan, 37, and Nazeer Haider Khan, 40, executives of Tampa-based Quality Health Plans, Inc., were arrested in Leon County, having filed the paperwork with the Florida Office of Insurance Regulation.
Both face 13 counts felony charges.
“When insurance companies choose not to play by the rules they put their policyholders and all Floridians at risk for their own personal gain,” Florida Chief Financial Officer Jeff Atwater stated in a release. “I am proud of the diligent efforts of our fraud investigators and the work of OIR in holding companies accountable for their actions and protecting the citizens of Florida.”
The investigation was handled by the Florida Department of Financial Services’ Division of Insurance Fraud.

http://www.sunshinestatenews.com/blog/jeff-atwater-two-health-insurance-executives-concealed-insolvency

Medical Records Sold for Profit From ER Room In Florida Hospital–FBI Makes Arrest -Time License & Quarterly Excise Tax Banks, Companies, Etc. Who Sell Data & Give Law Enforcement A Leg To Stand On

Look how long this took, ok with licensing and exciseimage taxing “any” data seller..law enforcement would have had grounds here, “selling data without a license” so this is really beginning to make sense as well as the ability to generate huge tax funds, maybe even bigger than taxing the rich!  The pot here is huge and companies are at all time profit highs because of this as there’s little overhead and some analytics are pretty useless and just written to sell data that they get for free, to make a buck.

Congress To Investigate the Data Sellers - Need To Create a Law to Tax Them As The Algorithms Used For This Business Generate Billions of Dollars, Partly Why Corporate Profits Are So High - Remove the Medical Device Tax as They Produce Needed Jobs/Tangibles

Data mining leads to spun data in many areas and it hurts consumers as we are now getting credible data combined with non credible data and crunching numbers is fine but when you do something like FICO sells on the medication compliance analytics they sell, we have mismatched data as this is the perfect example of credible with non credible information being combined.  How do you combine such intelligence and then turn around and score people individually from zero to 500 and sell that analyzed data to insurance and drug companies as being credible?  It hurts consumers as we don’t have enough folks out there that know how to work with “flawed data” and take everything they see on the computer screen to the bank?  There’s the big part of the insanity today and when a naïve novice looks at such numbers a patient may get denied access to medications.  Duh? 

Back on this story line, again the FBI would have had grounds to hold a suspect on selling data if the US required a license to do so.  It was good that audit trails showed the time stamps of access and that helps a lot.  All the patients that were in car accidents were solicited and one finally reported it.  The last line here is a bit of a joke saying the hospital was not able to participate due to HIPAA rules. 

So far we know of one source who paid for the medical records, but a good question to ask might be, were there others?  Again if there were licenses required to sell data, this case probably would have moved along a lot quicker.  We do need the data sellers who get their data (legal data) for nothing and their profits for free start kicking in some tax revenue soon.  If you read where Walgreens made short of $800 million on their SEC statement in 2010, think of how much in billions in out there to tax when you add everyone else in.   What is even a little more shaking with privacy was the post I made prior to this one…Walgreens giving access to all the medical records from their retail clinics to all the retail drug store locations, scary is it not?   What if a less than honest pharmacist wanted to make some extra cash?  It may not be the same scenario of course, but we are forgetting patient privacy and permissions and Sebelius is asleep at the wheel.   

Walgreens Expands Take Care EHR Medical Records to be Available at All Drug Store Locations for Reference–Not For Me I’d Rather Use My PHR And Choose What I Want To Share…

We had the cases of the auto refill algorithm making it difficult for consumers here too when pharmacists set them up at CVS and this too brought up patient permission as they were quite shocked when they returned to their normal pharmacy and were asked to pay $600 as the other pharmacy had already charged the insurance company before they ever got a chance to even pick up the prescription.  Again with the EMR data floating out there, what next with the world of connected algorithms for consumers?  The prescription situation was noted by several that patient permission would solve that issue too. BD 

The Automatic Prescription Refill Algorithm Causing Havoc at CVS When Not Personally Authorized By the Patient–Attack of the Killer Algorithms Chapter 40




The FBI has arrested a former employee of Florida Hospital's Celebration Health in Celebration, charging him with accessing 760,000 emergency department (ED) records over two years and selling some of them to someone who solicited for attorneys and chiropractors.

According to coverage by WFTV in Orlando, the FBI conducted a 10-month investigation and now alleges that Dale Munroe, who registered patients in the ED, primarily accessed records of patients who were in an automobile accident from several hospitals across the state.

The hospital has not posted a statement on the case on its website and, according to WFTV, the local authorities of Osceola County said they were not able to make arrests because the hospital did not cooperate with the investigation, citing federal HIPPA laws. 

http://www.cmio.net/index.php?option=com_articles&view=article&id=34934:records-sold-for-profit-in-florida-hospital-scheme

Walgreens Expands Take Care EHR Medical Records to be Available at All Drug Store Locations for Reference–Not For Me I’d Rather Use My PHR And Choose What I Want To Share…

The medical records system used at Walgreens retailimage clinics is provided by Greenway Medical and now in addition to the clinics access will be available in all retail stores and I’m guessing this is for the benefit of the pharmacists to consult with consumers.  Walgreens is going the mile here to connect all the data they can in various areas.  From a couple months ago you can see where you can get text messages as to what may be on sale outside of the pharmacy area when you enter a store.



Walgreens Using Social Networks to Send Ads To Mobile Phones for Promotional Sale Items When You Check In at the Store –Will Sperm Check Make the List?


If you have also watched the news of late then you may remember the purchase of Boots pharmacies in the UK with an option for full ownership in 3 years and Walgreens also owns  USA Drug, Super D Drug and May’s Drug through another purchase after the Boots deal.  It’s a good thing I guess that Walgreens and Express Scripts also finally made up along the line. 

Walgreens is Making Another Purchase From LaFrance Holdings To Include USA Drug, Super D Drug and May’s Drug Stores Located in the US Southeast

I am guessing this will work with with the incentives for pharmacists who in some areas can earn pay for performance with United Healthcare when signing up consumers for the YMCA and other programs as the pharmacist will be able to see even more information, again I am assuming that this is where the reasoning for the expansion lies. So along with additional information the pharmacist would appear to have additional access and maybe the P4P from United would kick in?   The EHR system is called Well Health.

UnitedHealthCare To Use Data Mining Algorithms On Claim Data To Look For Those At “Risk” of Developing Diabetes – Walgreens and the YMCA Benefit With Pay for Performance Dollars to Promote and Supply The Tools


United Healthcare Expanding Diabetes Prevention & Predictive Algorithm Program With Walgreens And Pay for Performance Incentives In Atlanta

For my own personal view in watching the data and merging of all the big healthcare concerns for right now I think I’ll stay clear of Walgreens when I can as again I like privacy and would prefer my medical records to be discussed with my doctor.  Granted a pharmacist can be a great ally and have a lot of information to offer but again, I don’t want this right now, and that is again my personal choice and it kind of bugs me with all the pay for performance issues here to be in the potential position of beingimage “hawked” for all these services as they seem to have more value to me when I make my own choices and I’m not having a pharmacists pushing it on me.  Been there and done that with refills at Walgreens and the auto refills and frankly in addition to filling my prescription from the other side of the coin, how much more are you going to throw at the pharmacist too I ask?  If all of this is too much to absorb, good news here is that more Walgreens stores are selling spirits too, so grab a bottle on your way with with your prescription <grin>.  So far Walgreens doesn’t scan alcohol like Target does I think, more data for sale with that effort. 

Walgreens Applying For and Getting Liquor Licenses Across the US – Be Healthy and Get Your Alcohol Here Too

This might be some nice extra Health IT revenue for Greenway though since they held their big IPO in February and need to show stockholders some progress and sales material?
 

Greenway Medical Records IPO–Videos and Pictures at NYSE Getting Old as Hospitals and Doctors Struggle for Income And Close


You know what I would rather have my PHR with me as you can put your medications in there and share with a pharmacists too and this way if I decide to share, they have more than just the Walgreens records.  So for me, not big news and I wonder if this is really necessary.  We all know that Walgreens makes millions selling prescription and other data too and in 2010 they made just short of $800 million so I wonder if they hit billion dollar mark in 2011?  If you read here often enough you know what I say about the data sellers, banks, businesses, and so forth…excise tax them as they get their data for nothing and profits for free.  That was Chapter 17 of the Attack of the Killer Algorithm series and there’s a few more posts around her on this topic.  So again, what’s the competitor here CVS going to do with Allscripts?  I guess we wait and see.  BD

Start Licensing and Taxing the Data Sellers of the Internet Making Billions of Profit Dollars Mining “Free Taxpayer Data”–Attack of the Killer Algorithms Chapter 17 - “Occupy Algorithms”– Help Stop Inequality in the US


Walgreens will implement a customized electronic health record system from Greenway Medical Technologies in its nearly 8,000 pharmacies to better track all health services provided in the facilities. 

The EHR is called WellHealth and Walgreens already uses the vendor’s PrimeSuite EHR in its Take Care convenient care clinics in more than 700 pharmacies.

Now, WellHealth will coordinate other care in the pharmacies, as well as Take Care services, including medication records, immunizations and health tests, regardless of the Walgreens location where services were rendered.

http://www.healthdatamanagement.com/news/walgreens-ehr-electronic-health-records-greenway-44878-1.html?ET=healthdatamanagement:e2792:120588a:&st=email&utm_source=editorial&utm_medium=email&utm_campaign=HDM_Daily_082212

Kindred Healthcare Buys Private Equity Held IntegraCare Holdings for $71 Million

Last year Kindred purchased RehabCare and now we have another company purchased that offers state of the art care for seniors, assisted senior living so making money off retirement continues to grow for investors.  In particular the website focuses on centers where those with Alzheimer's can live as well as regular nursing homes.  Maybe is this better to have a hospital run these types of facilities?  Could be as nursing homes run by PE firms has drawn a lot of fire and attention over the last few years.  At any rate some PE folks are cashing in here.  BD 

Kindred Healthcare To Acquire RehabCare for $900 Million Creating the Largest Post Acute Care Conglomerate in the US

Kindred has revenues of $6 billion annually.  BD


From the website:

”At June 30, 2012, Kindred through its subsidiaries provided healthcare services in 2,154 locations, including 118 long-term acute care hospitals, six inpatient rehabilitation hospitals, 224 nursing and rehabilitation centers, 27 sub-acute units, 52 hospice and home care locations, 102 inpatient rehabilitation units (hospital-based) and a contract rehabilitation services business, RehabCare, which served 1,625 non-affiliated facilities”



Hospital operator Kindred Healthcare Inc. will buy privately held IntegraCare Holdings Inc. for $71 million in cash to expand its home health and hospice business in Texas, Reuters wrote Tuesdayimage. IntegraCare’s current owner private equity firm Flexpoint Ford LLC could earn an additional $4 million in cash based on the company’s 2013 earnings.

(Reuters) – Hospital operator Kindred Healthcare Inc (KND.N) will buy privately held IntegraCare Holdings Inc for $71 million in cash to expand its home health and hospice business in Texas.

IntegraCare’s current owner private equity firm Flexpoint Ford LLC could earn an additional $4 million in cash based on the company’s 2013 earnings.

http://www.pehub.com/163373/reuters-kindred-healthcare-pays-71m-integracare/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+pehub%2Fnews%2Fall+%28PEHub+News%29

Here We Go Again–Digital Illiteracy With Lawmakers & Those Running for Office–Back to the “Default” Topic of Women’s Health With A Need to Control Something When the Intellect Is Not There…Akin

I guess it’s time once more to address the “digital illiteracy” and lack of focus of lawmakers and those running for office once more with the latest frick and frack routine with the latest news.  It’s the big white elephant in the living room and once more stirs up a lot of debate.  Oh it is getting so tiresome listening to such as this is just psychology gone whacked out for lack of a better way to say it.  Sure we have an apology but did he really mean it?  I think he really believed what he said.  Trouble is that when you converse with crowds that have the same stands, you start believing what is “not real” and this was loud and clear and again makes for big news rating.  Ho hum, just one more digital illiterate that keeps the world and lawmakers from focusing on what is important.  If he slipped once on this topic, what’s to stop him from doing it again and what we heard was what he feels and the public apology doesn’t mean much.  Time to get out of the race and let someone with some real intelligence get in there. 

I have many posts here on this topic and it’s a dog and pony show for the most part and the attack on women’s health is ridiculous and makes the US in our political world look kind of stupid to other countries.  I guess these folks have not come up to the real world yet to where this stuff is viewed as just plain out stupid.  Here’s a back post that was done here in May of 2011, so again been a focus here for a long time and the tech folks on the web see this with the “default” topic coming back into the limelight every time they need “something” to take a stand on, well this it dated folks so find another one.

Digital Illiteracy Still Plagues Law Makers–Severe Focus on Abortion Rights Proves It–Is This Where Our Lawmaking Knowledge Leaves Off or Even Begins? Scary…

 

Fact is that lawmakers need to step up to the plate and use some of the same business intelligence that corporate companies use as they are being buried in the dirt and sadly at the same time, they bury us with them as we suffer.  They don’t get that servers running 24/7 programmed with queries and algorithms are running the country based on what parameters are entered by those who write code.  They couldn’t even recognize a tool for modeling new laws when it was presented to them and thought IBM Watson was just for game shows…well maybe Washington is nothing but that today, a game show. 

IBM Watson Capabilities Being Pitched to Financial Industry-Congress Must Not Have Felt They Needed This So Further Behind We Fall With Effective Intelligent Lawmaking


So IBM did what any company would do and looked at another market, like Wall Street and look who’s using the technology to create more algorithms to use formulas to get more of your money.  Algorithms move money an that’s what happened over the years and the big mortgage scam could not have happened without those algos.  So while this side show continues Citibank will be using some new technology for some new algorithms and queries to figure out how to get more of your money..Algorithms are written for “desired” results and some actually get written to deliver “accurate” results but the two are not always the same..looks at who’s got the money..done by automation with queries and algorithms…

IBM Watson Going to Work At Citigroup on Wall Street–Congress Didn’t See Big Data As A Tool (Hadoop Framework) When They Had Their Chance…For Consumers The Attack of the Killer Algorithms–Chapter 22


Actually the above link was part of my ongoing series called “The Attack of the Killer Algorithms” and if you scroll down on this page there’s a couple videos and links to all Chapters. I would also like to thank all of those folks who are searching Killer Algorithms with search agents today too as it helps get the word out and educate consumers as to how this all works behind the scenes.  Also, when it comes to an answer for taxes, excise tax the data sellers and again the lawmakers are so tied up in women’s health they can’t seem to get to this point to where it’s a pot of gold for revenue.  Companies make billions doing this with getting their data for nothing and the profits for free.  Time to tax it is this process is built in to doing business every where you look and that excise tax on tires kind of irks me every time I have to pay it when I see corporate America on this free ride due to digital illiteracy.

Start Licensing and Taxing the Data Sellers of the Internet Making Billions of Profit Dollars Mining “Free Taxpayer Data”–Attack of the Killer Algorithms Chapter 17 - “Occupy Algorithms”– Help Stop Inequality in the US

Here’s a good video on that topic and I guess we need the counter part video at this point on “How idiots shape our world” you think?   Either that or maybe I should be writing about “The Attack of the Digital Illiterates?  (by the way you can find this video front stage on every page of this blog if you scroll a little)



I am just so tired of flat out stupidity and the dog and pony shows that go nowhere with lawmakers that hang on to emotional issues like this as it does nothing to help the US economy and gets more ridiculous every day.  Like I mentioned above you get folks talking things up that are maybe pretty far removed from the truth and it’s an old psychological game that thinking minds play on each other, “well if Joe wrote and said it’s true, it must be true” and then when they expose this to the rest of the world who knows better, they crash and burn.  It’s called the old “building teams” concept and there’s nothing wrong with that as long as it’s the truth and not a fragmented belief that is far from the truth

Heck I want to ask now “is this guy bi-polar”  <grin>.  We have enough issues without too many “bi-polar” type rhetorics in there trying to make laws as you can see the results of what appears to be “bi-polar lawmaking”.
  I said this to make a point and this is not an attack at all on mental illness, but maybe a call to action to see if this does exist with some lawmakers, you think?  What is the “mental health” of our lawmakers, inquiring minds want to know:) 

Now for my idea below, here’s a better topic that desperately needs attention and is a way to generate tax revenue from banks and corporations that reeling in the money in off the backs of US consumers and nobody’s minding this show and we all suffer because all of this is over their heads…digital illiterates.  Corporations and banks have to just love this distraction with women’s health issues as they can keep working in the background and make more money.  



Take notice is this is your hard lesson today on the the reality of what is happening with digital illiterate lawmakers and those running for office.  BD  
 

“Devaluate the Algorithm” And “Tax the Data Sellers”–A Cure for Both Healthcare and an Economy Based Heavily on Intangibles–We’ve Lost Our Balance



Republican leadership has a not so-subtle-hint for Todd Akin: They would like the Missouri Senate candidate, who remarked that “legitimate rape” rarely results in pregnancy, out of the race — and sooner rather than later. The National Republican Senatorial Committee has pulled $5 million in ads and multiple senators have demanded he step down.

“Congressman Akin’s statements were wrong, offensive, and indefensible,”NRSC chair Sen. John Cornyn (R-Tex.) said, offering a not-so-subtle suggestion that Akin step aside. ”Over the next 24 hours, Congressman Akin should carefully consider what is best for him,”

Sen. Ron Johnson (R-Wis.) was more to the point in a Monday morning tweet: “Todd Akin’s statements are reprehensible and inexcusable. He should step aside today for the good of the nation.”

http://www.washingtonpost.com/blogs/ezra-klein/wp/2012/08/21/in-akins-remarks-a-clash-between-pro-life-politics-and-principles/

Allscripts Turns to Microsoft To Expand Their Application Development

If you remember back at the end of the first quarter Allscripts was under the gun a bit with not having their two integrated systems ready to go to market and the task is huge.  I think one thing that was learned from the show down was that people now know that it takes time and a lot of code to integrate two pretty massive systems and a warning for marketing not to get ahead of itself with sales projections.  That’s a real spot to be in as shareholders want the latest updates and you want it to be good to keep money rolling in.  This makes sense to work with Microsoft since there’s a lot of their technologies already used within the systems. 


Class Action Lawsuit Filed Against Allscripts For Misleading Investors With Merging Data Systems–Too Much Code and Not Enough Time – Attack of the Killer Algorithms Chapter 30

If you go back to 2010 you can read about the Eclipsys and Microsoft Amalga integration which is part of the new integrated systems to go into the Allscripts system, so I am guessing too that the integrated system is going to have components of Amalga in there as well for the intelligence type reporting.  The NHS uses Amalga Healthcare integration services too. 

Eclipsys and Microsoft To Integrate Sunrise Enterprise Suite With Amalga Unified Intelligence System

In addition Microsoft’s CRM program will be rolled in here for healthcare which has been around since at least 2008.  Centricity from GE at one point also made a statement that they were also going to roll in Microsoft Dynamics and it’s a very good CRM system.  I remember the early days when it got started and it grew better with time.

In addition, American Well video conferencing and doctor consults is also on slate to begin a pilot program.  I look back to the Mysis days and this has been one big roll of software and integration in constant motion for sure and the system will be ready for Windows 8.  BD



Allscripts is moving on several fronts to expand the number and types of applications from outside developers that the company can integrate with its electronic health record (EHR) software.

Last week, the EHR vendor announced an agreement with Microsoft to expand Allscripts' application developer program. Allscripts also recently struck a deal with American Well to integrate the latter's telehealth technology into its EHR products.

Under the Microsoft pact, the two companies are working together to encourage software firms--including developers in the Microsoft community--to create applications for Allscripts in the new Windows 8 operating system. Noting that "much of our open platform is built using Microsoft technology," Allscripts CEO Glen Tullman told InformationWeek Healthcare, "We want to be in synch with Microsoft as they announce Windows 8 and invest a very substantial amount to get it used and integrated in the developer community. We're riding some of that wave, because we want all our developers to take advantage of that."

http://www.informationweek.com/healthcare/electronic-medical-records/allscripts-aims-to-ride-windows-8-apps-w/240005841

Steward Healthcare Signs Letter to Acquire More Catholic Hospitals–Mercy Health System of Maine

Steward is the hospital management company owned by Private Equity Firm Cerberus Capital Management which purchased several Catholic hospitals in Massachusetts and now it appears they are looking at 2 more community hospitals to add to their ownership and 11 urgent care centers.  As this has moved along they created their own insurance plan too.  The plan, administered through Tenet Health Plans, is called Steward Community Choice.

Steward Healthcare Outlines New Insurance Plan Called the Community Choice Plan Limiting Most Care to Their Owned Hospitals

Steward purchased on other hospital in the area in Rhode Island, Landmark but the deal is not complete yet and conditions are still being negotiated.  Landmark didn’t have a ton of options. 

Blue Cross Sues Financially Stressed Landmark Hospital in Rhode Island-Court To Determine New Owner in April


Pushing forward with its plans to expand out of state, Steward Health Care System LLC, which has amassed a chain of 10 community hospitals in Massachusetts, signed a letter of intent to buy financially struggling Mercy Health System of Maine from a Catholic hospital group.

The letter, which does not spell out financial terms, gives Boston-based Steward exclusive rights to negotiate with Mercy’s owner, Catholic Hospital East, a Pennsylvania-based network of 35 hospitals and other health care facilities operating in 11 states from Maine to Florida.

Toward that end, the parties would sign an agreement committing Steward to maintaining the Catholic church’s ethical and religious health care directives, including a prohibition on abortions. A similar pact was signed with Catholic authorities in Massachusetts when Steward acquired the six Caritas hospitals.

http://www.boston.com/businessupdates/2012/08/20/steward-health-care-system-moves-buy-mercy-hospital-portland-maine/oucj4WoYp4030I5qc0kt0M/story.html

US Health Panel Suggests Making HIV Testing/Screening Standard Practice–Public Comment Section Coming Soon-Let’s Make the Process Simple

This is a heated topic for sure and when you look at the doctor’s side of this as one MD commented, there’s a lot of counseling and imageadvising that goes along with the process, especially if the test were to show a positive result.  Doctors are already maxed out in so many areas and again this would add for a much longer consult time and the old 99213 consult for a positive result is not going to cut it for the reimbursement time.  As mentioned, the FDA has approved the OraQuick test which is expected to sell for around $60 for a consumer to do an over the counter test.  One wonders is this the correct route to go to home test first and then go see the doctor?  Obviously all who would use a home test would need to be plugged in to a resource to where free initial counseling and advice would be given to get the consumer on the right track to include urging making an appointment to see your doctor. 

Now let’s look at another aspect of the over the counter test.  $60 is not huge, but how many would purchase a product to self test at this price?  That answer remains with the consumer of course and with current economic times that could be tough.  If you look at the OraQuick test it takes 2 full minutes of swabbing and if not done correctly, the test could be compromised as well.  Right now it’s the only thing out there but what if the process were less expensive and easier?  I do some consulting work for a company named LifeSaver that is in the process of getting a much simpler test to market and it would cost somewhere around $13 or so for a test and 2 minute results versus 20-40 minutes.  Would this help? 


If a blood panel is drawn at a doctor’s office then you have to wait as usual for the results to come back from the lab.  Corporate labs do a ton of these tests all the time and of late I am hearing about a lot of discrepancies with what is orders and what is returned is not being the same and of course that costs time and money.  Better yet, why not work with the blood banks across the US and define a better methodology to screen for HIV, Hepatitis and other diseases?  It would save them money as well as some FDA millions of dollars that they get fined as well every year it seems.   

FDA Sends Warning Letter to Community Blood Centers of Florida For Not Meeting Guidelines–One Violation States It Takes 87 Days to Notify a Donor They Tested Positive for HIV–Better Solution Here


It appears that the consumer OTC role has been defined with the FDA approval so let’s make it simpler and easier for the consumer.  Take a look at LifeSaver Products here and see what you think about a 2 second tongue swipe and results in 2 minutes…and $13 versus $60 for the one HIV test.  For a little more cost with the same 2 minute results, multiple tests can be done on one Stik, up to 7 and again even though the price of the Stik goes up it would still be way below blood screenings for each test by far and again, 2 minute results. 


If this is in fact the direction we are going, for goodness sakes let’s make the process simple and get the resources lined up for consumers and providers so we have a system we can work with and get accurate screenings done. 

LifeSaver’s Saliva-based HIV Stik® Advantages

  • LifeSaver has simple, easy-to-use instructions featuring a (+) or (-) sign that virtually anyone can understand.
  • LifeSaver has a faster collection rate (seconds vs. 2 full minutes for OraQuick).
  • A small amount of saliva is all that is necessary As easy as licking a stamp
  • LifeSaver has a faster read time (2 minutes vs. OraQuick 20- 40 minutes).
  • LifeSaver is $7.00 vs. OraQuick $17.50 to health care professionals.
  • LifeSaver guarantees accurate results with a 2 year shelf life.

The LifeSaver Stik® technology will revolutionize the antiquated immunoassay testing methods being used around the world today, and in turn, become a leader in the global healthcare industry.  The company still needs a few more investors to get this on the road and you can read more about investor opportunities and distributorships here.  When it comes time for public commenting be sure to voice your opinion on how you want a simple process with the necessary resources available on what to do if a positive result is shown.  Education is the only way to move this forward and get treatment to those in need.  Also take note that many other screenings could be handled with the same technology.  BD



(Reuters) - A U.S. health panel may soon make HIV testing as standard a practice as checking cholesterol levels, a move that would fundamentally change how the virus is detected and treated.

The U.S. Preventive Services Task force, a government-backed group of clinicians and scientists, is expected to make a new recommendation on HIV screening available for public comment before the end of the year

Under President Barack Obama's healthcare law, passed in 2010, insurers are required to cover preventive services that are recommended by the task force.

While the task force doesn't factor cost into its considerations, the CDC and other healthcare providers do. Researchers at Stanford University estimate that over a 20-year period, expanding HIV testing to the general U.S. population would reach $27 billion dollars.

The U.S. Food and Drug Administration recently approved the first over-the-counter, self-administered HIV test from OraSure Technologies, which is expected to sell for $60. A positive result would require follow-up at a doctor's office

LeFevre, a primary care doctor in Missouri, cautions that the barriers to testing go beyond the rating of a single agency.

"I can't think of another blood test in all of my practice that carries that baggage," he says of the pre-test consent, counseling, and post-test follow-up that HIV screening requires.

http://www.reuters.com/article/2012/08/19/us-usa-health-hiv-idUSBRE87I04J20120819?feedType=RSS&feedName=healthNews&utm_source=dlvr.it&utm_medium=twitter

California Attorney General Suing Los Angeles Doctor For Refusing to Accept Lower Insurance Payments and Balance Billing Patients for Full Amounts

This is scary story if all in fact here is true about the practice of the doctor.  We all know that doctors reimbursement contracts keep getting lowerimage and lower all the time and there are tons of articles on this blog to substantiate but perhaps refusing the insurer’s payments and billing patients was going just a little too far.  She worked in an emergency room and was allowed to bill for the amounts not covered by insurance payments.  Here in the OC we have a ton of complications with insurance companies buying physician's groups.  One day this big surge of subsidiaries with insurers may come back to bite as the algorithms and contracts are getting beyond workability of many. 

Health Insurance Contracts at the OC Corral–Lawsuits, an ACO and A Lot of Mixed Up and Confused Patients As Data Disruption and Patient Care Move Center Stage…

With all the subsidiaries today that can and perhaps do connect data it would not be out of the question to see this type of activity with one entity of a conglomerate reducing compensation and then notifying another to run in and sell them software, or what ever the fix could entertain and create profits for another insurance subsidiary. 

Subsidiary Watch-Corporate Conglomerate Insurers Reduce Compensation Contracts Using One Subsidiary Then Market Same MDs With Another Subsidiary in Health IT


She also has her license at stake and this is unfortunate as obviously if the contracts were correct and ones she could work with I don’t think this would have occurred.  She was pretty aggressive and filed liens and lawsuits against many patients and that’s a little out there.  Sounds like the doctor had a pretty aggressive attorney at work for her as well.  The lawsuit is to recover damages and pay back the patients.  BD



LOS ANGELES — The California attorney general's office is suing a Los Angeles County doctor over her practice of refusing to accept lower insurance company reimbursements and instead billing patients for the full amount.

The lawsuit against South Pasadena physician Jeannette Martello is the first of its kind in the state, the Los Angeles Times reported Saturday.

The California Medical Board is also moving to revoke Martello's license over the same issue, known as "balance billing," which is illegal.

Selesnick said that even though Martello was treating patients in the emergency room, the patients were in stable condition. Because it was not emergency treatment, she was allowed to bill them for the amount insurance companies would not cover, he told the Times.

In that case, Martello sent back a $3,500 insurance check and then sued patient Bill Buck, his wife and his business for the full amount.

http://www.utsandiego.com/news/2012/aug/18/calif-sues-doctor-over-aggressive-billing-tactics/

E-Scoring Credit Algorithms Invisible To Consumers Used to Market and Evaluate, Does Not Fall Under Federal Law And Such Are Used by Insurance Companies - How Will This Work With Exchanges –Attack of the Killer Algorithms Chapter 42

This is a good question as we have states debating and some setting up health insurance exchanges.  E-scoring as noted here does not fall under federal law so they can buy and sell data and use it to market as well.  Ever wonder why you get some solicitations at times either in the mail or online?  What if an insurance company is using such “scoring”?  If there are exchanges set up, what good does it do to help those who are no insured with some bad credit rating information as those are the folks struggling to make a come back and obviously they are the crowd the healthcare reform law is trying to help.  If e-scoring is used to determine how to sell and market them with credit scoring sources outside the normal federally approved sources, what’s this going to do? 

The founder of one such company made $89 million when he sold RiskWise analytics to LexisNexis and then used that money to start eBureau.  See how this type of business builds on itself with the algorithms for analytics use and it works behind the scenes to where nobody knows. 

Obviously federal laws are outdated here it appears.  As a consumer, you don’t even know the information is being collected and reported on you, not nice.  In addition, you have no idea as to what “score” has been generated either so again an error that shows up here can also have the ability to black ball consumers, especially those who are trying to recover.  Interestingly enough I found this tweet on the Ebureau Twitter site.  Is this coming to a hospital near you?  If nothing else if states that hospitals are on the list as targets. 

imageRecently in the news the question of why the HCA hospital chain is so profitable…do they use services as such?  Might be good question to ponder?

How is HCA a For Profit Hospital Chain, Making All That Money–Billing in the ER a Contributing Factor for Reimbursements–The Algorithms Move Money and Created Some Very Large Profits And Others Generated ER Care Parameters for the Facilities


You know also one might ponder how this comes into play with re-admissions and the search for the perfect algorithm there?  Do companies search for risk in this fashion when re-admitting patients?  It’s certainly there to buy and write queries to use it that way.  I’m a realist with data and queries can be written at any time and used so again I am posing this question as everyone today is addicted to analytics of one form or another.  A lot of analytics are great and do a lot of good but when we start looking at encroaching into ethics areas for the sake of a bunch of algorithms and profits, it’s time to take a deep breath and look at what we are really doing.  Is the doctor doing the readmitting being presented with some fashion of this type of information?  If not now is this on the “data agenda”?  The algorithms of healthcare are way beyond what our Congress understands today and again since credit reporting as eBureau is invisible, the minds of Congress seem to be invisible as well

Medicare Re-Admissions Penalties–Algorithms Keep Money Shifting and Make It Difficult for Realistic Budgets to be Met Along With Good Patient Care–Algos Keep the Money Moving In One Direction or Another

One other item to keep in mind too is look at the millions and billions of dollars the data sellers make and I’ll repeat my one example of Walgreens in 2010 who made just short of $800 million selling data only, so how big is this pool of profits…huge!  This is exactly why these folks need to be charged an excise tax for starters.  This is a nasty business for the consumer as if they are not excluded by one algorithm, another algorithm will put them on a “hot” market list and bug the crap out them.  It’s back to the old “cherry picking” here and pretty soon the numbers of cherries are going to disappoint as the queries become more complex and more data is mined.


Back in February Chapter 17 of my Attack of the Killer Algorithms addressed this idea..this is also why we have a slow down with manufacturing in the US as companies just go out and mine and sell data with hiring a few geeks rather than build factories as there’s little overhead by comparison and very few employees needed, and again there’s no government regulation here.  So what Congress is going to do with this complex matter remains a mystery as they seem to be stuck on the “default” topic of abortions. 

Start Licensing and Taxing the Data Sellers of the Internet Making Billions of Profit Dollars Mining “Free Taxpayer Data”–Attack of the Killer Algorithms Chapter 17 - “Occupy Algorithms”– Help Stop Inequality in the US


They always come back to women’s health issues when complexities go beyond their comprehension or what they want to deal with.  All you have to do is look at some of the ridiculous laws that get prime attention today, in the news all the time. 

Congress To Investigate the Data Sellers - Need To Create a Law to Tax Them As The Algorithms Used For This Business Generate Billions of Dollars, Partly Why Corporate Profits Are So High - Remove the Medical Device Tax as They Produce Needed Jobs/Tangibles


We can go a step further here as well and talk about how much of the data agencies as such are collecting that is flawed.  Why”  Companies and people lie, make data input errors and use formulas to make money and then create studies to substantiate the selling of the analytics, flawed data and all.  FICO does a good job of “algo duping” with their medication compliance analytics. 

”Hey dude let’s crunch some numbers and see if we can come up with some analytics to sell”

Data mining leads to spun data in many areas and it hurts consumers as we are now getting credible data combined with non credible data and crunching numbers is fine but when you do something like FICO sells on the medication compliance analytics they sell, we have mismatched data as this is the perfect example of credible with non credible information being combined.  How do you combine such intelligence and then turn around and score people individually from zero to 500 and sell that analyzed data to insurance and drug companies as being credible?  It hurts consumers as we don’t have enough folks out there that know how to work with “flawed data” and take everything they see on the computer screen to the bank?  There’s the big part of the insanity today and when a naïve novice looks at such numbers a patient may get denied access to medications.  Duh? 

Ok so coming back around here let’s talk about selling health insurance exchanges…how’s this going to work.  Again we won’t know imagewhat companies are using such analytics and how will they be used to cherry pick and deny applicants and “algo dupe the consumer and government”.  It’s an algorithm game.  Health insurance exchanges will fail if credit companies as such are not brought under Federal Law as the algorithm scoring games will flow.  Right now this doesn’t speak well for HHS director Sebelius with her own former state where she was governor returning federal funds for insurance exchanges.  Do you think they might know something in Kansas about how some of this works?  This is why I keep saying we need someone in charge at HHS with some data knowledge so they can think on their feet quickly as figurehead executives are becoming a thing of the past.  
Nothing personal here but big business has figurehead executives by the “algorithm balls” and they have not figured this out yet nor even speak about it as they just don’t get it. 

So again this is something to look at before things are finalized as for sure this is yet one more unintended consequence that will occurimage if nobody addresses it and will make the insurance exchange business nothing but a zoo and disappointment for consumers.  Again it is the Attack of the Killer Algorithms and it appears that we have a Congress that has no clue on how to “model” laws that will work.  If you don’t look at every angle of a law and how it will play out, this is what you get, the battle of the algos on consumers.  Again these types of agencies should be regulated under federal control and they should pay to be licensed and assessed big excise taxes and I think about this as a consumer when I have to pay an excise tax to buy a tire.  Tax the intangibles that companies use today for big profits and give the consumers and the companies making tangibles that we need to live a break!   

Big Data, Flawed Data, Business Intelligence, Where’s The Future and What Has Been Our Past…A World With ”Algo Duping” of Society and Consumers

So again with health insurance exchanges, who’s going to complete this cycle and fix the laws?  Once again the intelligence at corporate levels is ahead of the game and consumers lose as the algorithms work for profit and move money and not only can the consumer not see the analytics being used, they are not told either, so game on for the complexities of insurance exchanges that will end up being a burden to administrate as the algorithms for shareholders and profits will rule again as the government tech departments are asleep at the wheel and on top of that missing out on a huge amount of tax revenue they could generate and give the consumer a break.  Companies may pay $8 for an insurance lead and up to $35 for a financial lead and $75 for a mortgage prospect so you are for sale in  more ways than one and look at the money and profits made. It’s all about the cherry picking marketing business that is algorithmically combined with risk assessment for the spin. 

Intangible data mining companies that sell data are not people – most are algorithms for profit.  BD 




So here’s a new score to obsess about: the e-score, an online calculation that is assuming an increasingly important, and controversial, role in e-commerce.

These digital scores, known broadly as consumer valuation or buying-power scores, measure our potential value as customers. What’s your e-score? You’ll probably never know. That’s because they are largely invisible to the public. But they are highly valuable to companies that want — or in some cases, don’t want — to have you as their customer.

Online consumer scores are calculated by a handful of start-ups, as well as a few financial services stalwarts, that specialize in the flourishing field of predictive consumer analytics. It is a Google-esque business, one fueled by almost unimaginable amounts of data and powered by complex computer algorithms. The result is a private, digital ranking of American society unlike anything that has come before.

It’s true that credit scores, based on personal credit reports, have been around for decades. And direct marketing companies have long ranked consumers by their socioeconomic status. But e-scores go further. They can take into account facts like occupation, salary and home value to spending on luxury goods or pet food, and do it all with algorithms that their creators say accurately predict spending.

Every month, eBureau scores about 20 million American adults on behalf of clients like banks, payday lenders and insurers, looking to buy the names of prospective customers. An eBureau spinoff called TruSignal, also located here, scores about 110 million consumers monthly for advertisers seeking select audiences for online ads. Mr. Meyer says eBureau’s clients use the scores to answer basic business questions about their potential audience.

http://www.nytimes.com/2012/08/19/business/electronic-scores-rank-consumers-by-potential-value.html?pagewanted=1&_r=1