Electronic Medical Records Still Bug CMS With Doctors Creating Better Documentation For Their Services–A Big Reason For The Increases-They Can Bill For Their Actual Time Easier Without Risking Stalling Claim Payments

<p>Here's that same old battle again over billing and the lump sum costs are a step in the right direction for treatments where it can be done and<img align="right" border="0" height="124" src="http://lh3.ggpht.com/-iAYIxCUQzBg/UV2UCP7NHQI/AAAAAAABGWM/TQKKLzd0GCk/image%25255B3%25255D.png?imgmax=800" style="border-left-width: 0px; border-right-width: 0px; background-image: none; border-bottom-width: 0px; float: right; padding-top: 0px; padding-left: 0px; display: inline; padding-right: 0px; border-top-width: 0px" width="150" /> this way all know up front what the bottom line is and it’s like one step at a time for a lot of the changes.  I looked at this latest idea with the ER room changes and right away the big hospitals are going to be right there as they do a lot of facility charges for clinics associated with the hospital.  When the fee is passed back to the patient it becomes more costly.  This was a recent discussion on those types of fees.  </p> <h5><a href="http://ducknetweb.blogspot.com/2012/12/hospital-facility-fees-up-for.html">Hospital Facility Fees Up for Discussion Again as Out of Pocket Costs Rise for Patients When Hospitals Buy Physician Practices And Appear to be Growing</a></h5> <p>Back in 2009 the Cleveland Clinic had patients upset over the billing.</p> <h5><a href="http://ducknetweb.blogspot.com/2009/06/cleveland-clinic-facility-fee-or.html">Cleveland Clinic “facility fee” or “hospital services fee” has Patients up in Arms</a></h5> <p><strong>There are a couple of facts here that are just that I saw this myself for overall increases in billing as whole and that was  for a few years that doctor’s offices would bill for a office visit as a 99213 just to keep their cash flow going as when you bill for a longer extended visit,</strong> then you have things that need to go along with the bill, review of systems, history of present illness, family history to name a few and to justify their time these had to be covered and documented and due to the hassle it was to send the paper to match up with the claim, it delayed payments so doctors for years instead of messing with it just billed the standard 99213 where the payments rolled in on schedule and they ate the rest of it.<strong> Cash flow is more important especially in a small practice.</strong>  </p> <p><strong>With electronic medical records, that barrier is gone and doctors can document and I guess some of this has not really set in back at CMS or maybe nobody has told them but this accounts for a good portion of the increases</strong> and not only just that one code, many of them but that one would be most common where doctors for years under billed because of the hassle and delayed payments.  <a href="http://www.ducknet.net/attack-of-the-killer-algorithms/"><img align="right" border="0" src="https://encrypted-tbn1.gstatic.com/images?q=tbn:ANd9GcRp9TBlvWqtr16ku9oa-uGY_yLITLV9hYmtozmPi5XdbJ5RW7Sm" style="border-left-width: 0px; border-right-width: 0px; background-image: none; border-bottom-width: 0px; float: right; padding-top: 0px; padding-left: 0px; display: inline; padding-right: 0px; border-top-width: 0px" /></a>When CMS sent out their nasty letter telling all they were cheating and not bringing one example to the table, I<strong> assumed and so did many others that the very medical records they campaign and encourage doctors to use were at crux of their big issue and they couldn’t see the full picture.</strong>  Otherwise I don’t think that letter would have gone out, just voice of frustration and it was nasty.</p> <h5><a href="http://ducknetweb.blogspot.com/2012/09/hhs-and-doj-send-letters-to-hospital.html">HHS and DOJ Send Letters to Hospital Trade Associations Warning of Gaming Billing System Via Use of Electronic Medical Records–Hospitals Just Learned How to Bill Better & Hired Consultants–Case of Being Algo Duped With Numbers?</a></h5> <p><strong>Now I am not overlooking at all the fact that some will game it and their new auditing software will help establish patterns, that’s what you look for with anti fraud queries</strong> that will lead in the right directions to start looking and that is the best tool they have.  Folks at the top though don’t quite understand queries I don’t think and the mechanics of it all. <strong>You will have false positives with<img align="right" src="http://lh3.ggpht.com/-K1o4j65QeXM/USKdyCUkMnI/AAAAAAABFRI/_fd174NJuUY/image9.png?imgmax=800" style="float: right; display: inline" /> it as well as every pattern will not be fraud</strong>.  Right after they sent out the nasty letter a month later we have this headline, (link below) so tell me folks are not confused about data:)  <strong>They are all over the place</strong>.  The recovery is good news catching fraud and it was the software patterns that put them in the right direction.</p> <h5><a href="http://ducknetweb.blogspot.com/2013/02/government-recovers-42-billion-in.html">Government Recovers $4.2 Billion in Medicare and Medicaid Fraud–With Numbers This Good Using Anti Fraud Analytics To Help Identify Patterns, Maybe Some Cheating Obsessions Might Lighten Up A Little</a></h5> <p>Things get equally as complicated trying to explain some of it to Congress too and one should note that<strong> 84 Senators still rely on and use all paper resources for their work and numbers are tiny bit better in the House so what does that tell you</strong>…non digital literate lawmakers and their questions..</p> <h5><a href="http://ducknetweb.blogspot.com/2013/04/senators-letter-to-hhs-regarding-fraud.html">Senators Letter to HHS Regarding Fraud Reform Tools–Oddest Thing I Have Read in a Long Time and Really Makes A Huge Case for Reinstating the Office of Technology Assessment!</a></h5> <p>I do HHS a favor with my blog and keep the link and widget to their most wanted list for readers to see and I don’t see any other bloggers out there doing that.  That’s a great program to keep out there and visible.  I also blog when they catch one. </p> <p><strong>CMS is right in saying they look for a mix of the levels of billing</strong> and this is exactly what the software will point out if there is not a mix and you have 90% of the visits at the top level and yes then you have something to question for sure.  It’s also worth noting that the records they are looking at are from 2001 to 2008, well that was right about the time and years that many were converting to electronic medical records too and the ER rooms are usually the firs to go electronic. <strong>Why not look at records starting at 2010 to present and get some recent numbers to work with.</strong>  Also remember the big stock market crash occurred in 2008 and that impacted hospital too as many lost their shirts on investments.  It’s not a direct hit to this but did play a roll.  </p> <h5><a href="http://ducknetweb.blogspot.com/2013/02/no-more-unsubstantiated-blame-shifting.html">No More Unsubstantiated Blame Shifting on EHRS, Doctors, Hospitals, Developers, Patients Or Whatever Your Role Happens To Be–Government Executives Wake Up On How Corporate USA Eats Your Lunch With Models, Math, and Formulas for Profit (Algorithms)</a></h5> <p><strong>I don’t know how much modeling they do there at CMS but it would really be helpful for them to have a computer model of a couple of different types of hospitals, a big one, a rural one and so forth</strong> so they could model this stuff.  When I say model I mean something along the lines of not only numbers but a visual that would replicate and maybe even in a video ER visits for an example, get an idea on how it would play out.  I think may have something to do with some of this and why not look at what HCA is doing since they seem to be somewhat bragging about their ER billing?</p> <h5><a href="http://ducknetweb.blogspot.com/2012/08/how-is-hca-for-profit-hospital-chain.html">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</a></h5> <p><strong>Perhaps along with the data and just plugging in numbers a little augmented reality would be help when it comes to understanding hospitals and how they operate.</strong>  Some companies do this and of course there’s other ways to model but something that gives the business intelligence angle of this as well as a virtual model as to how the model will play out across a number of scenarios. <img align="right" src="http://lh5.ggpht.com/_v3zjJigoAPE/TWIVynbAGVI/AAAAAAAAr9E/zewiugyQmSI/image_thumb%5B4%5D.png?imgmax=800" style="float: right; display: inline" /> It would put them miles ahead and then too there’s the money to invest in this but it seems like this is a never ending situation to be monitored and other areas could use the expertise as well.  This is some of what Big Data Machines IBM Watson or other could provide.  It  is doing it for banks…hint..hint..and those folks as I have said many times over on the Hill could use a blast of help with data mining to help create laws and model more before we get things with loop holes that could have been avoided.  </p> <h5><a href="http://ducknetweb.blogspot.com/2012/03/ibm-watson-going-to-work-at-citigroup.html">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</a></h5> <p>The hospitals and the medical associations would really appreciate it if some of the homework was researched ahead of time as well to model outcomes and get the obvious out of the way.  This is the way big business does it and I think it would be a much smarter working environment than having to “guess” if you will on how to make adjustments when needed.  On the overall picture, face it costs are going to go up and the fact that saving in one area will increase potential cost in another.  We’ve seen that.  I’d much rather see efforts in this direction rather than <a href="http://ducknetweb.blogspot.com/2013/09/sebelius-has-bees-in-her-bonnetgiving.html">money spent to get more data on HHS employees</a> with buying more software there…what’s the purpose of that.  Many patients, doctors and hospitals are either going broke or having some severe financial issues so can we go look elsewhere for some savings?   We all have to deal and work with two of the biggest software conglomerates around today, banks and insurance companies to survive.  BD</p> <h5><a href="http://ducknetweb.blogspot.com/2013/04/banks-are-actually-just-software.html">Banks Are Actually Just Software Companies and the Same Can Pretty Much Be Said for Health Insurance Companies As Well-5 Unspoken Reasons Tech Projects Fail</a></h5> <hr />Federal officials for more than a decade have let hospitals decide on their own how much to charge Medicare for certain emergency room overhead and staffing costs called “facility” fees — a controversial policy some critics believe invites overcharges. <p>Now in a major turnabout, the Centers for Medicare and Medicaid Services are seeking tighter controls over the fees as part of a plan to redirect billions of dollars Medicare spends annually on outpatient health care. But this new proposal, though still preliminary, is already drawing fire on its own.</p> <p>CMS officials want to replace five escalating price codes hospitals can choose from in billing facility fees with one flat rate, starting next year. Whether charged at one rate or five, the mere existence of facility fees is contentious because they come on top of physician bills and hospital charges for tests, medicines and other supplies, and have risen sharply in recent years. Hospitals counter that the fees are needed to help defray the costs of big-ticket medical technology and resources, such as operating rooms.</p> <p>The 2013 rates for ER facility fees start at $51.82 for a “level 1” patient visit and move up to $344.71 at the top range. CMS is proposing a new flat rate at $212.90 for emergency room visits regardless of how much medical muscle went into the treatment. Doctor fees aren’t affected. Several of the nation’s major hospital groups declined comment on the proposed rule, saying they are still studying its impact and preparing written responses. The rule was published July 19 in the <a href="https://www.federalregister.gov/articles/2013/07/19/2013-16555/medicare-and-medicaid-programs-hospital-outpatient-prospective-payment-and-ambulatory-surgical"><em>Federal Register</em></a> and comments are due by Sept. 16. It is set to take effect Jan. 1, 2014. As of Sept 12, 1,470 comments had been received.</p> <p>Between 2001 and the end of 2008, use of the two most expensive codes nearly doubled, from 25 percent to 45 percent of all claims. Many of these patients were treated for seemingly minor injuries and complaints and sent home without being admitted to the hospital.</p> <p><a href="http://www.publicintegrity.org/2013/09/13/13420/feds-propose-shakeup-emergency-room-billing">http://www.publicintegrity.org/2013/09/13/13420/feds-propose-shakeup-emergency-room-billing</a></p>

Electronic Medical Records Still Bug CMS With Doctors Creating Better Documentation For Their Services–A Big Reason For The Increases-They Can Bill For Their Actual Time Easier Without Risking Stalling Claim Payments

Here's that same old battle again over billing and the lump sum costs are a step in the right direction for treatments where it can be d...

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MiMedx Hit With Class Action Suit Based on FDA Ruling Products Had Relevant Characteristics of Structural Tissue Altered So FDA Classified As A Drug And Requires Valid Biologics License

<p>This is interesting and I went over to the MiMedx page and looked around and it appears they have have a meeting with the FDA in October to discuss<img align="right" alt="image" border="0" height="62" src="http://lh4.ggpht.com/-Bam_8zGZ-x0/UjN9VVv7YUI/AAAAAAABHvM/2iWkyZNume4/image%25255B3%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="168" /> the letter they received.  Boy looks like the lawyers couldn’t wait to get the lawsuit going form what I am reading.  There’s a lot hanging on that meeting of course and who knows what the exact outcome might be as you just never know and as technical as life sciences are today it is sometimes hard to really project, at least for me the layman but again common sense tells me that at least give them a chance to meet with the FDA and then proceed.  It could have been something or one small item overlooked but show those shareholder you are doing something if stock values decrease.  </p> <p>Who knows maybe the lawsuit will stand and maybe not.  The wound healing field is definitely full of many players today and it’s something we might all need at sometime.  BD  </p> <p> <hr />SAN DIEGO--(<a href="http://eon.businesswire.com/">EON: Enhanced Online News</a>)--Robbins Geller Rudman & Dowd LLP (“Robbins Geller”) (<a href="http://cts.businesswire.com/ct/CT?id=smartlink&url=http%3A%2F%2Fwww.rgrdlaw.com%2Fcases%2Fmimedx%2F&esheet=50708998&newsitemid=20130913005849&lan=en-US&anchor=http%3A%2F%2Fwww.rgrdlaw.com%2Fcases%2Fmimedx%2F&index=1&md5=71263da0ceae92de5340f04e89a22a18">http://www.rgrdlaw.com/cases/mimedx/</a>) today announced that a class action has been commenced in the United States District Court for the Northern District of Georgia on behalf of purchasers of MiMedx Group, Inc. (“MiMedx”) (NASDAQ:MDXG) stock during the period between March 7, 2013 and September 4, 2013 (the “Class Period”). </p> <p>Among other things, the Untitled Letter stated that because these products were micronized – and thus had the original relevant characteristics of the structural tissue altered – they were drugs. Because MiMedx did not possess a valid biologics license, the Untitled Letter concluded the Company was unable to lawfully market these products. It stated that “[n]one of the amniotic/chorionic-based products described in this letter are the subject of an approved biologics license application . . . , nor are there [investigational new drug applications] in effect for any of these products. Based on this information, we have determined that your actions have violated the [Federal Food, Drug, and Cosmetic] Act and the [Public Health Service] Act.” </p> <p>According to the complaint, the true facts, which were known by defendants but concealed from the investing public during the Class Period, were are follows: (a) MiMedx did not possess the necessary licensing to manufacture certain of its products; (b) the Company was manufacturing certain of its products unlawfully and in violation of FDA rules and regulations; (c) at all relevant times, MiMedix’s revenues from these products were substantially and materially threatened due to the Company’s lack of licensure; (d) because a portion of its revenues were subject to termination, MiMedx’s revenue guidance issued during the Class Period lacked a reasonable basis when made; and (e) as a result of the foregoing, defendants’ statements regarding the Company’s financial performance and expected earnings were false and misleading and lacked a reasonable basis when made. </p> <p><a href="http://eon.businesswire.com/news/eon/20130913005849/en/Notice-Filing-Securities-Class-Action-MiMedx-Group?utm_source=dlvr.it&utm_medium=twitter" title="http://eon.businesswire.com/news/eon/20130913005849/en/Notice-Filing-Securities-Class-Action-MiMedx-Group?utm_source=dlvr.it&utm_medium=twitter">http://eon.businesswire.com/news/eon/20130913005849/en/Notice-Filing-Securities-Class-Action-MiMedx-Group?utm_source=dlvr.it&utm_medium=twitter</a></p>

MiMedx Hit With Class Action Suit Based on FDA Ruling Products Had Relevant Characteristics of Structural Tissue Altered So FDA Classified As A Drug And Requires Valid Biologics License

This is interesting and I went over to the MiMedx page and looked around and it appears they have have a meeting with the FDA in October to ...

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Vanderbilt Medical Center Gets Hit With Medicare Fraud Suit, Billing and Clinical Support Documentation Software Use Questioned-Update: Doctors Were Whistleblowers

<p>I ran across this article this morning that gives a little additional information on the case as reported by the <a href="http://www.nashvillescene.com/pitw/archives/2013/09/12/whisteblowing-docs-allege-vast-vumc-medicare-deception">Nashville Scene.</a>  </p> <p>This should be an interesting case.  Software is software and how it is used is something else.  I don’t they are faulting the software here but rather how it was used by the staff and billing.  The University claims the<img align="right" alt="image" border="0" height="159" src="http://lh5.ggpht.com/-G4YvT5Mndbc/UjJURRAt5II/AAAAAAABHus/Zl6cFSoV6a0/image%25255B3%25255D.png?imgmax=800" style="border-left-width: 0px; border-right-width: 0px; background-image: none; border-bottom-width: 0px; float: right; padding-top: 0px; padding-left: 0px; display: inline; padding-right: 0px; border-top-width: 0px" title="image" width="206" /> accusations are not true and when doing an investigation and coming in and looking at data of course we have the raw numbers to look at but we don’t have the actual scenarios to see when it all occurred and thus the perception of the auditors is going to be right on the dollars, where it should be.  </p> <p>It states the documentation showed the doctors being in two places at once but as the University says it’s not unusual for surgeons to schedule multiple locations throughout the day either.  I’m not sure on the portion here that claims services were “medically directed” as why would they be performing them if not needed?  This is some billing mumbo jumbo language I’m not familiar with.  I remembered covering their Sepsis software program they built with Microsoft technologies back a few years ago that got a lot of good attention.  </p> <h5><a href="http://ducknetweb.blogspot.com/2009/06/vanderbilt-university-sepsis-detection.html">Vanderbilt University Sepsis Detection Technology Update – Added Management to Detection Process</a></h5> <p>I could see some legitimate errors when it all gets to billing, everyone has that issue but I would guess patterns may have been what brought this to the forefront but CMS is so messed up anyway on a lot of their models in recent news as well.  They gave insurance companies too much money here. </p> <h5><a href="http://ducknetweb.blogspot.com/2013/03/gao-states-cms-overpaid-medicare.html">GAO States CMS Overpaid Medicare Advantage Plans During the Years of 2010 to 1012–Flawed Risk Assessment Calculation Errors</a></h5> <p>There’s no dollar amounts or numbers of claims to talk about yet so I guess there’s more to come so I’m guessing it’s a sizable amount in question, otherwise why bother.  During this past summer the medical center announced layoffs of over 1000 employees by the end of the year due to budget concerns and some have taken early retirement.  BD  </p> <hr />One such stipulation is that an “attending physician” must attend surgeries, or at least key parts of them. <strong>According to the lawsuit, Vanderbilt double-booked attending physicians, making it impossible to meet Medicare billing standards, but VUMC billed state and federal insurers as if it had complied with regulations.</strong> <p>“As Vanderbilt is aware, many surgeons’ routine practice is to simultaneously schedule multiple surgeries in multiple locations throughout the day,” the lawsuit says. It continues to say that in the case of anesthesia services, for instance, <strong>Vanderbilt practically never complied with the steps to adequately classify its services as “medically directed,” yet reported them as such.</strong></p> <p>According to the lawsuit, the university encouraged physicians to refrain from making hand-written notes if they were unable to cover certain surgeries. The lawsuit includes an email sent out in late 2004 that said, among other things, “Please do not make annotations in the record about how many rooms you are currently covering; it only confuses and complicates the billing and documentation process.”</p> <p><strong>Vanderbilt also designed a software tool to perpetuate its billing practices, the lawsuit claims.</strong></p> <p>The suit states: “Vanderbilt’s Anesthesia Department, including specifically Drs. Michael Higgins and Jeffrey Balser, ‘collaborated in the engineering, design and development of a ... comprehensive electronic payment information system specialized for high-acuity care.’ Among the stated objectives of the system was for Vanderbilt to ‘(i)mprove financial margins with greater staff and resource efficiency.’”</p> <p><strong>“In reality, Vanderbilt has used the VPIMS to maximize its false billing practices by taking advantage of its remote access features to schedule attending physicians to be in multiple places at once,</strong> while continuing to bill their services as if they were actually present and personally performing the services at each place. VIPIMS’ purported improvements in billing efficiency are, in fact, largely a function of Vanderbilt’s development of mandatory default software settings that require its physicians, in all instances, to document that they meet Medicare’s conditions for payment.”</p> <p><strong>Howser said the software, however, is not a billing tool, but instead is used to “support medical documentation and detailed ... patient tracking.”</strong> The system was a 2008 recipient of a Microsoft Healthcare Innovation Award, Howser said, and has been licensed to other hospitals in several other states.</p> <p><a href="http://www.tennessean.com/article/20130912/NEWS07/309120046/Vanderbilt-Medical-Center-hit-Medicare-fraud-suit?nclick_check=1">http://www.tennessean.com/article/20130912/NEWS07/309120046/Vanderbilt-Medical-Center-hit-Medicare-fraud-suit?nclick_check=1</a></p>

Vanderbilt Medical Center Gets Hit With Medicare Fraud Suit, Billing and Clinical Support Documentation Software Use Questioned-Update: Doctors Were Whistleblowers

I ran across this article this morning that gives a little additional information on the case as reported by the Nashville Scene.   This s...

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Social Security Finds Some Potential Errors Resulting in Over Payments-If Fraud Then Pursue, If Not Drop It and Move On, Data Addiction Moves GAO To Want A Little Media Attention

<p>Audits of course are good and we find errors and this will go on and on and on.  This is a strange article where someone felt the real need to draw attention to this when they have not come to a full conclusion<img align="right" alt="image" border="0" height="97" src="http://lh4.ggpht.com/-2DxIAOYmaYY/UjMyyhT6WFI/AAAAAAABHu8/l6tROMrJkb8/image%25255B3%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="218" /> on what the problems is here and it’s based on “ONE” person and they are finding similar patterns.  This is is what fraud seeking software does, but patterns do NOT always equal fraud and instead help agencies find problems with their own computer code, the queries and algorithms.  </p> <p><strong>This is prime example of what I keep saying in the fact that we do not have enough trained people out there to know how to work with flawed data or errors they find, bingo.</strong>  Now someone wants to make some news and draw some big attention and with this news article, they did that, but yet their work is not finished, so what’s up with this?  There are big errors that take priority at Social Security like this example fixing the fact that people are listed as dead when they are not in their death index, from 2011, and we don’t go out and “kill” them to make the numbers match (grin).  <em>I said this satirical comment to again make note of hope folks get duped with numbers.  </em></p> <h5><a href="http://ducknetweb.blogspot.com/2011/10/social-security-master-death-index-data.html">Social Security Master Death Index Data Flawed–Over 31,000 Living Found in the Index</a></h5> <p><strong>Keep running the analytics and make sure you are not getting any false positives in here as well.</strong>  That happens a lot.  I guess the GAO needed to show they were doing something, best I can figure.  I would rather see then move on instead of attack consumers if “they” made the error.<strong>  This is stupid when Social Security makes their comment “we will recoup any improper payments”, if not fraud, let it die</strong>.  This article really didn’t even need to be published and it keeps the soap operas running along with the OMG media that follows.  </p> <p><em>"It is too soon to tell what caused these overpayments," said the spokesperson, "but if we determine that fraud is involved, we will refer these cases to our Office of the Inspector General for investigation."</em> </p> <p><strong>Put the facts out there when completed and not this media feeding witch hunt paradigm that feeds politicians.</strong>  I think all would appreciate that as it costs money to go back and recoup the money as well so<strong> make a smart business decision and move on if not fraud and stop wasting money with letting analytics dupe you</strong> into thinking you have to chase every penny when it’s going to cost more to recoup than what’s out there.   BD</p> <p> <hr />An upcoming GAO report obtained by NBC News says the federal government may have paid $1.29 billion in <a href="http://www.cnbc.com/id/10000899">Social Security</a> disability benefits to 36,000 people who had too much income from work to qualify. </p> <p>At least one recipient collected a potential overpayment of $90,000 without being caught by the Social Security Administration, according to the report, which will be released Sunday, while others collected $57,000 and $74,000. </p> <p>The GAO also said its estimate of "potentially improper" payments, which was based on comparing federal wage data to Disability Insurance rolls between 2010 and 2013, "likely understated" the scope of the problem, but that an exact number could not be determined without case by case investigations. </p> <p><a href="http://www.cnbc.com/id/101032599">http://www.cnbc.com/id/101032599</a></p>

Social Security Finds Some Potential Errors Resulting in Over Payments-If Fraud Then Pursue, If Not Drop It and Move On, Data Addiction Moves GAO To Want A Little Media Attention

Audits of course are good and we find errors and this will go on and on and on.  This is a strange article where someone felt the real need ...

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Insurance Company Asking Judge To Let Them Off the Hook and Does Not Want to Represent Their Client In A Lawsuit Over Privacy Issues Collecting Zip Codes..

<p>Ok as a company, you think have insurance to cover you with privacy issues?<strong>  Not in this case or at least we are waiting for a judge to decide as the lawyers are calling uncle.  They want out.</strong>  You read them all the time, the privacy statements and this kind of says one thing is <strong>that one group of lawyers doesn’t<img align="right" alt="image" border="0" height="170" src="http://lh4.ggpht.com/-0sWJwjkPbYU/UjI_jq__ZEI/AAAAAAABHuU/LSnnxW7feCk/image%25255B7%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="152" /> want to mess with the legal mumbo jumbo another group created</strong>.  This is interesting as now we have our real first challenge of the bull shit that we read on on these websites. <strong> People are getting tired of it and oh boy I cannot wait for a big suit to come out on this topic as banks and companies are making billions selling our data.  </strong></p> <p>Now what even makes this more interesting is that the insurer is whining and wants the judge to specially spell out exactly what defending the client, Urban Outfitters requires of them…pretty funny.  <strong>One group of lawyers wants nothing to do with the crap of a privacy policy the other lawyers wrote:)</strong></p> <p>Everybody talks about de-identified data and there’s some value there with what they do but that’s the key, what do they do and what’s left for a sharp query master to work with, a lot more than you think…</p> <h5><a href="http://ducknetweb.blogspot.com/2013/06/re-identifying-medical-records-all.html">Re-Identifying Medical Records All Depends on the Query Master and How Much Money Can Be Saved or Made With Adjusting Risk, Up or Down</a></h5> <p>I’m glad people some information out there about this too and we had the case with medical records matching on zips and other small bits of information.  Now there are some that just use zip codes that are not mining but there was story out to where a store was taken to task there too assuming they were doing the same thing and why would a consumer not be nervous…<strong>we have a huge profitable data selling epidemic in the US and it’s starting to crunch portions of the economy.</strong>  </p> <p><img src="http://lh5.ggpht.com/-P2uvWZKJRa8/UbC4TodWKwI/AAAAAAABG1k/jmDuWy4Dxc0/image%25255B5%25255D.png?imgmax=800" /></p> <p>It’s easy money and the only way to regulate it is to start with an IT infrastructure, called buying a license to #1 find out who they all are and #2 to excise tax them and use the tax money for the FDA and NIH for one.  Every day on the web I see article after article with someone crying about the lack of funds, well here’s your answer to help.  Now this insurer’s attorneys want out but look what happens with other types of insurers…like your health insurance companies who can’t get enough.  </p> <h5><a href="http://ducknetweb.blogspot.com/2013/03/insurance-companies-are-buying-up.html">Insurance Companies Are Buying Up Consumer Spending Data-Time is Here to License and Tax the Data Sellers-As Insurers Sell Tons of Data, Gets Flawed Data When Data Buyers Uses Out of Context Too</a></h5> <p>I just wonder how much money the insurer here,<img align="right" alt="image" border="0" height="115" src="http://lh4.ggpht.com/-7ioGxrCiKRI/UjI_kK5tAiI/AAAAAAABHuc/vq0ntM5840g/image%25255B3%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="235" /> OneBeacon American is making off of their data selling efforts…<a href="http://www.onebeacon.com/OneBeacon/listview.page?">look at what they underwrite…</a>  This sector in particular caught my eye, <a href="http://www.onebeacontech.com/">Technology Insurance.</a>  They underwrite medical devices for insurance and <a href="http://www.onebeacontech.com/OneBeaconTech/pages/productscoverages/dataprivacy.page?">Data Privacy</a>.   I wonder how profitable that area is today (grin) and what’s required on a claim to cover a breach…nope..didn’t have the right risk management in place, sorry…who knows.  Anyway, they want no part of this case with the zip codes being recorded.  They said their policies don’t cover this kind of action.  </p> <p><strong>This will be interesting and maybe a warning to those who sell data with their crappy privacy statements</strong> as it sounds they will be challenged sooner or later as <u>consumers get mad having to spend more time fixing their flawed data on their own dime while and corporations make billions selling it.  BD</u></p> <p> <hr />OneBeacon American Insurance Company doesn’t want to defend Urban Outfitters Inc. and Anthropologie Inc. in a string of customer privacy lawsuits.</p> <p>Consumers are suing in California, Massachusetts and Washington, D.C. over the company’s practice of collecting zip codes during credit card transactions — a practice they say is forbidden in those jurisdictions.</p> <p>In a lawsuit filed Tuesday, OneBeacon said the retailers’ insurance doesn’t cover those privacy issues.</p> <p>A general coverage policy covering both Urban Outfitters and subsidiary Anthropologie has a $1 million personal and advertising limit and a $2 million general aggregate limit.</p> <p><a href="http://www.mainjustice.com/2013/09/12/insurer-wants-out-of-clients-consumer-privacy-suits/">http://www.mainjustice.com/2013/09/12/insurer-wants-out-of-clients-consumer-privacy-suits/</a></p>

Insurance Company Asking Judge To Let Them Off the Hook and Does Not Want to Represent Their Client In A Lawsuit Over Privacy Issues Collecting Zip Codes..

Ok as a company, you think have insurance to cover you with privacy issues?   Not in this case or at least we are waiting for a judge to dec...

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Practice Max EHR and Practice Management Firm Buys Analytics/Clinical Trials Data Company Medi-data

<p>Well if a medical records company doesn’t have a full on offering of analytics today I guess they buy one.  Medi-data is also involved in the clinical trial business which is where everyone wants to have access to medical records with the data being recorded with them.  <img align="right" alt="image" border="0" height="53" src="http://lh6.ggpht.com/-A1gJt_37L-U/UjI1BHZDyHI/AAAAAAABHt8/6Xw9T4O00fk/image%25255B3%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="209" /></p> <p>I do have to say that I have never seen a time where there is such a glut of software in healthcare.  I know everyone needs the opportunity to build their business, no problem there but as you can see here the overcrowding I think leading to even more action in the mergers and acquisitions side of things.  I just wonder at times how the code’s all going to work.  Obviously it makes sense to have “like” or similar systems work but we don’t always see that.  It gets tougher all the time with the large groups of subsidiaries that are growing as well to really see where some huge conglomerates focus.  BD <hr /></p> <p>PracticeMax, Scottsdale, Ariz., acquired Medi-Data Service, a Naperville, Ill.-based medical management firm. <br />Financial terms weren't disclosed. The deal expands<img align="right" alt="image" border="0" height="50" src="http://lh4.ggpht.com/-xFnQHCjaQ7c/UjI1B_JuCMI/AAAAAAABHuE/CVhxTnymJo8/image%25255B7%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="161" /> the Midwest presence of PracticeMax, which develops software and offers billing and consulting services. Medi-Data, located in Chicago's suburbs, is more than 30 years old and has provided billing and practice <a href="http://www.modernhealthcare.com/section/articles?tagID=949">management</a> services to physician groups, individual physicians and hospital-owned practices. </p> <p><a href="http://www.modernhealthcare.com/article/20130912/NEWS/309129942?AllowView=VW8xUmo5Q21TcWJOb1gzb0tNN3RLZ0h0MWg5SVgra3NZRzROR3l0WWRMWGJYZndERWxiNUtpQzMyWmVpNW40WUpiaWo=&utm_source=link-20130912-NEWS-309129942&utm_medium=email&utm_campaign=hits" title="http://www.modernhealthcare.com/article/20130912/NEWS/309129942?AllowView=VW8xUmo5Q21TcWJOb1gzb0tNN3RLZ0h0MWg5SVgra3NZRzROR3l0WWRMWGJYZndERWxiNUtpQzMyWmVpNW40WUpiaWo=&utm_source=link-20130912-NEWS-309129942&utm_medium=email&utm_campaign=hits">http://www.modernhealthcare.com/article/20130912/NEWS/309129942?AllowView=VW8xUmo5Q21TcWJOb1gzb0tNN3RLZ0h0MWg5SVgra3NZRzROR3l0WWRMWGJYZndERWxiNUtpQzMyWmVpNW40WUpiaWo=&utm_source=link-20130912-NEWS-309129942&utm_medium=email&utm_campaign=hits</a></p>

Practice Max EHR and Practice Management Firm Buys Analytics/Clinical Trials Data Company Medi-data

Well if a medical records company doesn’t have a full on offering of analytics today I guess they buy one.  Medi-data is also involved in th...

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Johnson and Johnson Files A Patent Violation Lawsuit Against Decision Diagnostics For Making Glucose Test Strips That Work With J&J Lifescan Ultra Meters–Stick Wars

<p>J and J wants the strip business and want no competition and Decision Diagnostics countered with J&J advertising that the One Touch system<img align="right" alt="image" border="0" height="109" src="http://lh4.ggpht.com/-cs7VkLPVBhc/UjFho2mXBxI/AAAAAAABHts/rwQ5jGsm1bU/image%25255B3%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="104" /> provides more accurate results than other companies.  Genstrip is the name of the testing strips.  The article here suggests that J&J could buy them up and get rid of the competition, and I guess court costs versus loss of business will some influence on what happens here.  </p> <p>We used to hear about the J&J stent wars and now we are down to stick wars (glucose strips), but there’s a lot of money in those strips.  Before my mother passes away who was a diabetic the mail order pharmacies are all over get those out and even over supplying at times.  BD <hr /></p> <p>With more than 250 units making and marketing therapeutic products worldwide, <a href="http://www.forbes.com/companies/johnson-johnson/">Johnson & Johnson</a> <a href="http://www.forbes.com/companies/johnson-johnson/">JNJ +0.79%</a> (JNJ) is one of the most diversified global healthcare companies. And as a leader in pharmaceuticals, medical devices, and consumer personal-care products, the company not surprisingly makes sure it adequately protects its turf. <br />Of late, its largest division, the medical device and diagnostic operations that generates some 40% of the company’s total sales, has been a focus of some of its attention. In particular, it’s defending its product called Lifescan Ultra, used for glucose monitoring in diabetes patients, which is estimated to be a $10 billion market. Right now, J&J dominates the market for single-use strips necessary for patients to use the Lifescan Ultra diagnostic device to check their glucose levels.</p> <p>J&J, the largest player in this market, filed in September 2011 a patent infringement suit against a small company called Decision Diagnostics and sought an injunction to stop the company from selling its product named Genstrip, an alternative glucose testing strip designed specifically for use with Lifescan Ultra meters. </p> <p><a href="http://www.forbes.com/sites/genemarcial/2013/09/11/jj-seeks-court-aid-to-protect-its-glucose-monitoring-test/">http://www.forbes.com/sites/genemarcial/2013/09/11/jj-seeks-court-aid-to-protect-its-glucose-monitoring-test/</a></p>

Johnson and Johnson Files A Patent Violation Lawsuit Against Decision Diagnostics For Making Glucose Test Strips That Work With J&J Lifescan Ultra Meters–Stick Wars

J and J wants the strip business and want no competition and Decision Diagnostics countered with J&J advertising that the One Touch syst...

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Detroit Wants To Give Retirees Under 65 $125 a Month To Buy Insurance Where Ever They Can

<p>We all know about the sorrow in Detroit where there should be some <img align="right" alt="image" border="0" height="128" src="http://lh5.ggpht.com/-nWWY76hx0qU/UjFa9XIOMTI/AAAAAAABHtc/P_p1qAjOAsI/image%25255B4%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="161" />nervous actuaries running around after the deal on the pension system so here's’ the next deal and it’s not final yet but the cost for insurance on exchanges in Michigan are not out yet on the Exchanges so fat chance there’s any policy that would be around $125 a month and probably double that would a guess would be the bottom rate or some where around there.  BD  </p> <p> <hr />Detroit emergency manager Kevyn Orr is considering a plan to replace current health care benefits for retirees under 65 with a stipend of $125 a month to buy coverage beginning next month from the state’s new health insurance exchange, city officials said on Wednesday.</p> <p>The city intends to help those retirees figure out the best health insurance plan offered under the Affordable Care Act, also known as Obamacare. Michigan’s insurance marketplace where the plans will be sold launches Oct. 1 and coverage is effective Jan. 1.</p> <p>It is uncertain how much health care coverage Orr’s stipend of $125 a month would buy because neither the state nor insurers are saying how much plans available under the new health care system will cost.</p> <p><a href="http://www.freep.com/article/20130912/NEWS01/309120035/Detroit-retiree-health-care-cuts">http://www.freep.com/article/20130912/NEWS01/309120035/Detroit-retiree-health-care-cuts</a></p>

Detroit Wants To Give Retirees Under 65 $125 a Month To Buy Insurance Where Ever They Can

We all know about the sorrow in Detroit where there should be some nervous actuaries running around after the deal on the pension system so ...

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CA Court of Appeals Rules HMO Regulator Can No Longer Use A Segmentation Algorithm With Parameters Requiring Professionals To Have a License, Where There Is No State License To Treat Autistic Children

<p><strong>Ok here we have some additional Killer Algorithms at work with the health plans of government employees and those enrolled in Healthy Families being denied.</strong>  HMOs and health insurers are supposed to provide coverage for children by certified professionals, and they do not need a state license.<img align="right" alt="image" border="0" height="127" src="http://lh6.ggpht.com/-JPR8VoZE-sQ/UjFQ02LJNdI/AAAAAAABHtM/x1Up4fJnNio/image%25255B3%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="176" />  OK so here comes the interpretation with the analytics business models at work, the public employee healthcare was not included so analytics said, save money.  There are no state licenses for ABA therapists…all about context again to save some dollars.  So set the parameters to “deny” so the machines can automatically process the claim according to the verbiage with not finding a license listing, there’s the algorithms at work.  This case was won by the Consumer Watch Dog.  </p> <p>The original law was passed in 2011 as insurers were denying care right and left for autistic children and the Department of Managed Care stuck to their guns it appears and were still wanting a license…so they let all the claims get denied and offered no assistance in settling the matter.  What lawyer found this fine line one has to wonder advising the Department of Managed Care to hold tight with requiring a license, either that or someone didn’t do some research to find out there is no state license..duh on this one.  BD</p> <p> <hr />SANTA MONICA, Calif., Sept. 11, 2013 — /PRNewswire-USNewswire/ -- In a complex opinion issued yesterday, the California Court of Appeal ended the Department of Managed Health Care's (DMHC) discriminatory practice of allowing HMOs to deny treatment for autistic children of state employees and low-income families enrolled in the Healthy Families program on the basis that such treatment can only be administered through state-licensed providers.</p> <p>The case was brought by the non-profit Consumer Watchdog and Strumwasser & Woocher LLP.</p> <p>The treatment at issue, known as Applied Behavioral Analysis (ABA), has been found to be the most effective treatment for autistic children, as yesterday's opinion acknowledged. After the lawsuit was filed, the California Legislature agreed with Consumer Watchdog by passing a law in 2011 clarifying that HMOs and health insurers must provide coverage for ABA for children enrolled in private health insurance plans and that such treatment could be provided through providers who are certified by a national board, but not state-licensed. However, the Legislature did not include public employees and Healthy Families enrollees.</p> <p><a href="http://www.heraldonline.com/2013/09/11/5199124/court-of-appeal-rules-hmo-regulator.html" title="http://www.heraldonline.com/2013/09/11/5199124/court-of-appeal-rules-hmo-regulator.html">http://www.heraldonline.com/2013/09/11/5199124/court-of-appeal-rules-hmo-regulator.html</a></p>

CA Court of Appeals Rules HMO Regulator Can No Longer Use A Segmentation Algorithm With Parameters Requiring Professionals To Have a License, Where There Is No State License To Treat Autistic Children

Ok here we have some additional Killer Algorithms at work with the health plans of government employees and those enrolled in Healthy Famili...

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Health Insurance Exchange Contractors Give Update Report to House Energy & Commerce Committee–The Federal Data Hub Beta

<p>This was nice to get some updates from the contractors involved in the process.  Again I’m still curious to see how the old COBOL servers work with some middleware to scale the results out.  After reading this article it sounds like if there no answer to “pings” at the IRS, Social Security, and Homeland Security that we have some sort of a fall over to Equifax and Serco.  Those were last minute contracts given out as contingencies just a couple  months ago.  </p> <p>Back in July I wrote Will it Blend, based on information that had been given at that time.  </p> <h5><a href="http://ducknetweb.blogspot.com/2013/07/obamacare-health-insurance-exchanges.html">Obamacare Health Insurance Exchanges “Will It Blend”….Cobol Lives On With the Feds</a></h5> <p>California has since changed their web site to be a little more positive and adds a little more confidence as additional testing has occurred.<img align="right" src="http://lh3.ggpht.com/-tVrr142FoXY/UdErl2ge1eI/AAAAAAABHJE/kqkPcuYlFCQ/image%25255B19%25255D.png?imgmax=800" style="float: right; display: inline" />  I did a walk through and site looks nice and it all at that time directed towards the idea that a lot would be manually done, in other words without the data connections with mailing in applications.<strong>  I think they also took a hard look due to complexities of insurance companies today as to how many would “really” do a complete automated shopping and full transaction and that number they indicated would be around 20%</strong> so that leaves 80% of the shoppers for insurance using other methodologies.  Amazing when you look at the potential of all the data running through what 80% might mean as far as traffic delivering up some data, maybe a little different context here? </p> <h5><a href="http://ducknetweb.blogspot.com/2013/08/california-insurance-exchange-website.html">California Insurance Exchange Website Live for Price Comparisons and Information–A Quick Walk Through…</a></h5> <p>Since this presentation was given to the Energy Commission I wonder if they are renting space from the DOE too for this project.  I think I already said that a while back on another post a while back.  I call it a beta as that’s what it is and nothing wrong with that as huge companies like Microsoft for one use betas and until all the bugs are out, and yes there will be bugs<strong>, so I’m going to refer to it as the Federal Data Hub Beta (grin).  </strong></p> <p><strong>Here’s what DOE has over there in computing power and this post is a couple years old so there’s probably much more over there now.</strong>  DOE runs this Innovative and Novel Computational Impact on Theory and Experiment (INCITE)program to where they give time and space to environmental projects that need to crunch big numbers.  So who knows, it would not be a surprise to see if our Federal Data Hub data processing capabilities are entirely or partially supported here.  </p> <h5><a href="http://ducknetweb.blogspot.com/2010/12/17-billion-super-computer-hours-awarded.html">1.7 Billion Super Computer Hours Awarded by the DOE–Biomedical Research Projects Included for Parkinson’s and Cancer</a></h5> <p>Serco, the one contractor who is set up to do a lot of the manual support says it’s ready to go and their corporate offices in the UK are currently under investigation for fraud where new contracts are frozen pending the outcome but I don’t think that has any impact on the US branch.  They are planning on 3 facilities all together so sounds like they anticipate a measureable amount of paper items coming through.</p> <h5><a href="http://ducknetweb.blogspot.com/2013/07/obama-administration-doles-out-yet-one.html">Obama Administration Doles Out Yet One More Contract to Help With Eligibility Infrastructure And to Operate One Massive Mail Room-With Insurance Exchanges - Serco The Biggest Company You Have Never Heard Of</a></h5> <p><em>“John Lau, program director for Serco, said his company is staffing up to handle paper applications and other tasks. It will open a service center in Kentucky on Oct. 1, followed soon by two others in Arkansas and Missouri.”</em></p> <p>In addition Equifax added their information on the  proprietary data base they were going to use to use.  A couple weeks ago another division of Equifax just had to shell out $18 million on a court case when didn’t fix a woman’s credit information for years.  Keep in mind too this was a lawyer giving the update not a technician so she’s reliant on what the tech folks tell her.  They way the article is written it sounds like if there’s a “no ping” at the IRS for whatever reason it will kick over to Equifax.  </p> <p><em>“Lynn Spellecy, a corporate lawyer for Equifax Workforce Solutions, said the subsidiary of the well-known credit reporting company is ready to help verifying income and employment. It will rely on a proprietary database called The Work Number, widely used by lenders, employers and government agencies. Final testing is scheduled for Sept. 15.”</em> </p> <p>As I said before so what if all the automation is not ready, the fact is you will be able to apply for health insurance on that day, whether it is the old paper and faxing methods or if the big Beta Federal Data Hub is up to the task.  This is a lot of data work and there will be updates and the states can more than likely look forward to updates to their systems for connectivity as the Hub and the rest of it will be updated.  Come on who makes a perfect data system out there today..nobody.  Just this week speaking of code issues, United had another recall on one of their medical systems.  It was the sixth one but this was the first we heard about it.  They wrote a fix and distributed the update so the exchange system can join the crowd in that respect:)</p> <h5><strong><a href="http://ducknetweb.blogspot.com/2013/09/picis-software-used-in-emergency-rooms.html">Picis Software Used in Emergency Rooms At Hospitals, Subsidiary of UnitedHealthcare Issues A Recall As Doctors Notes Relative to Prescriptions Vanished-Killer Algorithms Show Up Again..</a></strong></h5> <p>I know it is a little odd when you hear lawyers and politicians talking about high tech and sometimes they stumble all over themselves with mistakes, as was with the NSA trying to listen to Feinstein describe the NSA incident when it happened.  One thing the exchanges have been is a lesson for both politicians and the public on the time and effort required and how IT<img align="right" height="63" src="http://lh6.ggpht.com/_v3zjJigoAPE/TJcGp1oHKzI/AAAAAAAAhfM/jyY8xKNrAKY/image_thumb%5B4%5D.png?imgmax=800" style="float: right; display: inline" width="169" /> infrastructure works, that is if you don’t get enough news out of Wall Street on that end, it’s all math models, data and code.  The whole world operates this way today and it’s all of our fears that flawed data will be used out of context, which we have read in the news with denials from insurers for years, or that the data if correct will be taken out of context.  A mathematician and I both agree we don’t have enough people trained on how to work with flawed data as well and that’s yet one more issue we need to face as well.  Here’s a post I wrote in back in November and it still holds true…</p> <h5><a href="http://ducknetweb.blogspot.com/2012/11/big-dataanalytics-if-used-out-of.html">Big Data/Analytics If Used Out of Context and Without True Values Stand To Be A Huge Discriminatory Practice Against Consumers–More Honest Data Scientists Needed to Formulate Accuracy/Value To Keep Algo Duping For Profit Out of the Game</a></h5> <p>We do have a data selling epidemic in this country and some of the contractors here in this project make some of their profits that way as well, so be aware and be skeptic and question the data if you don’t think it is correct.  If you<img align="right" alt="image" border="0" height="156" src="http://lh3.ggpht.com/-lfu_n5waqUI/UjEotZ_Yy1I/AAAAAAABHs8/eaqKtLb65DA/image%25255B3%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="209" /> want a blazing example, and it’s funny too, <a href="http://ducknetweb.blogspot.com/2013/01/im-sorry-your-google-plus-name-does-not.html">see how Google told me my real name was not machine compliant…this stuff happens and they cut off my account in Google plus, and then had to ask me where they could verify me on the web…well it was the Google product Blogger right here</a> and<strong> see it how it was not connected</strong> when the machines thought I was a real “duck” and booted me out?  MIT roared with the story as well:)</p> <p>I mention that to help educate and again be aware that a lot of flawed data lives amongst use basically due to the huge billions of dollars companies make selling it and it impacts data everywhere, this is no different so ask questions and make sure your data as reported is correct and don’t take it for granted when you apply for health insurance. Hopefully the <a href="http://ducknetweb.blogspot.com/2013/08/ftc-tries-to-bring-strong-case-for.html">FTC and Congress can rise to education level needed</a> here one day to address privacy laws for all of us consumers that get bit over and over by the <a href="http://www.ducknet.net/attack-of-the-killer-algorithms/">Killer Algorithms.</a>  So let’s see what October 1 brings and how it all works.  BD</p> <p> <hr />WASHINGTON -- Major contractors hooking up the internal plumbing of President Barack Obama's health care law projected confidence Tuesday that they will be ready to go by an Oct. 1 deadline, even though the system is still being tested.</p> <p>With just three weeks to go before new state health insurance markets launch, efforts are ongoing to reliably link up government agencies, the markets themselves and private health plans.</p> <p>The congressional Government Accountability Office warned this summer that with so much work left for the last minute, the timely and smooth launch of the markets could not be guaranteed. Still, with the president's image at stake, his administration is working all out to deliver. </p> <p>But the administration got a boost this week when California officials said their marketplace — the nation's largest — would start enrolling uninsured people Oct. 1 as scheduled, through a mix of online access, call center support and community helpers.</p> <p>Representatives of four big contractors testified in a rare joint appearance Tuesday before the House Energy and Commerce committee. Republicans who run the panel billed the hearing as a "pulse check" on Obama's law. The contractors have routinely ignored media requests to explain their work, but they could not rebuff Congress.</p> <p>Cheryl Campbell, a senior vice president of CGI Federal, Inc., said her company is "confident" its part of the job will be ready Oct.1. The Virginia-based contractor is building the federally run marketplace, with Washington running the markets or taking the lead in 35 states. </p> <p>Michael Finkel, an executive vice president of QSSI, Inc., delivered a status report on the lynchpin of the system, a federal data hub that functions as the router for verifying key eligibility data. The hub will ping federal agencies such as Social Security, Homeland Security and the Internal Revenue Service to verify identity, legal residence and income. </p> <p>John Lau, program director for Serco, said his company is staffing up to handle paper applications and other tasks. It will open a service center in Kentucky on Oct. 1, followed soon by two others in Arkansas and Missouri.</p> <p>Lynn Spellecy, a corporate lawyer for Equifax Workforce Solutions, said the subsidiary of the well-known credit reporting company is ready to help verifying income and employment. It will rely on a proprietary database called The Work Number, widely used by lenders, employers and government agencies. Final testing is scheduled for Sept. 15.</p> <p><a href="http://www.sacbee.com/2013/09/10/5723431/obamacare-contractors-project.html">http://www.sacbee.com/2013/09/10/5723431/obamacare-contractors-project.html</a></p>

Health Insurance Exchange Contractors Give Update Report to House Energy & Commerce Committee–The Federal Data Hub Beta

This was nice to get some updates from the contractors involved in the process.  Again I’m still curious to see how the old COBOL servers wo...

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Recalls Kicking Back In for Johnson and Johnson–Mold With Injected Drugs

<p>By the time J and J gets done with all their recalls they should have some of the most uncontaminated stuff out there:)  <img align="right" alt="image" border="0" height="80" src="http://lh4.ggpht.com/-WxIkeQq8zeM/UjEMMtH4UXI/AAAAAAABHsk/8onEwyMKF88/image%25255B11%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="146" />This time the recall involves Risperdal Consta, the liquid, not the pills so the recalls affect more hospitals and doctor’s offices as not one consumers keep at home. </p> <p>Here’s the beauty of outsourcing here I guess you could say as another drug  company by the name of Alkermes made the drug who also produces a line of their products.  BD  </p> <p><a href="http://online.wsj.com/public/quotes/main.html?type=djn&symbol=JNJ"> <hr />Johnson & Johnson</a> <a href="http://online.wsj.com/public/quotes/main.html?type=djn&symbol=JNJ?mod=inlineTicker">JNJ +0.79%</a> recalled another product Wednesday, pulling some vials of its antipsychotic treatment Risperdal Consta after discovering mold during routine quality testing.</p> <p>In recent years, the New Brunswick, N.J.,<img align="right" alt="image" border="0" height="131" src="http://lh3.ggpht.com/-w9mrD49eQL4/UjEMNGRJNiI/AAAAAAABHss/3Ri4cbASThM/image%25255B3%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="332" /> health-products maker has issued dozens of recalls for a variety of products, costing it hundreds of millions of dollars sales and prompting close government oversight of some manufacturing plants.</p> <p>In the latest case, <a href="http://online.wsj.com/public/quotes/main.html?type=djn&symbol=JJSF">J&J</a> <a href="http://online.wsj.com/public/quotes/main.html?type=djn&symbol=JJSF?mod=inlineTicker">JJSF +1.19%</a> estimates that 5,000 of the 70,000 vials made in a single lot last year remain unused in doctor's offices, community mental health centers and pharmacies and must be withdrawn. Because it is injected, Risperdal Consta is stored and given at the clinics, rather than the patients keeping and taking the drug themselves.</p> <p>Risperdal Consta is one of J&J's top-selling drugs, with $1.4 billion in sales last year. It is different from Risperdal pills, which patients store and take at their homes.</p> <p>The Risperdal Consta that was recalled was the 25mg dose and from lot No. 309316. It was made by another company, <a href="http://online.wsj.com/public/quotes/main.html?type=djn&symbol=ALKS">Alkermes</a> Inc., <a href="http://online.wsj.com/public/quotes/main.html?type=djn&symbol=ALKS?mod=inlineTicker">ALKS -0.09%</a> and shipped from Jan. 14 to May 20, 2013, according to J&J. An Alkermes spokeswoman directed questions to J&J.</p> <p><a href="http://live.feedjit.com/live/ducknetweb.blogspot.com/0/" title="http://live.feedjit.com/live/ducknetweb.blogspot.com/0/">http://live.feedjit.com/live/ducknetweb.blogspot.com/0/</a></p>

Recalls Kicking Back In for Johnson and Johnson–Mold With Injected Drugs

By the time J and J gets done with all their recalls they should have some of the most uncontaminated stuff out there:)  This time the recal...

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FDA Approves Test for Faster Confirmation of Sterilization of Medical Devices From Steris

<p>Why did the company do this, back in 2009 they had issues <img align="right" src="http://lh3.ggpht.com/_v3zjJigoAPE/SyMoppvh4sI/AAAAAAAAbYw/kdulMSm9yPU/image_thumb%5B2%5D.png?imgmax=800" style="float: right; display: inline" />and this is great to see the company working to solve it and look how many years we have in this research and development, 5.  It takes time and there’s a lot of robotics and algorithms that go into a project like this.  </p> <h5><a href="http://ducknetweb.blogspot.com/2009/12/hospitals-need-to-replace-steris-system.html">Hospitals Need To Replace The Steris System Endoscope Sterilizer in 6 Months – FDA Mandate</a></h5> <p>This process if I am reading correctly speeds up the time a bit to confirm that devices have been sterilized properly and ready for use.  All the bean counters with measuring medical staff productivity will probably be all over this one:)  BD</p> <p> <hr />The FDA recently granted permission for marketing of the Verify Cronos Self Contained Biological Indicator (SCBI), a new test that can help speed the determination of the effectiveness of steam sterilization of reusable medical devices.</p> <p>According to the test’s manufacturer, <a href="http://www.steris.com/">Steris Corporation</a>, the Verify Cronos SCBI is the first biological indicator test that gives test results in two hours.</p> <p>“This is a novel and innovative use of recombinant DNA technology in biological indicator tests,” said Christy Foreman, director of the Office of Device Evaluation in the FDA’s Center for Devices and Radiological Health. “By providing faster confirmation of sterilization, this innovation may help health care facilities provide their medical staff with a faster turnaround of their sterilized reusable devices.”</p> <p>To support its FDA petition, Steris conducted a number of tests to ensure the performance of the Verify Cronos SCBI. This included subjecting more than 300 Verify Cronos SCBIs to a partial sterilization cycle and then comparing results after two hours and at seven days of incubation. The results showed that samples that fluoresced at two hours also exhibited growth at seven days.</p> <p><a href="http://www.gastroendonews.com/ViewArticle.aspx?d=FDA%2BUpdate%2B%26%2BProduct%2BNews&d_id=183&i=September+2013&i_id=993&a_id=24045">http://www.gastroendonews.com/ViewArticle.aspx?d=FDA%2BUpdate%2B%26%2BProduct%2BNews&d_id=183&i=September+2013&i_id=993&a_id=24045</a></p>

FDA Approves Test for Faster Confirmation of Sterilization of Medical Devices From Steris

Why did the company do this, back in 2009 they had issues and this is great to see the company working to solve it and look how many years w...

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Bar Codes for Drugs Is Not Dead, They are Edible Now, The Battle Against Counterfeit Drugs With Tagging the Pills…

<p>If you have followed my blog then you might remember I had quite a few posts on using bar codes to identify recalls on drugs and devices. <img align="right" alt="image" border="0" height="125" src="http://lh5.ggpht.com/-h13ETaQjf04/Ui_jPqkPjVI/AAAAAAABHsI/0bK1CIrDnuU/image%25255B3%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="205" /> I finally put a bunch of it together on one page and <a href="http://ducknetweb.blogspot.com/p/healthcare-bar-code-posts.html">it’s here in my archives</a>.  Microsoft recently announced they are out of the bar code business and services will be transitioned to <a href="http://www.scanlife.com/">ScanLife.</a>  TruTag is another company who has developed the bar coding even further so we can eat or swallow them with no harm, made out of things that are already found in our bodies or in food products we eat.    </p> <p>This is pretty good that any pill could be scanned for authenticity.  How many stories have we read about counterfeit drugs..too many.  TruTag is located in Hawaii so developed right in the good old USA too.  The silica micro tag is pretty durable and in addition to drugs there’s an open door for use with other products that get copied as well.  So far from what I read they have a “specific” reader developed for the process on the drugs and it there’s a phone app for scanning too.  I’m sure the FDA if they haven’t already, will be taking a look at this technology as well.  On consumer products though, I still wouldn’t mind a bar code for recalls to be available, can’t hurt.  Sorry compliance folks this product is not for that:)  Someone will try though you can almost bet given a little time here.  </p> <p>The product specifically addresses FDA’s PCID (physical-chemical identifier) guidance for anti-counterfeiting measures.  BD  </p> <p> <hr />The microtags developed by TruTag Technologies are made from silica — an ingredient already found in many foods, including sweeteners — and are independent of packaging and labels and can be integrated directly into a product’s infrastructure. About the size of a dust particle and smaller than the width of a human hair, the silica “TruTags” provide a<img align="right" alt="image" border="0" height="95" src="http://lh4.ggpht.com/-CduOJ21IcG4/Ui_jQHegmkI/AAAAAAABHsQ/4z18HC9FGk4/image%25255B7%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="164" /> vast library of unique codes, allowing for improved tracking and authentication of electronics, industrial parts and consumer goods. Each tag’s coded, nano-scale pattern can be scanned using the company’s proprietary instruments. These patterns are like ID numbers that can be associated with a variety of information, such as product strength, site of manufacture, expiration date and country of authorized sale.</p> <p><strong>Putting product intelligence on a pill</strong>, instead of the package, could help drug manufactures and product security teams authenticate their product. A few years ago, GSK, one of the top pharmaceutical companies in the world, was found guilty of felony distribution of adulterated drugs and paid a $750 million fine for mixing up an anti-anxiety drug and a diabetes drug in the same GSK packaging. Had the drugs been equipped with TruTag microtags, the inspectors could have determined where each pill was made to help diagnose where the problem was in their global supply chain.</p> <p>TruTag has been named a 2014 Technology Pioneer by the World Economic Forum, an award given to 36 companies that are designing, developing and deploying innovative technologies that affect business and society.</p> <p><a href="http://news.discovery.com/tech/gear-and-gadgets/edible-bar-codes-choke-counterfeit-drug-market-130910.htm#mkcpgn=rssnws1">http://news.discovery.com/tech/gear-and-gadgets/edible-bar-codes-choke-counterfeit-drug-market-130910.htm#mkcpgn=rssnws1</a></p>

Bar Codes for Drugs Is Not Dead, They are Edible Now, The Battle Against Counterfeit Drugs With Tagging the Pills…

If you have followed my blog then you might remember I had quite a few posts on using bar codes to identify recalls on drugs and devices. I...

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Theranos, Inc. And Walgreens Partner to Offer In Store Lab Tests Requiring a Few Small Drops of Blood, The Cost For Each Test = 50% of What Medicare Charges For Any Test, Insured or Not Insured

<p>This has been quit a story that has been developing for years with the company Walgreens is now going to business with, <a href="http://www.theranos.com/">Theranos.</a>  This also stands to be a bit disruption to how we perform and get lab tests.  LabCorp and Quest I’m<a href="http://www.theranos.com/"><img align="right" alt="image" border="0" height="60" src="http://lh6.ggpht.com/-BB1FPxaNJ8I/Ui_TSTG9z0I/AAAAAAABHrQ/tPHCFVuHpHM/image%25255B30%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="150" /></a> sure have been watching it closer than anyone else as they are the ones who stand to be impacted by a new process here.   Elizabeth Holmes, the CEO dropped out of Stanford to create her company at 19 and she’s 29 now so we are looking at 10 yeas of development.  She’s an engineer and has the talent.  Prior to starting her company while in high school she started a business to distribute C++ sharp software to Asian universities.   She was spending all her time talking to VCs and was not making the classes so she took the break.  </p> <p>  </p> <p><script type="text/javascript" src="http://ecorner.stanford.edu/embeddedPlayer.html?mid=2201&width=420"></script>Anyway back on track with the story the company makes inexpensive and efficient lab tests and I looked at the website and read quite a bit of what was on there.  The first location will be a Walgreen store in Palo Alto.  In addition there will be a lab on the east coast in Newark.  The economic development folks<img align="right" alt="image" border="0" height="133" src="http://lh3.ggpht.com/-HJi8PcedpX0/Ui_TS72E-jI/AAAAAAABHrY/msYpw2CK4ZY/image%25255B3%25255D.png?imgmax=800" style="border-left-width: 0px; border-right-width: 0px; background-image: none; border-bottom-width: 0px; float: right; padding-top: 0px; padding-left: 0px; display: inline; padding-right: 0px; border-top-width: 0px" title="image" width="170" /> in Newark said this was the most secretive company they had ever worked with so lips have been sealed and due to the nature of the business I can see why. </p> <p>With a few ounces of blood, hundreds of diseases can be diagnosed in a very short time.  In 2010 they raised $45 million so there was serious attention here and nice compared to seeing VC money going like that out on games.  Theranos actually selected Walgreens as a partner and with all the stores they have and are buying up, it was the biggest way to get the product out there I would guess.  They just bought yet another chain I posted earlier today.</p> <h5><strong><a href="http://ducknetweb.blogspot.com/2013/09/walgreens-makes-another-purchase-buys.html">Walgreens Makes Another Purchase, Buys Regional Pharmacy Chain In North Carolina, Kerr Drug</a></strong></h5> <p>I read somewhere that Larry Ellison was on the board as well as some pretty other high ranking business executives so she’s connected well.  <a href="http://www.theranos.com/our-company">You can see who’s on the board here.</a>  The Wellness Centers will be inside the Walgreen stores so I am guessing it might resemble something like the retails clinics as far as having an area and maybe smaller in size, and might be right inside the clinics in stores where they have them.  With what they are doing you can obviously see the military connection with a member of the DOD on the board as well. <strong> The president and CEO is a computer scientist</strong> so again this is a focused technology company and no digital illiterates in the key positions here.  </p> <p><img align="left" alt="image" border="0" height="279" src="http://lh5.ggpht.com/-2B0qSXJhWzQ/Ui_TTfX8tAI/AAAAAAABHrc/ZncKSMlOHjU/image%25255B8%25255D.png?imgmax=800" style="border-left-width: 0px; border-right-width: 0px; background-image: none; border-bottom-width: 0px; float: left; padding-top: 0px; padding-left: 0px; display: inline; padding-right: 0px; border-top-width: 0px" title="image" width="426" /></p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p>The work appears to be done for integration with medical records as well with electronic results available from anywhere with an internet connection.  The site has a place where doctors can sign up and they can send patients to Walgreens where the Theranos wellness centers will be located.  </p> <p><img align="left" alt="image" border="0" height="165" src="http://lh4.ggpht.com/-0E2yXf-gRSU/Ui_TT0BVdhI/AAAAAAABHro/ladckkDEhpw/image%25255B12%25255D.png?imgmax=800" style="border-left-width: 0px; border-right-width: 0px; background-image: none; border-bottom-width: 0px; float: left; padding-top: 0px; padding-left: 0px; display: inline; padding-right: 0px; border-top-width: 0px" title="image" width="428" /></p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p>This is the kicker and the huge advantage here is the price…50% less than what Medicare pays, so there would be a rush on this I would think as I don’t any insurer or Medicare or Medicaid is going to complain in this area.  </p> <p><em>“We’re committed to making lab testing more accessible to everyone. That means pricing our tests at dramatically low rates. We can accept major insurance carriers as well as Medicare and Medicaid. And if you’re uninsured, we offer you the same discounted prices we offer everyone else. Because a test should cost the same, no matter who you are.”</em></p> <p>Here’s a couple screenshot samples of what tests will cost:</p> <p><img align="left" alt="image" border="0" height="304" src="http://lh3.ggpht.com/-zx1diutnn1w/Ui_TUelejVI/AAAAAAABHrw/L77nZpIbS8M/image%25255B20%25255D.png?imgmax=800" style="border-left-width: 0px; border-right-width: 0px; background-image: none; border-bottom-width: 0px; float: left; padding-top: 0px; padding-left: 0px; display: inline; padding-right: 0px; border-top-width: 0px" title="image" width="426" /></p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p><img align="left" alt="image" border="0" height="208" src="http://lh5.ggpht.com/-Whnku6QJaOc/Ui_TUqvvA3I/AAAAAAABHr4/_L1yov-uhC4/image%25255B25%25255D.png?imgmax=800" style="border-left-width: 0px; border-right-width: 0px; background-image: none; border-bottom-width: 0px; float: left; padding-top: 0px; padding-left: 0px; display: inline; padding-right: 0px; border-top-width: 0px" title="image" width="426" /></p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p><strong>Glucose test for example $2.70, anyone can afford that.</strong>  The allowable error margins are less than 10%.  This also stands to save Medicare a ton of money if you have not figured that one out yet if the prices are half and stay there.  </p> <p><strong>I think the company is going to make a big stir</strong> and again how it impacts the current giants in the business will be very interesting.  Right now it has to get started and running.  Stay tuned as I’ll update this one as more information becomes available and I’m sure once the Palo Alto store opens up on Monday we will be hearing a lot more.  BD  </p> <hr /> <p>Theranos, Inc. and Walgreens (NYSE: WAG) (Nasdaq: WAG) today announced a long-term partnership to bring access to Theranos' new lab testing service through Walgreens pharmacies nationwide. As the service becomes available through<strong> Theranos Wellness Centers inside Walgreens stores,</strong> consumers will be able to access less invasive and more affordable clinician-directed lab testing, from a blood sample as small as a few drops, or 1/1,000 the size of a typical blood draw. The samples are either taken from a tiny finger stick or a micro-sample taken from traditional methods, eliminating the need for larger needles and numerous vials of blood required for most diagnostic lab testing. </p> <p>Theranos and Walgreens are taking the first step in making this service available to consumers with the first Theranos Wellness Center location opening this month at Walgreens drugstore at 300 University Ave. in Palo Alto, Calif., in the heart of Silicon Valley. The companies plan to offer the service at Walgreens locations nationwide. </p> <p>For the first time, Theranos is introducing CLIA-certified laboratory services with the ability to run its tests on micro-samples. Theranos' proprietary laboratory infrastructure minimizes human error through extensive automation to produce high quality results. Test results are available to physicians in a matter of hours, enabling fast diagnoses to help informed treatment choices. Theranos tests are low cost -- always 50 percent of Medicare reimbursement rates or less -- and are reimbursed by major insurance carriers, Medicare, and Medicaid. Developed to be accessible to everyone, Theranos tests cost the same amount for everyone, regardless of insurance plan or whether they are uninsured. </p> <p><a href="http://online.wsj.com/article/PR-CO-20130909-904497.html">http://online.wsj.com/article/PR-CO-20130909-904497.html</a></p>

Theranos, Inc. And Walgreens Partner to Offer In Store Lab Tests Requiring a Few Small Drops of Blood, The Cost For Each Test = 50% of What Medicare Charges For Any Test, Insured or Not Insured

This has been quit a story that has been developing for years with the company Walgreens is now going to business with, Theranos.   This als...

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Picis Software Used in Emergency Rooms At Hospitals, Subsidiary of UnitedHealthcare Issues A Recall As Doctors Notes Relative to Prescriptions Vanished-Killer Algorithms Show Up Again..

<p>Well if you think the market glitches were enough to enough to deal with we have some glitches over in the healthcare medical records end of things now.   As the world of software gets more complex, we end up with more<img align="right" height="61" src="http://lh5.ggpht.com/_v3zjJigoAPE/TEhjc3XtwWI/AAAAAAAAfz4/zB-cTHf20nI/image%5B5%5D.png?imgmax=800" style="float: right; display: inline" width="175" /> issues as such.  This was a company that UnitedHealthcare purchased back in 2010, so it was not developed “in house” you could say.  The subsidiary of United formerly called Ingenix, made the purchase and now the name has been dropped a while back and Optum and/or Optum Insights replaced the name.  </p> <h5><a href="http://ducknetweb.blogspot.com/2010/07/ingenix-subsidiary-of-unitedhealthgroup.html">Ingenix (Subsidiary of UnitedHealthGroup) Buys Picis Hospital Software Analytics Company – Algorithms of Healthcare Continue To Grow</a></h5> <p>As you can see from a prior link from a while back the software is used even at the VA and <strong><a href="http://ducknetweb.blogspot.com/2013/07/health-insurance-business-under-radar.html">when it comes to looking at subsidiaries of health insurers, take a look</a></strong> as I keep telling all that this is where the actions take place in the money areas at least and now we other types of actions taking place.  </p> <h5><a href="http://ducknetweb.blogspot.com/2010/12/va-awards-contract-to-picis-subsidiary.html">VA Awards Contract to Picis, Subsidiary of Ingenix for Anesthesia Record Keeping Software</a></h5> <p>Also noted in here was the fact that the FDA had records of of six recalls relating to electronic medical records on file.  When companies are certified by the ONC, this goes to show you can’t catch everything and sometimes other problems develop later.  There’s been an issue of who should be in control of monitoring mHealth software and electronic medical records and perhaps this issue might be what I was headed for when <strong>I commented to stop fighting and move the ONC over to the FDA as a division as this recall clearly shows the need for collaboration amongst both of them.</strong>  I wrote that up back in July after reading numerous article about “who should be in control”, answer is both, working together.  Some of the folks over there liked the idea too as noted on Twitter.  </p> <h5><a href="http://ducknetweb.blogspot.com/2013/07/mhealth-why-battle-over-where.html">mHealth Why Battle Over Where the Responsibility Lies, Make the ONC A Division of the FDA, Better Collaboration and Software Engineering Exposure Both Ways Around</a></h5> <p>This is not the first battle UnitedHealthcare has had with software as we can go back to the <a href="http://ducknetweb.blogspot.com/2009/12/ama-announced-settlement-of-class.html">AMA  lawsuit</a> whereby doctors and hospitals were short paid for 15 years on out of network reimbursements.  So we have a little bit of both going on in the world today, <strong>some issues by accident and some by design when it comes to models and making money for sure.</strong>  </p> <p>The recall looks pretty big here and includes California, New Jersey and Florida, and the particular software was “Pulsecheck” portion of the software suite.  Just recently too in discussing the FDA I brought up the fact too that <a href="http://ducknetweb.blogspot.com/2013/04/more-data-for-sale-soon-with-shared.html">we have  insurer subsidiaries actually competing with the FDA Sentinel program too with “selling” claim and other data versus a “free contribution”</a> as Sentinel was set up to do and all insurers a few years ago made their statements that they would donate this information.</p> <p>It is interesting to follow the crosshairs when profits and money are discussed in healthcare I must say.  In this case it’s all about those SQL action queries not posting the data as it was designed to do.  Way back in my early days I spent many long nights getting bugs out for such items and sometimes you never find them all, like in this case and with complexities with interfacing with other software, that could be the culprit as well as it may have functioned perfectly as a stand alone but now some code from other software disrupts this process.  </p> <p>It happens all the time and time to call in the the Query Master to figure out what when wrong with the code.  <a href="http://ducknetweb.blogspot.com/2013/02/speed-up-rate-of-change-in-health.html">This is why HHS drive me nuts when they publicly come out and say “hurry up Health IT”..</a>lack of digital literacy gets exploited like this and they do it to themselves:)  We also get this with the exchanges from Deparle, <a href="http://ducknetweb.blogspot.com/2013/08/nancy-deparle-returns-to-what-she-knows.html">“all the IT work is done” while campaigning for the program…we all know that’s not true either:)</a></p> <p>Anyway, this should be an eye opener to all to really look and see what health insurers do with their subsidiaries and you will find their businesses in  areas you never thought of before and this is kind of dangerous as we are ending up with “insurers being too big to fail”..lots of the same things that happens in<img align="right" src="http://lh5.ggpht.com/_v3zjJigoAPE/TKGKedAqGlI/AAAAAAAAhuI/bumKfZLtMII/image%5B13%5D.png?imgmax=800" style="float: right; display: inline" /> markets finds its way to healthcare too and it usually profit related.  How many of you realized <a href="http://ducknetweb.blogspot.com/2010/08/ingenix-subsidiary-of-united-health.html">United was in the medical records business</a> before this?  They have a couple other subsidiaries that sell medical records too, not just limited to this one.  Back in 2010 they bought this company too that does EHRs and HIE so they are right in the heart of things when it comes to meaningful use and physician incentives.  </p> <h5><a href="http://ducknetweb.blogspot.com/2010/09/axolotl-subsidiary-of-ingenix-creates.html">Axolotl (A Subsidiary of Ingenix) Creates Reporting and Analytics Solution for Health Information Exchanges–Algorithms for HIE–Business Intelligence -Subsidiary Watch</a></h5> <p>If you read the Picis site they are talking they just went live in the middle east so their markets are international and all of this goes right down to the UnitedHealthcare bottom line profits.  Take a look at Aetna and Humana and others, doing a lot of the same but not as long and big as United is with subsidiaries.   <a href="http://ducknetweb.blogspot.com/2011/09/united-healthcare-optum-owns-consulting.html">Have you ever heard of CanReg?</a>  This is a Untied company that consults and introduces drugs and devices to the FDA and takes their client through the processes.  Interesting at times to look and see if and how subsidiaries interface with each other, you think?  There’s also the <img align="right" src="http://lh3.ggpht.com/-HnTn619yPL4/ToABdn-QntI/AAAAAAAA32I/cclGtJCjevk/image_thumb%25255B2%25255D.png?imgmax=800" style="float: right; display: inline" />Chinese company, <a href="http://ducknetweb.blogspot.com/2010/05/unitedhealth-subsidiary-ingenix.html">ChinaGate</a> kind of doing the same thing with drugs and devices made in China, another subsidiary.  </p> <p>Sometimes with software you think you have a problem fixed and you do, but the fix creates other issues or other areas of the software code that also need to be checked or revised…the way it works…voice of experience here as year ago <a href="http://ducknetweb.blogspot.com/2009/01/what-does-antiquated-emr-electronic.html">I wrote a very simple EMR before the big complexities rolled in and that’s when I quit:)</a>  This is why too what you see here at the Quack is a lot different than what you might read else where as whether it’s me or someone else, nothing beats hands on experience.  We have problems with that today too with too may so called experts never having any hands on whether it be a simple consumer app or business software.  They read about something, <a href="http://ducknetweb.blogspot.com/2011/02/doctors-have-become-one-of-largest.html">become a magpie</a> but never do any investigating hands on when if the situation allows.  </p> <p>So does this situation demand a big panic and leave hospitals without software, no as I am guessing they will revert back to a prior version of it where the problem did not exist and that’s the first route any software company would take.  United is busy though on the payment software as they have a subsidiary that they created to work with Epic on being a clearinghouse to go after that business<strong>.  Ok so nobody wants to talk about subsidiaries a lot in the news maybe…I call such posts “subsidiary watch” and have been writing them for about 3 years.  Just use those search words and you will find a ton of them here as relates to all insurers and Health IT companies.  </strong></p> <h5><a href="http://ducknetweb.blogspot.com/2011/11/so-what-part-of-health-it-has-united.html">OptumInsight (A Wholly Owned Subsidiary of United HealthCare Optum Division) Creates Medical Clearinghouse Integrated With Epic Practice Management Software-Subsidiary Watch</a></h5> <p>This situation does say something though for Epic though with keeping all their development in house and why they fly above others with those who feel confident with their software, they have control and CEO Judy know that as well (smart lady) as do some of their clients so when it comes to buying up code someone else wrote, you run into this and there’s the <a href="http://ducknetweb.blogspot.com/2010/09/allscripts-and-eclipsys-merger.html">Allscripts story</a> too as they did a lot of buying up someone else’s code and got into trouble when their integration process was not done on time to please the shareholders<strong>…can’t help some of this but don’t stretch the truth either as you can make the coder work any faster, public and HHS is just now learning this fact too.</strong>   It was better that United reported their issue first before it was found by the users of course.  <strong>This issue this time is somewhat critical though as I read where the doctors notes are not being included…some rogue algorithm at work here.</strong>  </p> <p>There are and will be errors and we end up with flawed data too out there so be a skeptic when you need to be and the <a href="http://www.ducknet.net/attack-of-the-killer-algorithms/">Algo Duping video page</a> I have has some great videos that will open up your eyes as to how some of what you see out there works, relative to clinical trials, all these reports on “how much money can be saved” and so forth as it gets difficult to see what’s coded for profit and when you are being duped to some degree.  It’s not all bad out there but it’s not all good either as data selling has reached epidemic stages in the US and you do see some strange stuff out there with numbers that make one say hmmmm at times if they are presented out of context.  </p> <p>I’m sure with a <a href="http://ducknetweb.blogspot.com/2013/06/qssi-subsidiary-of-united-healthcare.html">subsidiary of United  building the federal data hub</a> for exchanges, this might open up some opportunities for questions there as well.  That was also another company United bought, two weeks after HHS awarded the contract.  More code…so as the markets goes with glitches, so does healthcare.  BD  </p> <p><a href="http://www.businessweek.com/news/2013-09-10/unitedhealth-recalls-digital-health-record-software-after-error">http://www.businessweek.com/news/2013-09-10/unitedhealth-recalls-digital-health-record-software-after-error</a></p>

Picis Software Used in Emergency Rooms At Hospitals, Subsidiary of UnitedHealthcare Issues A Recall As Doctors Notes Relative to Prescriptions Vanished-Killer Algorithms Show Up Again..

Well if you think the market glitches were enough to enough to deal with we have some glitches over in the healthcare medical records end of...

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Wellmont Health System in Tennessee Tells United Healthcare Their Rates Are Too Low, But Standard Medicare is Still An Option for Patients At Their Facilities

<p>It’s interesting that Medicare is still ok and I say this as not too long ago the AAFP confronted United on paying doctors less than Medicare.<img align="right" alt="image" border="0" height="71" src="http://lh5.ggpht.com/-ikCRQTRZwbI/Ui6mWIQuZqI/AAAAAAABHrA/q-Xru_QXcAY/image%25255B3%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="156" />  I wondered if this extends out to hospitals too?  The company is still making big profits as we see.</p> <h5><a href="http://ducknetweb.blogspot.com/2012/12/the-aafp-confronts-united-healthcare-on.html">The AAFP Confronts United Healthcare On Reimbursements, Some Are Below Medicare Rates In Parts of the US–Payment Algorithms/Formulas Calculated Deep Within IT Infrastructures Do the Job</a></h5> <p>If you have never seen the United truckloads of subsidiary companies and what they all do, <a href="http://ducknetweb.blogspot.com/2013/07/health-insurance-business-under-radar.html">take a look at this post</a> for some information there to include even hospice for profit which I found when I was in Arizona not too long ago when my mother passed away as a choice, but didn’t go there and stayed in the non profit realm for Mom.  </p> <p>The Wellmont system is pretty close to the back yard of <a href="http://www.ramusa.org/">Remote Area Medical</a> too in Tennessee and I might guess they get some volunteers from Wellmont too.  They have a few up and coming free medical clinics on their schedule for Tennessee.  </p> <p>If nothing occurs by October 1st and the impasse is still in effect, then patients will need to find another insurance carrier.  BD  </p> <p> <hr />KINGSPORT - Contract talks between UnitedHealthcare and Wellmont Health System are at an impasse, and Wellmont says patients covered by four UnitedHealthcare plans face higher hospital rates and limited physician access after Sept. 30. <br />In a prepared release, Wellmont called the latest proposal from UnitedHealthcare “unacceptable.” To continue receiving in-network rates at Wellmont hospitals, patients will need to obtain coverage from another insurance carrier, according to the health system.</p> <p>Wellmont advises patients who would like to retain in-network rates at their hospitals can switch from one of the UnitedHealthcare plans to BlueCross BlueShield of Tennessee Blue Advantage, Humana, Windsor Health Plan or the federal government’s traditional Medicare program.</p> <p><a href="http://www.timesnews.net/article/9067075/wellmont-calls-unitedhealthcare-proposal-unacceptable">http://www.timesnews.net/article/9067075/wellmont-calls-unitedhealthcare-proposal-unacceptable</a></p>

Wellmont Health System in Tennessee Tells United Healthcare Their Rates Are Too Low, But Standard Medicare is Still An Option for Patients At Their Facilities

It’s interesting that Medicare is still ok and I say this as not too long ago the AAFP confronted United on paying doctors less than Medicar...

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UnitedHealthcare and Cigna Opt Out of New Jersey and Pennsylvania Insurance Exchanges, Aetna On the Fence

<p>Aetna is already said they were out in California (completely gone with individual policies outside the exchanges too)New York, Ohio and Maryland and they <img align="right" height="103" src="http://lh5.ggpht.com/_v3zjJigoAPE/TXCfvYCDCBI/AAAAAAAAsv0/8biVjC7dBI0/image_thumb%5B1%5D.png?imgmax=800" style="float: right; display: inline" width="101" />have not decided on these two states.  United almost has to participate in New York since they own and operate a subsidiary, Oxford Insurance with individual polices.  </p> <h5><a href="http://ducknetweb.blogspot.com/2013/01/united-healthcare-states-they-will-pick.html">United Healthcare States They Will Pick and Choose Health Insurance Exchanges Where They Participate, As They Algorithmically Model Where Profitability Will Exist and Allow for the Creation of Additional Analytics</a></h5> <p>According to the article, Cigna only sold individual policies in 10 states.  I thought it was interesting too when not too long ago they pulled out of Pennsylvania for their headquarters and moved up with Aetna in Connecticut.  <a href="http://ducknetweb.blogspot.com/2013/07/health-insurance-business-under-radar.html">United has so many subsidiaries in so many different businesses</a> it’s<img align="right" alt="image" border="0" height="95" src="http://lh3.ggpht.com/-mBS0c-JIpsI/Ui6e5GoUkRI/AAAAAAABHqw/Ua_PinHJZ3Y/image%25255B3%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="91" /> hard to keep track of them, which struck me as a bit odd with all the folks worrying about controlling Microsoft in the news with their different divisions.  If anyone had their senses about them they should be looking this way as changes with health insurance will directly impact you more than anything that will happen at Microsoft, what a disruptive world we live in at times.  BD</p> <p> <hr />When the health insurance marketplaces, previously known as exchanges, open for business next month, some major insurers will not be participating in Pennsylvania and New Jersey.</p> <p><a href="http://www.bizjournals.com/profiles/company/us/pa/philadelphia/unitedhealthcare/3293714">UnitedHealthcare</a> and Cigna, both publicly traded managed-care companies, will not be offering products through the exchanges. Aetna (NYSE: AET) has not yet decided what it will be doing in the two states, but the Connecticut-based health insurer has already opted not to participate in several states including New York, Ohio and Maryland.</p> <p>Minneapolis-based UnitedHealthcare (NYSE: UNH) said in a prepared statement that the company “evaluated each exchange opportunity individually, starting with our ability to honor our commitments to our existing local customers, members and care providers. We will not be participating in the 2014 Pennsylvania exchange because we believe we have a robust off-exchange product offering for small business owners including defined contribution and self-insured health plans as well as a solid local and national provider network.”</p> <p>He noted that Cigna currently sells policies in individual markets in 10 states which have large numbers of sole proprietorships. Neither Pennsylvania or New Jersey are on that list. Cigna will participate in exchanges in five of those states: Arizona, Colorado, Florida, Tennessee and Texas.</p> <p><a href="http://www.bizjournals.com/philadelphia/blog/health-care/2013/09/some-large-insurers-to-bypass.html?page=all">http://www.bizjournals.com/philadelphia/blog/health-care/2013/09/some-large-insurers-to-bypass.html?page=all</a></p>

UnitedHealthcare and Cigna Opt Out of New Jersey and Pennsylvania Insurance Exchanges, Aetna On the Fence

Aetna is already said they were out in California (completely gone with individual policies outside the exchanges too)New York, Ohio and Mar...

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Rite Aid To Place Commissioned Insurance Agents in Stores to Sell Health Insurance in 31 States And in DC Where the Feds Are Running the Exchanges

<p>As we all know open enrollment begins October 1st and in one form or another with contingencies in place to mail applications instead of the<img align="right" alt="image" border="0" height="182" src="http://lh5.ggpht.com/-gvebMuBeBA4/Ui6bIEJu2JI/AAAAAAABHqk/qVXwF9eVyDY/image%25255B3%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="155" /> mass IT project being totally finished to handle all of it.  Now in those states where the Feds are running the show you can expect to see agents at Rite Aid stores.  They will be independent and not associated with the store but when a policy is sold, Rite Aid gets a small cut of the sale. There had to be some incentive for Rite Aid in all of this I suppose. </p> <p>So when you get your flu shot or prescription there will be yet one person at your disposal in the pharmacy areas.  This will be interesting to see how this goes.  At one point in time it was discussed on the web that Walgreens would sell insurance, and that way long before we got closer to the insurance deadline here.  Rite Aid seems to be coming back from 2009 when they actually had to sell a few of their stores to Walgreens and in 2010 they closed their distribution center in Rome New York.  BD  </p> <p> <hr />HOBOKEN, N.J. (AP) -- One of the nation's largest drugstore chains has signed on to promote the implementation of the federal Affordable Care Act, pledging to have insurance agents on hand at its stores in 31 states and the District of Columbia to help consumers navigate the new system. </p> <p>U.S. Health and Human Services Secretary Kathleen Sebelius announced the partnership with Rite Aid on Monday, along with company chairman John Standley. </p> <p>Standley said the agents would be available in 2,000 stores. Rite Aid has about 4,600 locations nationwide. He said they will be independent and not affiliated with insurers who are offering health insurance through newly created exchanges, but they will receive commissions if they sign people up for policies. Rite Aid also will receive a small commission for each policy sold, he said. </p> <p>The agents will be in stores beginning Oct. 1 when the first open enrollment period for the health exchanges begins. The Congressional Budget Office has estimated that 7 million people currently uninsured will sign up for health insurance during the first six-month period. </p> <p><a href="http://finance.yahoo.com/news/health-care-initiative-announced-nj-184843710.html" title="http://finance.yahoo.com/news/health-care-initiative-announced-nj-184843710.html">http://finance.yahoo.com/news/health-care-initiative-announced-nj-184843710.html</a></p>

Rite Aid To Place Commissioned Insurance Agents in Stores to Sell Health Insurance in 31 States And in DC Where the Feds Are Running the Exchanges

As we all know open enrollment begins October 1st and in one form or another with contingencies in place to mail applications instead of the...

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Express Scripts Buys CMS Sanctioned SmartD Medicare Prescription Drug Plan

<p>According to the news business will continue at usual at SmartD and Express grows another 87,000 Medicare clients.  The sanctions from CMS are recent and <img align="right" alt="image" border="0" height="89" src="http://lh3.ggpht.com/-4a2ohWJbdpo/Ui6NgzelUUI/AAAAAAABHqU/_bV8TnDx8DA/image%25255B4%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="392" />began in April of this year.  SmartD cannot market and pick up new customers as the sanction was in place as CMS said they were a danger to Medicare clients due to some of their current operations methodologies.  You can read the CMS letter <a href="http://insuremekevin.com/wp-content/uploads/downloads/2013/04/Smart-Immediate-Sanction-4_23_2013.pdf">here.</a>  </p> <p>Before acquisition, SmartD RX was owned by SmartD insurance and I’m not sure if they are all wrapped in this together, hard to tell.  BD</p> <p> <hr />Pharmacy benefit manager Express Scripts (<a href="http://www.rttnews.com/SymbolSearch.aspx?Symbol=ESRX">ESRX</a>:<a href="http://www.rttnews.com/corpinfo/quotedetails.aspx?symbol=ESRX"> Quote</a>) Monday announced the acquisition of the SmartD Medicare Prescription Drug Plan, or PDP, which will add 87,000 covered Medicare lives. The financial terms of the deal were not disclosed. </p> <p>"Working together with independent and chain pharmacies, we look forward to serving SmartD members and we are pleased in the continued growth and enhancement of our Medicare PDP offering," said Brit Pim, vice president and general manager, government programs at Express Scripts. </p> <p><a href="http://www.rttnews.com/2185281/express-scripts-acquires-smartd-medicare-prescription-drug-plan.aspx?type=maa" title="http://www.rttnews.com/2185281/express-scripts-acquires-smartd-medicare-prescription-drug-plan.aspx?type=maa">http://www.rttnews.com/2185281/express-scripts-acquires-smartd-medicare-prescription-drug-plan.aspx?type=maa</a></p>

Express Scripts Buys CMS Sanctioned SmartD Medicare Prescription Drug Plan

According to the news business will continue at usual at SmartD and Express grows another 87,000 Medicare clients.  The sanctions from CMS a...

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Your Cheating Tooth Will Tell On You..Tracking The Activity In Your Mouth, Who Knows Maybe It Will Send Data About Oral Sex Activities Too…

<p>I swear people want to just track everything and anything they can.  Who wants crowns with tracking devices or an implant for that matter.  Tire companies have been putting chips in tires for years so no we have to check use of the<img align="right" alt="image" border="0" height="137" src="http://lh3.ggpht.com/-m3Xjes27eB4/Ui1qMIa1kpI/AAAAAAABHqE/tav1ycF1GBU/image%25255B3%25255D.png?imgmax=800" style="border-left-width: 0px; border-right-width: 0px; background-image: none; border-bottom-width: 0px; float: right; padding-top: 0px; padding-left: 0px; display: inline; padding-right: 0px; border-top-width: 0px" title="image" width="117" /> crown or implant too?  I can it for research purposes as the article mentions for those who are grinding their teeth  as temporary tool and not put in a tooth for life.  The article says it can tell when you swallow, cough eat, you name it so why would it leave out the oral sex data (grin).  </p> <p>Gosh forbid don’t let the insurers loose with this as they have an insatiable appetite for data and will do anything to get that data to work on their risk assessments.  We would be stuck for sure seeing dentists who use spying chips in tooth replacements for sure.  Again if it were used as a temporary agent to help diagnose something or to seek additional information for treatment, then ok, but as I said four years ago the <a href="http://ducknetweb.blogspot.com/2010/08/data-addiction-and-abuse-up-and-coming.html">next 12 step program on the horizon will be data addiction and abuse</a> and when do you draw the line on when enough is enough sometimes.  These folks wanted to put your PHR in your tooth too…</p> <h5><a href="http://ducknetweb.blogspot.com/2010/02/i-denti-fied-sink-your-phr-into-your.html">I-Denti-Fied – Sink Your PHR Into Your Teeth And Take A Bite Out of Healthcare…</a></h5> <p>Data sellers would love to get more data to sell as well if it becomes available.  We already have insurers buying up Visa and Master card records to see (in the words of Blue Cross) to monitor to see if their members are buying clothes a size larger, so now with this they could get data on when you feed your face too?  The article says the tooth sensor can do all of that.  Technology like this is interesting but we still have to be able to live and survive like humans so<strong> how many of the Quantified Self folks are going to line up for one of these (grin)?</strong>  BD  </p> <h5><a href="http://ducknetweb.blogspot.com/2013/05/health-insurers-and-others-trying-to.html">Health Insurers and Others Trying to Track Junk Food Consumers Purchase–Attack of the Killer Algorithms for Corporate Profits</a></h5> <hr /> <p>A new invention stands to revolutionize the work of dentists and dietitians. The so-called “smart tooth” monitors an individual’s oral habits by recording gross and minute movement of the jaw. Developed by researchers from the <a href="http://www.ntu.edu.tw/engv4/">National University of Taiwan</a>, the innovation will allow doctors to track chewing, drinking, eating, coughing, and even smoking. </p> <p><a href="http://www.dailymail.co.uk/health/article-2413866/An-invention-chew-Scientists-create-smart-tooth-monitor-persons-drinking-eating-smoking-habits.html?ico=health%5Eheadlines">According to <em>The Daily Mail</em></a>, the device can be used detachable fake tooth or inserted in a crown. Once installed, the small motion sensor registers movement of the jaw. The data is then fed to a computer, which interprets the pattern and pairs it with an oral action. </p> <p><a href="http://www.medicaldaily.com/smart-tooth-tracks-smoking-drinking-innovation-could-help-dentists-and-dietitians-provide-better?utm_source=dlvr.it&utm_medium=twitter" title="http://www.medicaldaily.com/smart-tooth-tracks-smoking-drinking-innovation-could-help-dentists-and-dietitians-provide-better?utm_source=dlvr.it&utm_medium=twitter">http://www.medicaldaily.com/smart-tooth-tracks-smoking-drinking-innovation-could-help-dentists-and-dietitians-provide-better?utm_source=dlvr.it&utm_medium=twitter</a></p>

Your Cheating Tooth Will Tell On You..Tracking The Activity In Your Mouth, Who Knows Maybe It Will Send Data About Oral Sex Activities Too…

I swear people want to just track everything and anything they can.  Who wants crowns with tracking devices or an implant for that matter.  ...

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Doctor From Santa Clara Medical Center Accused of Using Cancer Research Money To Pay His Own bills

<p>If things are not bead enough with the stingy silicon billionaires up in this area with nobody contributing and the hospital facing<img align="right" alt="image" border="0" height="134" src="http://lh6.ggpht.com/-_0vH0dcYpyE/UiuX_gocmlI/AAAAAAABHp0/1LsXesPm8qg/image%25255B3%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="237" /> a huge shortfall of money, now we have this..the hospital is a county facility right in the heart of the big Silicon companies and I never see any mention of anything going here.  Now this doctor takes money donated for cancer research and pockets a bunch of it, even mad his parents house payments the report says.  Now this doctor is not in the poor house and you can read the article that talks about his income and the package of money he just received when he quit, a bit under 100k.  </p> <h5><a href="http://ducknetweb.blogspot.com/2013/02/santa-clara-valley-medical-center.html">Santa Clara Valley Medical Center Projecting Close to a $24 Million Dollar Shortfall–Can’t the Billionaires of Silicon Valley Help Their Hospitals Out a Little, Tattoo Parlor Fee Increases Won’t Cover It</a></h5> <p>The hospital caught on to the scam after the radiology  doctor had resigned.  BD</p> <p>Here’s the video that tells more.  BD</p> <script type="text/javascript" src="http://CBSSF.images.worldnow.com/interface/js/WNVideo.js?rnd=699722;hostDomain=video.sanfrancisco.cbslocal.com;playerWidth=425;playerHeight=270;isShowIcon=true;clipId=9268879;flvUri=;partnerclipid=;adTag=News;advertisingZone=CBS.SF%252Fworldnowplayer;enableAds=true;landingPage=;islandingPageoverride=false;playerType=STANDARD_EMBEDDEDscript;controlsType=fixed"></script> <p> </p> <hr />SAN JOSE (KPIX 5) — A former doctor at a South Bay hospital is accused of taking money intended for cancer research to pay his own bills. <p>According to authorities, 45-year-old Dr. Tri Minh Do has been charged with felony misappropriation of public funds. Do recently resigned from Santa Clara Valley Medical Center in San Jose.</p> <p>Investigators said Do received checks from the American College of Radiology to head a cancer research study. According to the Santa Clara County District Attorney’s Office, the radiologist pocketed more than $46,000.</p> <p>According to the hospital, Do earned $293,000 in base pay last year. He also received a $93,000 lump sum when he cashed out his vacation and sick leave.</p> <p><a href="http://sanfrancisco.cbslocal.com/2013/09/04/san-jose-doctor-accused-of-paying-bills-with-cancer-research-money/" title="http://sanfrancisco.cbslocal.com/2013/09/04/san-jose-doctor-accused-of-paying-bills-with-cancer-research-money/">http://sanfrancisco.cbslocal.com/2013/09/04/san-jose-doctor-accused-of-paying-bills-with-cancer-research-money/</a></p>

Doctor From Santa Clara Medical Center Accused of Using Cancer Research Money To Pay His Own bills

If things are not bead enough with the stingy silicon billionaires up in this area with nobody contributing and the hospital facing a huge ...

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