OrderMedicalRecords.Com–Company That You Can Hire to Get Copies of Your Medical Records & A Service for Retiring Doctors With Medical Record Transfers for Patients to New Doctors

<p>I almost feel like this is somewhat of a public service post here as I have read so many stories about patients trying to get copies <img align="right" alt="image" border="0" height="45" src="http://lh4.ggpht.com/-9vI2QRvGfU8/UiLcZ1Z6B9I/AAAAAAABHlE/3xbpRSMoqSA/image%25255B23%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="191" />of their medical records and if they are still “paper” records, well that takes a bit longer as we all know.  Sometimes you luck out and it’s not that hard, but every office, hospital, medical entity is different, so if you get stuck here’s a company for what seems like a reasonable fee, will chase them down for you.</p> <p>The company is a division of another company <a href="https://www.datafied.com/index.aspx">“Datafied”</a> it appears and there’s a little more information on their website as well.  The company goes out and scans your records if needed and you can download them online.  You get an email when your records are available.  The web page states they are HIPAA compliant.  Do check to see which metropolitan areas for their coverage.  </p> <p>What is also interesting here is their sister company<img align="right" alt="image" border="0" height="61" src="http://lh6.ggpht.com/-lxHDfHwweLw/UiLcaZvKp-I/AAAAAAABHlM/mSRXwZs5flg/image%25255B27%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="220" /> called <a href="http://www.myretireddoctor.com/">Retireddoctor.com</a> where a physician can send off the patient records to make sure they are available for patients and how many articles have you read about paper medical record dumps, too many.  The records get scanned and they handle the transition to transferring to the new doctor for the patients.  I don’t have any idea what the cost is and it would depend on the number of files, etc. but  this sure beats getting fined or going to jail with trying to dump off paper medical records somewhere and everyone is happy.  </p> <p>They have a web interface to where it looks like you can either do it all online or you can also reach them by phone.  BD  </p> <p> <hr /><a href="https://www.ordermedicalrecords.com">OrderMedicalRecords.Com</a>, a leading company specializing in the release of information, recently launched a new website. The website facilitates the secure ordering of medical records over the internet through online submission and authorized record collection services. Corporate entities and professionals, as well as individuals and families, now have the option of online ordering.</p> <p><img align="right" alt="image" border="0" height="165" src="http://lh4.ggpht.com/-tJeLp1GkV3o/UiLca-MatOI/AAAAAAABHlU/01eaw2qauUI/image%25255B19%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; margin: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="503" /></p> <p>As companies and professionals narrow down their business practices to very specialized activities, the need for high-volume medical records acquisition becomes more and more prevalent. At the same time, the volume of individuals requesting medical information for themselves or their loved ones is also increasing, as members of society become more assertive in their own medical care needs. To fill the gap, OrderMedicalRecords.Com (OMR) stepped forward to become a proficient procurer of records that require release of information. </p> <p>In addition to other record ordering formats, including over the phone, mail, or fax, the new website now makes it possible to <a href="https://www.ordermedicalrecords.com/why-choose-omr/">request medical records online</a>. The new online format streamlines the ordering process making it simple and straight-forward. It can be used by corporate entities desiring bulk record acquisitions as well as individuals desiring their own records. Clients may also use the website to check the status of their orders. Data security policies are strictly adhered to and all processes and information that are handled through the website are protected using data encryption and other appropriate data security measures.</p> <p><a href="http://www.itbusinessnet.com/article/OrderMedicalRecordsCom-Launches-a-New-Website-Where-Clients-May-Order-Medical-Records-Online-2781487">http://www.itbusinessnet.com/article/OrderMedicalRecordsCom-Launches-a-New-Website-Where-Clients-May-Order-Medical-Records-Online-2781487</a></p>

OrderMedicalRecords.Com–Company That You Can Hire to Get Copies of Your Medical Records & A Service for Retiring Doctors With Medical Record Transfers for Patients to New Doctors

I almost feel like this is somewhat of a public service post here as I have read so many stories about patients trying to get copies of thei...

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“The Tax Free Tour” Documentary on How the Tax Havens Work, Who Runs and Owns Them, How Accountants Are Taking Over the Regulators And Not Held Accountable…

<p>If you liked the video about the <a href="http://ducknetweb.blogspot.hk/2012/09/quants-alchemists-of-wall-street-video.html">Quants</a>, which is always located in the footer of this blog, <img align="right" alt="image" border="0" height="231" src="http://lh3.ggpht.com/-cpdtzj3POgo/UiLBl1rBQ_I/AAAAAAABHks/0IRYoXkNKY8/image%25255B11%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="255" />this is another film they made and it does good a job of explaining how the big corporations get their tax havens.  Right out of the barrel they begin with Apple and interesting how they explain and the Netherlands has like no tax on intellectual property so the chain there is interesting on how it leads back to a US LLC.  See how the names don’t always identify who they are as well.  Wal-Mart is also covered in depth.  If you like this video, hop on over to the <a href="http://www.ducknet.net/attack-of-the-killer-algorithms/">Attack of the Killer Algorithm page</a> to view more documentaries on financial fraud and related subjects.  </p> <p>According to this video, there are always 4 companies present, (screenshot at the right) with most tax havens, all names you probably recognize too.  Familiar advisers are why they are used and the constant feature.  Without one or all of the firms you really will not have a good tax haven.  Banks in there too, all of them.  Banks, lawyers and accountants are the 3 needed elements.  What is “neutral” taxation?  It means “no tax”.  Tax optimization is another term that means “no tax”. </p> <p><iframe style="height: 255px; width: 423px" height="315" src="//www.youtube.com/embed/d4o13isDdfY?list=PL9ABD0BB3C3BEDE19" frameborder="0" width="560" allowfullscreen="allowfullscreen"></iframe></p> <p>The video shows the internal, secret world of where the billionaires live and travel.  They make themselves invisible from money, nothing has their name on it and they deal with “cash”…amazing as they try to push consumers away from cash.  The same laws and regulations don’t seem to apply <img align="right" alt="image" border="0" height="178" src="http://lh3.ggpht.com/-CQ-SxGwzACs/UiLBmX6DoEI/AAAAAAABHk0/3LbPpzqaFKI/image%25255B10%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="162" />to many of the billionaires.  </p> <p>The process of "globalization" was organized by the banksters at the helm of multinational companies with a single purpose in mind, make money. Certainly 35% which is the rate for the US is large percentage but somewhere between 35% and zero would be a help.  </p> <p><strong>Intellectual property profits go to a Dutch “mail box” company for one example, where patents are held…so guess where the royalties go?  You got it, the mailbox.</strong>  Starbucks is identified as a mailbox company and the “trademark fees” flow back to the Netherlands so they are another one that hardly pays any tax.  The one man interviewed here said it’s hard to compete with “zero”, in other words no tax.</p> <p>The Parliament meeting in the UK with asking Starbucks about their 15 year running streak of no profits is rich “why are you still operating here”…you show you are losing money here and we need a better explanation.  They hammer on Amazon pretty well too.  The woman leading it gets right to the point in her speech and then apologizes.  </p> <p>It’s called working within the gaps of the law, why we digital centric types of laws soon that spell out the IT infrastructure and transaction paths.  Accountants have had a pretty good ride and nobody has really questioned them.  Why are the accountants no held accountable when banks failed?  <strong>Nobody judges them and in the UK they are taking over the regulators, so we are back the same 4 pictured above.</strong>  </p> <p>What kind of models do these tax havens have, I guess we go back to the big 4 accountants for answers, right?  Markets get distorted with all this as well with share prices.  It’s the same old story with the middle class and the poor paying taxes.  BD  </p> <p><a href="http://www.youtube.com/watch?v=d4o13isDdfY&list=PL9ABD0BB3C3BEDE19">http://www.youtube.com/watch?v=d4o13isDdfY&list=PL9ABD0BB3C3BEDE19</a></p>

“The Tax Free Tour” Documentary on How the Tax Havens Work, Who Runs and Owns Them, How Accountants Are Taking Over the Regulators And Not Held Accountable…

If you liked the video about the Quants , which is always located in the footer of this blog, this is another film they made and it does goo...

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Mayo Blooming Prairie Clinic Closes As Only Person Licensed to See Patients Resigned, Replacement Needed

<p>The closure was real quick, as most said they heard it on Tuesday and on Wednesday the clinic was closed.  The only person at the clinic who could see patients, a nurse <img align="right" alt="image" border="0" height="87" src="http://lh3.ggpht.com/-_dDrU7Ux3r0/UiJRVj7u96I/AAAAAAABHkc/yhEX8maStho/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" />practitioner left.  So the clinic is looking for a replacement and the reason for the closure is “staff shortage”.  Her page is still up <a href="https://mayoclinichealthsystem.org/local-data/press-releases/austin/kathy-crabtree-new-blooming-prairie-np">here</a> but I would guess it won’t be for long.  </p> <p>Some doctors are not taking new patients so this is a bit of a hardship here as well as patients driving to other Mayo facilities until a replacement is found.  Patients would have to travel to Austin or Rochester.   According to this article it states even if they do get a doctor it may only be open a couple days a week, wonder what they are paying a doctor?  </p> <p>This is considered a rural area so again that might make it more difficult to attract a replacement.   This might indicate too that doctor shortages may appear more rapidly in the rural areas of the nation.  BD  </p> <p> <hr />BLOOMING PRAIRIE — As far back as H. Peterson can remember, there has always been a clinic or doctor’s office open in Blooming Prairie — something that Peterson, the town’s mayor, says has added to the community’s standard of living.</p> <p>That all changed this week when Mayo Clinic Health System in Austin — the health care campus through which the Blooming Prairie clinic operated — announced that a staffing shortage has forced the closing of the Blooming Prairie facility, at least on a temporary basis.</p> <p>“I’m incredibly disappointed,” Peterson said about the announcement. “We’ve worked hard to maintain the clinic.”</p> <p>And he said, the community itself has expressed what Peterson called “a lot of general disappointment” about the closing, even if it just on a temporary basis.</p> <p>“She’s the one who was licensed to see patients,” said Tammy Kritzer, the operations administrator for both the Austin and Albert Lea campuses of Mayo Clinic Health System.</p> <p>Becky Noble, the executive director of the Blooming Prairie Area Chamber of Commerce, said that the closing happened quickly, with most people hearing about the closing on Tuesday and the doors being shut on Wednesday.</p> <p><a href="http://www.southernminn.com/blooming_prairie_leader/news/local/article_f4d26ae7-c07d-5763-b9f6-af61356950b8.html">http://www.southernminn.com/blooming_prairie_leader/news/local/article_f4d26ae7-c07d-5763-b9f6-af61356950b8.html</a></p>

Mayo Blooming Prairie Clinic Closes As Only Person Licensed to See Patients Resigned, Replacement Needed

The closure was real quick, as most said they heard it on Tuesday and on Wednesday the clinic was closed.  The only person at the clinic who...

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Walgreens Accused of Overcharging Customers-Algorithms-Drug Stores Have to Pay Penalties on Their Issues, Why Does Wall Street Skate When Their Killer Algorithms Attack?

<p>You can read this report and it pretty much tells you that someone didn’t get the data input done on time or missed some to coincide with what was advertised…algorithms are also supposed to check and make sure both are in sync too besides a manual data entry operation alone. <img align="right" alt="image" border="0" height="101" src="http://lh6.ggpht.com/-8eH2S7avT6E/UiEKzDIczSI/AAAAAAABHj0/YxJVjXa5qB8/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="152" />  You can read in the article about other settlements as such and that’s pretty much the mechanics of what goes on here.  It’s good though that it does come up as it keeps people on their toes.  Same stuff with those horrible consumer doctor and hospital rating sites.  I can go on there at any time and easily find errors and usually it’s stuff in the mainstream news that has been around for a while that they don’t scan and update. </p> <h5><a href="http://ducknetweb.blogspot.com/2012/08/healthgrades-ceo-founder-joins-worldone.html">HealthGrades CEO Founder Joins WorldOne Board–Flawed Data And Broken Algorithms On the Move to Advise Market Research? Algo Duping Society?</a></h5> <h5><a href="http://ducknetweb.blogspot.com/2012/06/healthgrades-puts-out-top-hospital.html">HealthGrades Puts Out Top Hospital List–Time to Drop All the Hospital Ratings Sites As Nobody Cares, Many Don’t Have Time To Read and Too Much “Flawed Data”</a></h5> <p>So if drug stores are held to such tight regulations what in the heck allows Wall Street firms to just walk?  It’s usually the digital illiteracy of the folks running the SEC that lack any real tech knowledge and thus their confidence levels will be dragging bottom too as that’s what happens when knowledge lack.   It was portrayed very well in the PBS documentary “The Untouchables”…DOJ man spoke with no confidence as voice and body language said it all.  I didn’t care what else everyone said, it was clear as day that this was the problem to me.  </p> <h5><a href="http://ducknetweb.blogspot.com/2013/01/the-untouchables-too-big-to-jail.html">“The Untouchables-Too Big to Jail” Frontline Documentary Shows Department of Justice’s Fear of Prosecuting Big Banks–No Confidence In Using Current Day Technologies To Investigate –Video</a></h5> <p>Everything today has an IT Infrastructure and there will be glitches…so again I call it the Attack of the Killer Algorithms combined with Algo duping.  You can watch videos on that topic here and you will be a much smarter person when you learn a tiny bit about how the mechanics works and the layman can completely understand these videos from folks smarter than me. Some of the attacking algorithms bite a lot worse than others.   </p> <h3><a href="http://www.ducknet.net/attack-of-the-killer-algorithms/">Attack of the Killer Algorithms – “Algo Duping 101″</a></h3> <p>Their data selling records are off too if the money you spent and is tracked by Walgreens is not accurate either, they make about a billion a year selling your data/data profiles too.  BD</p> <p> <hr />The country's largest drugstore chain, Walgreens, has been accused of overcharging customers.</p> <p>The lawsuit filed by Missouri's attorney general alleged that “Walgreens has consistently and systematically displayed inaccurate sales tags, overcharged customers and used misleading or confusing in-store signs.”</p> <p>It's not the first time Walgreen Co. has faced charges of inaccurate pricing. Earlier this year, the retailer settled suits with California and Wisconsin without admitting wrongdoing.</p> <p>“This level of consumer deception is inexcusable from a corporation as sophisticated as Walgreens,” said Chris Koster, Missouri’s attorney general.</p> <p><a href="http://news.yahoo.com/blogs/beyond-the-headline-abc-news/lawsuit-alleges-walgreens-overcharging-customers-134850643.html">http://news.yahoo.com/blogs/beyond-the-headline-abc-news/lawsuit-alleges-walgreens-overcharging-customers-134850643.html</a></p>

Walgreens Accused of Overcharging Customers-Algorithms-Drug Stores Have to Pay Penalties on Their Issues, Why Does Wall Street Skate When Their Killer Algorithms Attack?

You can read this report and it pretty much tells you that someone didn’t get the data input done on time or missed some to coincide with wh...

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FTC Tries to Bring Strong Case for Consumer Protections With Use of Data–But Nothing About Creating IT Infrastructure Path to Allow Regulation–Gov Can’t or Won’t Model?

<p>As you should be aware today everything requires an IT infrastructure to run and if you have not come to terms with that, well it is what it is.  It seems like we have the same old problem here with yet another attorney trying to make headway in a very high tech world with more low<img align="right" height="164" src="http://lh4.ggpht.com/-9yH5tRIAip0/Uc-Kpm6i8LI/AAAAAAABHIc/e2V2CizVTWo/image%25255B4%25255D.png?imgmax=800" style="float: right; display: inline" width="141" /> tech solutions and maybe just a lot of political talk?  Sure the issues are addressed but no real solution talked about at all.  It’s not just limited to the FTC as we have the same thing going on with reviving Glass-Steagall with a low tech partial solution for a very complex high tech problem.  Without an IT infrastructure to regulate, all this goes nowhere sadly.  I have full respect for Elizabeth Warren but again we have have “low tech” solutions out there that are merely band aids for big problems.  I keep blogging about restoring the Office of Technology Assessment for Congress and there’s never been a time when we have had such digital illiteracy with our Lawmakers and this would help them.  </p> <h5><a href="http://ducknetweb.blogspot.com/2013/07/glass-steagall-revival-presents-low.html">Glass-Steagall Revival Presents a “Low Tech” Partial Solution for an Industry that Needs “High Tech” Regulation-Consumers Get 5 More Years of Bank Modeling For Inequality With Segmentation - No Real Regulation In Sight</a></h5> <p>Another good example of a real lack of any IT infrastructure back bone is the consumer financial agency run by Richard Cordray, yet one more lawyer trying to keep up with the high tech world.  Put some technologists in charge and back them up with a full force of lawyers for goodness sakes as they all seem to be swimming in a pool of neglect when it comes to the power of math models and algorithms as they function today in the business world.  Hire a few quants from the business world who know it functions and cut to the chase by all means.  I don’t mean any disrespect here for anyone but it’s time to get off the pot in so many words as current efforts are going nowhere and totally ignore the impact on how technology is being used today.  </p> <h5><a href="http://ducknetweb.blogspot.com/2013/04/richard-cordray-fail-with-understanding.html">Richard Cordray, Fail With Understanding Flawed Models and Algorithms -Big Case of“Algo Duping”With Big Data-Save Time, Hire Quants Who Know How Consumer Financial Models Are Built and Function…Geez</a></h5> <p>The agency, the FTC is 100 years old but we can’t use solutions that are that old by all means:)  When you read this you can see the “duping” effect here with just some of the statements <img align="right" src="https://encrypted-tbn1.gstatic.com/images?q=tbn:ANd9GcRp9TBlvWqtr16ku9oa-uGY_yLITLV9hYmtozmPi5XdbJ5RW7Sm" style="float: right; display: inline" />“<em>Ramirez noted that she is a big fan of big data</em>”…please…duped and duped again to the most over used lingo out there.  Data is data.  A few other technologists of late have said the same thing.  Now her background is with intelligent property and that’s a whole different arena, did she ever write any code?  Probably not but having someone at the FTC who has or who had modeled would be wonderful to bring the real world of non accountability into focus and how models lie and deceive, most playing around with risk, and without it we end up with more “low tech” partial band aid solutions sadly.  Again, hired some professional experience quants and let’s get with it as the real world operates today.  </p> <p><strong>Not only myself but many other technologists pounced on the “Reclaim Your Name Campaign” which again fits under the “low tech” band aid topic as that’s what it is</strong>.  Any technologist will tell you that who knows what they are doing.  Again regulation efforts here are futile without establishing an IT infrastructure and path to regulate.  I suggest all who sell data should be required to purchase a license and top of that excise tax the banks and companies making windfall profits selling data.  Did you see the news yesterday that banks are reaching all time profits?  Data selling adds to their bottom line.</p> <h5><a href="http://ducknetweb.blogspot.com/2013/06/ftc-reclaim-your-name-campaign-not-good.html">FTC “Reclaim Your Name Campaign” Not Good Enough–No Path for Regulation Identified–All Data Sellers Including Banks, Insurers, Etc. Should Be Required to Buy a License</a></h5> <p>Just yesterday another new venture on selling data with big pharma working with an insurer to sell more data and again what we all worry about is data used against us out of context and we have had years of that with insurance, just read the news for the last few years, all about profit.  I really don’t know where some of these folks are coming from to totally ignore or be oblivious of the data selling epidemic that is taking place in the US as it’s now affecting the economy.  <strong>Why would companies want to lay out capital expenditures when they can mine and sell data with some algorithms out there and put “easy” money to their bottom line with no concern on how it impacts the consumer.</strong>  </p> <p>Actually the series of posts I called <a href="http://www.ducknet.net/attack-of-the-killer-algorithms/">“The Attack of the Killer Algorithms”</a> covers every day events of this happening and <a href="http://ducknetweb.blogspot.com/2013/01/im-sorry-your-google-plus-name-does-not.html">I have had my share.</a>  The prior link is actually pretty entertaining as Google’s machine learning identified me as a real duck and cancelled my account with them due to that fact..see how it works…and I had to write to them..I was right so what now, “Duck is not a machine compliant name”?  It’s the one I have:)  MIT had a hay day with it as again they are technologists and understand how it happened and said “look at a big corporation attacking one little person here:)</p> <p><img src="http://lh4.ggpht.com/-KSB5S33qBpo/UOzGbup5u9I/AAAAAAABCmc/qT3muViz1o8/image%25255B15%25255D.png?imgmax=800" /></p> <h5><strong><a href="http://ducknetweb.blogspot.com/2013/08/pharma-and-health-insurance-companies.html">Pharma and Health Insurance Companies Pairing Up, Humana’s Analytics Subsidiary and Lilly To Figure Out How to Save (Make) Money and Provide Better Patient Care–Selling Research Data That Competes With FDA Sentinel Initiative</a></strong></h5> <p>If it sounds like I am frustrated, well I guess I am as when myself and others see what goes on behind the scenes that hurts consumers (me too) and the oblivious government efforts we have seen thus far, it’s scary.<strong>  We talk about inequality well it is designed that way with powerful math formulas and subsequent algorithms that move and take your money.  Cathy O’Neil has done a good job explaining this with her series called “Weapons of Math Destruction” and she was the former Quant at DE Shaw who modeled for Larry Summers.</strong>  List to the Q and A for the bonus section there and the dangers of him running the Fed.  This video was done over a year go so it was in no way prompted by today’s news, it’s reality and how he functions, again that portion for some bonus education and watch “Inside Job” again for more information.</p> <h5><a href="http://ducknetweb.blogspot.com/2013/04/modeling-for-inequality-with.html">Modeling for Inequality With Segmentation, Insurance Industry Uses Backwards Segmentation As Some Models Stand to Threaten Overall Democracy</a></h5> <p><strong>The SEC has the same problem with a lawyer at the top of the helm<img align="right" src="https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcTmQCQK-KLTS53DO5NRDgnVJnvbZij8gQTou-YVM2Dy6Lg6HSWrtQ" style="float: right; display: inline" /> as lawyers are no competition for the thousands of quants and actuaries working at banks, insurers and other companies across the US, the are outdone in a few seconds in the case of market on Wall Street.</strong>  DOJ, same problem as we saw with the fear of prosecuting a bank, no IT knowledge and DOJ Mann ran for the hills and <a href="http://ducknetweb.blogspot.com/2013/01/the-untouchables-too-big-to-jail.html">Frontline documented this</a> very well.   It will be interesting to see what this new case of “stolen code” does as you have to laugh as a technologist at the original interpretation <a href="http://ducknetweb.blogspot.com/2013/08/another-stolen-code-case-on-wall-street.html">admitted by the FBI on “subversion” with the Sergey/Goldman case.</a>  </p> <p>You need an IT Infrastructure to allow any type of regulation here, bottom line and thus so without it privacy help for consumers will go nowhere.  It’s hard, I agree for most to embrace what goes on behind the scene with intangibles as you can’t touch, feel or see the algorithms, but they are there making life impacting decisions about all of us.  FTC please take note.  </p> <h5><a href="http://ducknetweb.blogspot.com/2013/02/time-has-come-to-license-and-tax-data.html">Time Has Come to License and Tax the Data Sellers of the Web, Companies, Banks, Social Networks..Any One Making a Profit-Latest Microsoft/Google Privacy War Helping the Cause –Consumers Deserve to Know What Is Being Sold and To Who in a Searchable Format </a></h5> <p><strong>Use my idea or someone else’s but please stop kidding yourself and this goes for Congress too, get some kind of IT Infrastructure in place that has some “balls” and step up to the plate and help consumers as it’s not getting done present day.  BD</strong></p> <p> <hr />Edith Ramirez, the Commissioner of the Federal Trade Commission laid out the case for strong consumer protections regulating the private industry’s use of big data, as the agency asks Congress for the power to level civil fines against businesses for weak consumer data security.</p> <p>Speaking at the <a href="http://www.ftc.gov/speeches/ramirez/130819bigdataaspen.pdf">Aspen Forum</a>, Ramirez offered “A view from the lifeguard’s chair,” as her keynote was titled, alluding to her roots in coastal southern California.</p> <p>“The already intricate data-collection ecosystem is becoming even more complex,” said Ramirez, whose term as commissioner ends in 2015.  Ramirez pointed to the “Internet of Things” as a growing technology that will test the bounds of the law.</p> <p>The FTC, an independent federal agency that turns 100 years old next year, believes it has “an obligation” to protect consumer privacy, said Ramirez. Congress directed the FTC to prevent unfair commercial practices — “conduct that substantially harms consumers, or threatens to substantially harm consumers, which consumers cannot reasonably avoid, and where the harm outweighs the benefits,” said Ramirez, who prior to joining the FTC was a partner in the Los Angeles office of law firm Quinn Emanuel Urquhart & Sullivan, al law firm specializing in intellectual property litigation with clients including Google, Shell Oil, Motorola, Samsung and Sony.</p> <p>Ramirez noted that she is a big fan of big data. “The fact that decision-by-algorithm may be less than perfect is not to condemn the enterprise. Far from it. Using data-driven <a href="http://www.healthcareitnews.com/directory/analytics">analytics</a> to improve decision-making may be an important step forward. After all, human decision-making is not error-free. People often make imperfect decisions for a variety of reasons, including incomplete information, poor decisional tools, or irrational bias. But the built-in imperfections in the decision-by-algorithm process demand transparency, meaningful oversight and procedures to remediate decisions that adversely affect individuals who have been wrongly categorized by correlation. At the very least, companies must ensure that by using big data algorithms they are not accidently classifying people based on categories that society has decided — by law or ethics — not to use, such as race, ethnic background, gender, and sexual orientation.”</p> <p><a title="http://www.healthcareitnews.com/news/ftc-chief-pledges-tight-reign-data?single-page=true" href="http://www.healthcareitnews.com/news/ftc-chief-pledges-tight-reign-data?single-page=true">http://www.healthcareitnews.com/news/ftc-chief-pledges-tight-reign-data?single-page=true</a></p>

FTC Tries to Bring Strong Case for Consumer Protections With Use of Data–But Nothing About Creating IT Infrastructure Path to Allow Regulation–Gov Can’t or Won’t Model?

As you should be aware today everything requires an IT infrastructure to run and if you have not come to terms with that, well it is what it...

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Kaiser Permanente IT Center Opens in Colorado–Looking to Add More Employees to Existing Base of 350

<p>This is interesting to watch how different companies in healthcare are expanding in some areas and retreating in other.  Aetna for one pulled out of the Colorado insurance market a while back and they continue to leave other markets.  Just the size of the number of employees should give all an indication today as the time and expense required in healthcare today.<img align="right" alt="image" border="0" height="171" src="http://lh6.ggpht.com/-Q6bPVJRktWY/UiDUEsg_3jI/AAAAAAABHjg/dikXH93298E/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="236" />  It is something that most may not even think about.  The plan is grow to approximately 700 employees when full staffed.  It sounds like they have all the “green” IT options in place as well.  In Ohio Kaiser is trying to sell their operations by contrast. </p> <h5><a href="http://ducknetweb.blogspot.com/2013/05/kaiser-permanente-working-on-deal-to.html">Kaiser Permanente Working On Deal to Sell Their Ohio Operations to Catholic Health Partners–Not Making Any Money Here</a></h5> <p>In addition to Epic Medical Records, Kaiser is a big client with Oracle, relying on their Identity Manager software for security, same as what Harvard and a few other places use.  Video at the link below from the Kaiser IT department along with a couple Oracle related links.  </p> <h5><a href="http://ducknetweb.blogspot.com/2013/02/kaiser-permanente-using-oracle-access.html">Kaiser Permanente Using Oracle Access and Identity Manager for Healthcare Security And Some Other Oracle Solutions at Harvard and University of Maryland</a></h5> <p>What I found interesting as well is the use of the Bloom Boxes by Kaiser and I would guess they are in place here too.  IT/Data  centers use a lot of power.  There’s a 60 Minute segment video at the link below that tells you all about them, EBay, Google and others use them too.  </p> <h5><a href="http://ducknetweb.blogspot.com/2011/01/kaiser-permanente-to-install-bloom-box.html">Kaiser Permanente to Install Bloom Box Fuel Cells at California Facilities</a></h5> <p>Kaiser is now also one of the largest employers in Colorado and they have plans for more additional clinical medical facilities in the near future.  BD  </p> <p> <hr />Nearly 350 employees are now working at the new information technology center opened by Kaiser Permanente in Colorado on Aug. 22. Kaiser officials say they want to fill an additional 95 positions there by year's end.</p> <p>By 2015, Kaiser Permanente anticipates that some 700 professionals will work at the new IT center. Some of the new positions currently being recruited there include solutions architects, managers/directors, software developers, project/program managers and programmers.</p> <p>"As healthcare evolves, there is an increased demand for IT solutions and support to deliver quality patient care," said Phil Fasano, executive vice president and chief information officer, in a statement. "This new IT location is a center of excellence where best in class employees use technology to ensure the delivery of high-quality, affordable healthcare to Kaiser Permanente members living in Colorado and across the country."</p> <p>With more than 6,000 staff in Colorado, Kaiser Permanente is one of the state's largest private employers. This December, it will open a new multi-specialty center in Lone Tree, where approximately 130 positions will be new hires, officials say. As Kaiser adds new membership in Colorado, it's estimated that hundreds of additional jobs could be created in the state in the next three to five years.</p> <p><a href="http://www.healthcareitnews.com/news/new-kaiser-it-center-seeks-fill-jobs?topic=06,17,24">http://www.healthcareitnews.com/news/new-kaiser-it-center-seeks-fill-jobs?topic=06,17,24</a></p>

Kaiser Permanente IT Center Opens in Colorado–Looking to Add More Employees to Existing Base of 350

This is interesting to watch how different companies in healthcare are expanding in some areas and retreating in other.  Aetna for one pulle...

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California Insurance Exchange Website Live for Price Comparisons and Information–A Quick Walk Through…

<p>I read it was open so off I went to look around.  In addition there are new<img align="right" alt="image" border="0" height="110" src="http://lh5.ggpht.com/-Dh7w60tKzBI/UiAgxTnP8RI/AAAAAAABHiQ/gk2FkMWpyMs/image%25255B57%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="98" /> commercials that have begun running advertising “Covered California”. </p> <p>So I plugged some numbers in for a person being 55, income of $40k a year and no dependent and insurance for only one.  I was presented with the tiers of Platinum, Gold, Enhanced Silver70 and Bronze.</p> <p>This was interesting to take a quick look and get a preview of how it’s all going to function.  California is one of the states that chose to set up their own health insurance exchange versus the federal government doing it.   <img align="left" alt="image" border="0" height="263" src="http://lh3.ggpht.com/-qaI7avInBUU/UiAgyIvG5dI/AAAAAAABHiY/hg_HPao7L88/image%25255B3%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: left; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="392" /></p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p>Here’s the next screen…in two parts…</p> <p><img align="left" alt="image" border="0" height="247" src="http://lh4.ggpht.com/-jwx9TJZPgAY/UiAgyYb2sSI/AAAAAAABHic/nVAxLHAFFx4/image%25255B8%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: left; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="389" /></p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p align="left"><img align="left" alt="image" border="0" height="261" src="http://lh3.ggpht.com/-xebx121Nkhk/UiAgzGzeA-I/AAAAAAABHio/eJYwXAH2Ilo/image%25255B15%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: left; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="385" /></p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p>So you do get a quick comparison here of how each level covers each item with MOOP, co-pays, etc.  No prices yet until you clear the window and then you get to see the insurance carriers and here we go…more screenshots…</p> <p align="left"><img align="left" alt="image" border="0" height="224" src="http://lh4.ggpht.com/-LCWpWVCs_lM/UiAgzvGV8bI/AAAAAAABHiw/tpVz6QXlC6k/image%25255B21%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: left; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="387" /></p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p>On the next screenshot only Health-Net is shown while the others are “grayed” out a bit but they seem to work on the Platinum Screen. </p> <p><img align="left" alt="image" border="0" height="191" src="http://lh6.ggpht.com/-W7V2kTzbzDw/UiAgz3dy-3I/AAAAAAABHi0/HriL_wZGQhs/image%25255B34%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: left; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="386" /></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="228" src="http://lh3.ggpht.com/-L9cacs5hOkE/UiAg0YbZFNI/AAAAAAABHjA/pq3fGk_fwqs/image%25255B42%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: left; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="391" /></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="236" src="http://lh3.ggpht.com/-bX7n_yXmwIo/UiAg08Z_xuI/AAAAAAABHjI/XLllqgNghww/image%25255B48%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: left; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="393" /></p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p>You get to see the monthly premiums before and after tax credits which makes huge difference.  </p> <p>So I went to Health Net Enhanced Silver 70…for the next bit of information…there might be a formatting issue but this window pops up and this might be done on purpose too until everything is finished.  I checked a couple others and it’s the same thing.  </p> <p><img align="left" alt="image" border="0" height="202" src="http://lh5.ggpht.com/--PLzbAkldUY/UiAg1U5nMaI/AAAAAAABHjQ/e4COW2bQPNU/image%25255B53%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: left; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="408" /></p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p>When I looked at the <a href="http://www.coveredca.com/fieldcalc/#enrollmentProcess">enrollment instructions</a> it looks like contingency plans are in place as again we all know the situation with the federal data hub being <a href="http://ducknetweb.blogspot.com/2013/07/obamacare-health-insurance-exchanges.html">designed by a subsidiary of United Health care and the issues with connecting to IRS and Social Security Legacy COBOL system</a>.  It says now you can call, find a center in person and you will need to “mail” the application. </p> <p>These are the two contracts given out to cover contingencies until they figure out how to get COBOL to scale and delivery results online.</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> <h5><a href="http://ducknetweb.blogspot.com/2013/07/government-gives-contract-to-equifax-to.html">Government Gives Contract to Equifax to Verify Incomes of Those Who Apply for Health Insurance Via Exchanges That Qualify For Subsidies–There Goes the Honor System</a></h5> <p>It’s getting interesting with government contractors as if they are not owned by an insurance company they have their own issues as Serco is a UK company with a US branch that is under investigation in the UK for fraud and has been frozen from any new contracts and Equifax just had to put out $18 million for not correcting a woman’s credit information as we are seeing a lot more flaws in data today as the data selling epidemic in the US continue to grow.  Overall it looks very good and represents a lot hard work and very long hours for a lot of IT folks so hats off to them.  </p> <p>IT infrastructures take a lot  more time than they used to and as a cross example the state of California itself has been trying to replace it’s legacy COBOL payroll system for 20 years and still has not been successful with a few vendors, last being SAP and millions spent so keep that in mind when you look at complex IT infrastructures such as the insurance exchanges.  As I said above contingencies are in place right now as all cannot be done online and connect to the federal data hub.  There was some recent misinformation of course from the political side recently that said the IT work was done and it’s not.  </p> <h5><strong><a href="http://ducknetweb.blogspot.com/2013/08/nancy-deparle-returns-to-what-she-knows.html">Nancy DeParle Returns to What She Knows, Private Equity-Technology Experience, Knowledge And Being In Touch With Reality Is What Government Needs Today</a></strong></h5> <p><strong>There’s also a <a href="http://www.coveredca.com/fieldcalc/#faq">nice FAQ page</a> and some information on qualifying for <a href="http://www.coveredca.com/fieldcalc/#incomeGuidelines">Medicaid, called Medi-Cal in California</a>.  </strong></p> <p><a href="http://www.coveredca.com/">http://www.coveredca.com/</a></p>

California Insurance Exchange Website Live for Price Comparisons and Information–A Quick Walk Through…

I read it was open so off I went to look around.  In addition there are new commercials that have begun running advertising “Covered Califo...

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Update on Dr. Afridi–Will Get a New Trial–Helped US Capture Bin Laden and Has Been Jailed Since Then In Pakistan

<p>You have probably seen this and the widget on my blog for a few months <img align="right" src="http://lh5.ggpht.com/-N0iF78z_bns/UVmb0ss1t-I/AAAAAAABGUM/bRygAt-xC0o/image%25255B8%25255D.png?imgmax=800" style="float: right; display: inline" />now, well today there’s some good news for him.  The New York Times actually adds some new details too that I was not aware of in the fact that he worked with the US CIA for three years on this project.  Now it appears an official in Pakistan says the sentence was too long and the former official handing down the ruling over stepped his bounds. </p> <h5><a href="http://ducknetweb.blogspot.com/2013/02/doctor-who-helped-us-find-bin-laden.html">Doctor Who Helped US Find Bin Laden Sits Jailed in Pakistan–Will Zero Dark Thirty Nominated for an Oscar Help Free America’s Abandoned Hero?–Update</a></h5> <p>The doctor will get a new trial.  He doesn’t get out though and remains incarcerated until the new trial is done.  Pakistan has suffered some US aid from the US over this issue as well.  BD</p> <p> <hr />ISLAMABAD, Pakistan — A Pakistani judicial official on Thursday overturned the <a href="http://www.nytimes.com/2012/05/24/world/asia/doctor-who-helped-find-bin-laden-given-jail-term-official-says.html">conviction</a> of a Pakistani doctor who helped the C.I.A. while it was searching for Osama bin Laden, and ordered a retrial.</p> <p>The official, Sahibzada Muhammad Anis, who presided over an appellate court hearing the case, ruled that the tribal judge who convicted the doctor, Shakil Afridi, exceeded his authority when he sentenced him to 33 years in prison in May 2012. </p> <p>Dr. Afridi’s lawyer, Samiullah Afridi, told reporters gathered outside Mr. Anis’s office in Peshawar, that the court had agreed to a fresh trial under the auspices of the political agent of Khyber, the most senior government official in Dr. Afridi’s home district. </p> <p>Dr. Afridi’s fate has been a matter of contention between Pakistan and the United States. Leon E. Panetta, who was director of the C.I.A. at the time of the raid, <a href="http://www.nytimes.com/2012/01/29/world/asia/panetta-credits-pakistani-doctor-in-bin-laden-raid.html">confirmed</a> in early 2012 that Dr. Afridi had played a role in the hunt for Bin Laden and expressed anger at his prosecution. Later, Dr. Afridi’s 33-year prison sentence drew sharp criticism from American congressmen, who <a href="http://thecaucus.blogs.nytimes.com/2012/05/24/senate-panel-holds-up-aid-to-pakistan/">cut American aid</a> to Pakistan by $33 million. </p> <p>American officials say Dr. Afridi was originally recruited to the C.I.A. about three years earlier to provide intelligence about Islamist militants in the Khyber tribal area, where he was working as a senior medical officer. </p> <p>In Abbottabad, Dr. Afridi used C.I.A. funds to establish a hepatitis vaccination program that allowed his team to approach the house where Bin Laden was staying in a bid to confirm whether he was indeed inside</p> <p><a href="http://www.nytimes.com/2013/08/30/world/asia/conviction-of-doctor-who-helped-cia-find-bin-laden-is-overturned.html?_r=0">http://www.nytimes.com/2013/08/30/world/asia/conviction-of-doctor-who-helped-cia-find-bin-laden-is-overturned.html?_r=0</a></p>

Update on Dr. Afridi–Will Get a New Trial–Helped US Capture Bin Laden and Has Been Jailed Since Then In Pakistan

You have probably seen this and the widget on my blog for a few months now, well today there’s some good news for him.  The New York Times a...

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HHS Rules Exchange Customers Who Are “Unbanked” Can Use Prepaid Credit Cards To Pay Premiums

<p>That’s the first time I have hear this term “unbanked” as I have heard “inadequately banked” and “under banked” before.  If this is not a sign of the times on how much control banks have, even the terminology!  Unbanked<img align="right" alt="image" border="0" height="72" src="http://lh5.ggpht.com/-fskWCQ_zSRE/Uh_2_1UaapI/AAAAAAABHiA/SRmyjqz3DNY/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="170" /> means you don’t have an account at a bank so to allow payments from those who either can’t afford it or just simply don’t want an account at a bank they can now use prepaid credit cards for premium payments.  </p> <p>To hear the insurers complain about the “high fees” they have to pay on prepaid and debit cards is enough to make you choke with the billions in profits they make every year as well.  A lot of people are unbanked as they are members of credit unions.  BD</p> <p> <hr />In a victory for health insurance exchange customers with lower incomes, HHS <a href="http://www.ofr.gov/OFRUpload/OFRData/2013-21338_PI.pdf">issued a final rule (PDF)</a> Wednesday that will allow individuals to pay their premiums with a prepaid debit card. The move allows individuals who do not have a bank account, called the “unbanked,” to pay premiums with a card they add money to that's issued by a credit card company.</p> <p>The rule responds to widespread concerns that insurers would only take payment by check and credit card, while millions of lower-income Americans who will be buying coverage on the <a href="http://www.modernhealthcare.com/section/articles?tagID=990">state insurance exchanges</a> are unbanked because they can't afford the costs associated with checking accounts and credit cards. Some insurers had said they wanted to be able to set their own payment policies. They don't necessarily like credit or prepaid debit cards because the fees they have to pay are high. </p> <p><a href="http://www.modernhealthcare.com/article/20130829/NEWS/308299967/reform-update-rule-allows-unbanked-consumers-to-pay-premiums-with&utm_source=twitterfeed&utm_medium=twitter">http://www.modernhealthcare.com/article/20130829/NEWS/308299967/reform-update-rule-allows-unbanked-consumers-to-pay-premiums-with&utm_source=twitterfeed&utm_medium=twitter</a></p>

HHS Rules Exchange Customers Who Are “Unbanked” Can Use Prepaid Credit Cards To Pay Premiums

That’s the first time I have hear this term “unbanked” as I have heard “inadequately banked” and “under banked” before.  If this is not a si...

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Pharma and Health Insurance Companies Pairing Up, Humana’s Analytics Subsidiary and Lilly To Figure Out How to Save (Make) Money and Provide Better Patient Care–Selling Research Data That Competes With FDA Sentinel Initiative

<p>I guess one could make a lot of comments about this but as I have stated if you think insurance is just about claims and policies anymore, you better take a second look, and here’s one good example with truckloads of subsidiaries that all put money to the corporate bottom line and with an army of subsidiary companies <a href="http://ducknetweb.blogspot.com/2013/07/health-insurance-business-under-radar.html">they can stay under the radar</a> easier as nobody pays much attention what kind of organizations are getting their hard earned dollars.  On the other hand, perhaps this affiliation may find more potential patients for the drugs that Lilly makes (grin).  I laugh at my satire but we really don’t know.  Medical device companies have been partnering up with insurance companies too.  They all want to go where t<img align="right" alt="image" border="0" height="196" src="http://lh3.ggpht.com/-fXyAjFcXgkI/Uh_M_gmBfoI/AAAAAAABHho/AN5w2Wb2r5k/image%25255B8%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="238" />he money’s at.  Here’s a fairly recent post on how the device folks are flocking to the trade associations and lobbyists of health insurers.  </p> <h5><a href="http://ducknetweb.blogspot.com/2013/04/medical-device-companies-joining.html">Medical Device Companies Joining America’s Health Insurance Plans Trade Association (Lobbyists), Affiliations Allow for More Data Selling Between Both Entities–The Epidemic Continues to Grow</a></h5> <p align="left">Ok so we talking about selling data again it appears and here’s a screenshot right from the Comprehensive Health Page…Data Sales…well and at least they are up front about selling our data to a degree.  So is Lilly a big data customer?  Just a good question one might ask..</p> <p>Well the subsidiary comes full equipped to run out those surveys we all hate and present outcomes.  Sounds familiar as United got a deal going like this too with selling data to pharma and device companies.  </p> <h5><a href="http://ducknetweb.blogspot.com/2013/01/united-healthcare-buys-humedica-and.html">United Healthcare Buys Humedica and Gets More Data to Analyze and Sell To Medical Device and Drug Companies–More Big Profits From Health Data</a></h5> <p>Bottom line here is the entire economy is being afflicted by the data selling epidemic and when is enough enough?  We need to license and excise tax these folks as when you see the likes of Walgreens taking in about a billion a year just selling data it does put dollar amount on the huge pot of gold companies and banks are making with <strong>“flipping algorithms” for profit by selling data.</strong></p> <p>Of course what we all worry about is data being used out of context against us and we have history on this with tons of news stories on denied claims and the reasons used, and that goes back years and years, but today it’s the wild west out there to query data bases and use some non linear methodologies and gee, next week you see some new analytics services available for purchase as well.<strong>  </strong></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>They already purchase MasterCard and Visa records so will they combine their research with this and claim they have some brand new predictive software available?</p> <h5><a href="http://ducknetweb.blogspot.com/2013/03/insurance-companies-are-buying-up.html">nsurance 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>The FDA with their Sentinel Program is doing all this and I guess now they have competition with insurers who found out they can create an analytics subsidiary and make money at it instead of being “for” consumers as the FDA project is targeted…from a prior post…BD </p> <p><em>This sounds like it’s direct competition for the FDA Sentinel program too as remember back a few years ago when insurers<img align="right" border="0" height="90" src="http://lh4.ggpht.com/_v3zjJigoAPE/SgyYmrRtv_I/AAAAAAAAPr0/zj6tygciyAg/image%5B5%5D.png?imgmax=800" width="186" /> were going to donate claim information to add to the device and drug files that were being gathered to evaluate for safety along with medical records added?  Dr. Hamburg has talked about the program quite favorably as it is helping with safety devices and drugs, but did the insurance companies decide not to send claim information to the FDA and decide to make a buck instead selling data?   About the FDA Sentinel below:</em></p> <p><em>“Monitoring the safety of its regulated products is a major part of FDA’s mission to protect public health. But, currently, the Agency’s efforts are limited to its largely passive safety monitoring systems, which depend on healthcare professionals, patients, consumers and pharmaceutical companies to report any adverse effects of FDA-regulated products. The Sentinel System would enable FDA to actively query diverse automated healthcare data holders—like electronic health record systems, administrative and insurance claims databases, and registries—to evaluate possible medical product safety issues quickly and securely.</em></p> <p> <hr />Louisville-based health benefits and wellness provider <a href="http://www.bizjournals.com/profiles/company/us/ky/louisville/humana_inc/2849180">Humana Inc.</a> (NYSE: HUM) plans to collaborate on research with Indianapolis-based Eli Lilly & Co. (NYSE: LLY).</p> <p>Through a partnership, the companies will analyze data and information with<img align="right" alt="image" border="0" height="32" src="http://lh3.ggpht.com/-uWhnD4Qkf5E/Uh_NAJgnAPI/AAAAAAABHhw/u7IEsz0xyYA/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="173" /> a focus on improving health care quality and outcomes, according to a news release. The partnership aims to address the challenges of improving quality of care and reducing treatment costs.</p> <p>Comprehensive Health Insights, a subsidiary of Humana, will serve as the research engine in the collaboration, according to the release.</p> <p><a href="http://www.bizjournals.com/louisville/blog/health-care/2013/08/humana-lilly-sign-multi-year-research.html">http://www.bizjournals.com/louisville/blog/health-care/2013/08/humana-lilly-sign-multi-year-research.html</a></p>

Pharma and Health Insurance Companies Pairing Up, Humana’s Analytics Subsidiary and Lilly To Figure Out How to Save (Make) Money and Provide Better Patient Care–Selling Research Data That Competes With FDA Sentinel Initiative

I guess one could make a lot of comments about this but as I have stated if you think insurance is just about claims and policies anymore, y...

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Aetna Will Not Sell Insurance on New York Health Insurance Exchange

<p>Here we go again, and if you have not caught wind of this yet, “it’s a business decision” based on extreme math modeling and profits.  Aetna not too long ago also pulled out of California on both the exchange<img align="right" border="0" src="http://lh4.ggpht.com/_v3zjJigoAPE/Tdw_o4vsq8I/AAAAAAAAx5I/6eXxsnT8M9A/image_thumb%5B10%5D.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" />s and is no longer selling individual policies, they all want the business accounts via employers.  This is a big issue today as all the insurers are competing in this area quite aggressively.  Government contracts are also heavily coveted by insurers and those too have been very aggressively pursued.  In California some policy holders got an extra bonus of a 19% increase for their last 3 months of coverage, so was this a move to say “hurry up and switch”?</p> <h5><a href="http://ducknetweb.blogspot.com/2013/08/aetna-who-is-leaving-california.html">Aetna Who Is Leaving the California Individual Health Insurance Market at the End of the Year Jacks Up Policies 19% for the Remaining 3 Months And Withdraws From Participation in the Connecticut, Maryland and Georgia Exchanges</a></h5> <p>I have said it before and it’s worth repeating that our government doesn’t model very well and end up behind the 8 ball and this is everywhere from Congress and of late even the White House is failing here.  White House used to do a lot better but of late, not so good with putting more lawyers in places to where a technologist backed up with a team of lawyers would be much better as they are just totally out done.  I read every day and when I see stuff like “hurry up Health IT and having Facebook contests”, I just have just shook my head in disbelief on some of it and where some feel the perception of reality lies.  The reality is math models that manipulate risk for profit, either up or down.  Insurers are experts at this for sure.</p> <h5><a href="http://ducknetweb.blogspot.com/2013/06/lack-of-modeling-and-algorithm-sleuths.html">Lack of Modeling and Algorithm Sleuths and Stalkers In Government, Part of Why We See Such “Silly” HHS and Congressional News About Financial Donations And/Or Solicitations…</a></h5> <p>I just wrote yesterday about the “app contest” now for behavioral health, again where’s the perception here?  We have some lost folks out there I swear.  Is this the Miley Cirus bunch calling some of these shots?  I’m beginning to wonder. Also cluttered news about Steve Ballmer, hey maybe he’s tired and wants to retire, but I full understand that a ton of news articles needs to be generated to allow those investors using software that reads the news to have something to base their sells and buys upon in the markets.  If you have not watched the documentary, Quants, the Alchemists of Wall Street, roll on down to the footer here and watch it as it will explain how this works, so again maybe Mr. Ballmer is just tired and want to have some family fun.</p> <p>Back on target here, will United pull out too, probably not as they have a pretty high stake in New York already with their Oxford insurance subsidiary but who knows.  Recently Oxford was in the news regarding a US Supreme Court decision that over turned the rules from insurers that doctors could not collaborate and group together with insurers with litigation issues.  This was a long time coming and goes back quite a while.  </p> <h5><a href="http://ducknetweb.blogspot.com/2013/06/us-supreme-court-rules-physicians-can.html">US Supreme Court Rules Physicians Can Work As A Group To Fight Unfair Business Practices of Health Insurers–Victory Over United Healthcare (Oxford Subsidiary)–Context Once Again With Contracts</a></h5> <p>Also there’s been a very confusing doctor-insurer matter that has hit and I don’t know if others outside of United have been hit but contracts with their reimbursement and pay for performance provisions are actually paying doctors less than Medicare.  When you have business intelligence math models and algorithms it gets to be quite complex.  This was first noticed a few years back with the <a href="http://ducknetweb.blogspot.com/2009/12/ama-announced-settlement-of-class.html">calculations for out of network pay</a> to where most of the major insurers licensed and used formulas created by a United subsidiary.  BD</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> <hr />(Reuters) - Aetna Inc, the No. 3 U.S. health insurer, said on Thursday it has decided not to sell insurance on New York's individual health insurance exchange, part of the country's healthcare reform. <p>New York is the fifth state where Aetna has pulled its application to sell the plans that go on sale on October 1 and into effect on January 1, 2014. It has also reversed course in Maryland, Ohio, Georgia, and Connecticut, where it is based.</p> <p>Aetna spokesman Cynthia Michener said it made the move after assessing its business strategy, following the acquisition of smaller insurer Coventry Healthcare in May. Coventry also filed applications to sell plans in more than 10 states.</p> <p><a title="http://news.yahoo.com/aetna-pulls-york-health-insurance-exchange-145710678.html" href="http://news.yahoo.com/aetna-pulls-york-health-insurance-exchange-145710678.html">http://news.yahoo.com/aetna-pulls-york-health-insurance-exchange-145710678.html</a></p>

Aetna Will Not Sell Insurance on New York Health Insurance Exchange

Here we go again, and if you have not caught wind of this yet, “it’s a business decision” based on extreme math modeling and profits.  Aetna...

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ONC Has Another New Contest–Toss Another App Out to the Consumers, But Hey Around 69% of all Mobile Apps Have Just Been Reported “Dead”…

<p>This may be an odd time for such a contest as you really have to look and see what apps are “really” getting used.  They take time to use and people seem to forget that and there are good ones out there but there’s a ton of “me too’s” and the Quantified Self folks seem to think you should be using all of them that are out there (grin).  Remember the guy who tried this and almost killed himself in the process?  It was a pretty good story as he did show how much “work” it took to use a truckload of apps to improve his health…<img align="right" src="http://lh3.ggpht.com/_v3zjJigoAPE/TKYXI9HNaQI/AAAAAAAAh1M/7da7_nnWx-c/image_thumb%5B7%5D.png?imgmax=800" style="display: inline; float: right" />and it’s didn’t do that.  We need some balance and realize that apps can help but a lot of times the very developers that create them, don’t use them either..now that’s a big oxymoron and once the app appears there will be many magpies on the social networks who won’t use it either but they lecture you to death on why you should use it (see it all the time)…funny.  </p> <p>We don’t have very good role models at HHS and I started that line of thought back in 2010 and that combined with a ton of Algo Duping out there thinking that apps are the complete answer adds to all of this.  So great, let’s get some more apps out there (grin).  This is being headed up by an analyst at the ONC and I wonder how many apps he uses:)</p> <h5><a href="http://ducknetweb.blogspot.com/2012/06/hhs-secretary-sebelius-still-looking.html">HHS Secretary Sebelius Still Looking for Tech Breakthroughs To Save the Day</a></h5> <h5><a href="http://ducknetweb.blogspot.com/2010/06/hhs-national-plan-to-improve-health.html">HHS National Plan to Improve Health Literacy – Not Going To Happen Until We Focus on Using Technology (The Tool for Literacy) Which Includes Role Models at HHS And Other Places in Government</a></h5> <p>I said a while back that the ONC would be wise to be it’s own entity under the FDA as right now all are disputing as to who should control mHealth devices and the analysts and bean counter type of would have access to the folks at the FDA who look at safety and a lot of the “human” side so we wouldn’t have as much <a href="http://www.ducknet.net/attack-of-the-killer-algorithms/">“algo duping” going on</a> as the FDA approach leans more toward some common sense on what works.  Dr. Hamburg does well and being a doctor herself she’s in touch with the human side and doesn’t get too duped out there, good leadership.  Good example of her commencement speech from last year.  This would be a good mix as we would get the best of both worlds and not exhorted by “here’s an app to fix you”.  </p> <h5><a href="http://ducknetweb.blogspot.com/2012/06/fda-commissioner-margaret-hamburg.html">FDA Commissioner Margaret Hamburg Delivers Commencement Address at Albert Einstein College of Medicine–Video</a></h5> <p>Anybody feeling any love yet?  Really when you read and watch what is going on like that Facebook HHS contest a couple years ago you do have to wonder what goes on with some of this thinking?  Again, I want to see all at the ONC uses these apps too (grin).  <img align="right" height="62" src="http://lh6.ggpht.com/-FxTtKvxbSjo/UXeeSoJcM8I/AAAAAAABGmQ/8o1LZjLlNeI/image%25255B15%25255D.png?imgmax=800" style="display: inline; float: right" width="147" />I do like the FDA mobile app because it’s useful, <a href="http://ducknetweb.blogspot.com/2013/04/fda-creates-new-mobile-cellphone-app-to.html">check it out</a>.  I like the <a href="http://ducknetweb.blogspot.com/2013/06/scanadu-tricoder-scoutone-mhealth.html">Tri-Coder app/device</a> that’s in the works too.  Anyway the ONC folks would do well to work as a team with the FDA and vice versa.  </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>Not too long ago I wrote about an app for depression that was originally financed by the NIH and it’s that sells data too, so please let’s be real here and get real consumer apps out there.  If you haven’t noticed, the apps contest are slowly dying as well as the apps.<strong>  So get get those Quantified Self analysts over there with the real FDA regulators, scientists and researchers and you might get some nice blended ideas coming forward</strong>.  Everyone is not going to be a “quantified self” so we can’t expect that and we need to realize that just tossing another app at folks is not the answer, you still need the human element and balance here.  </p> <p><strong>So the winners get to to to the White House on this contest, and is Obama going to use the app too to handle his depression or other mental issues (grin</strong>)…you need to give some real thought to some of these things as again the <a href="http://www.ducknet.net/attack-of-the-killer-algorithms/">Algo Duping</a> and the old routine of tossing numbers at people is pushing things to the edge of where a software model begins and how it will function in the real world.  I want to know “how many people are going to use and benefit from an app?  <a href="http://ducknetweb.blogspot.com/2013/02/time-has-come-to-license-and-tax-data.html">I don’t want yet another one that sells data for sure</a> as that’s another epidemic of it’s own that’s now even ripping at the economy with way too many using models to “flips algorithms” for profit, and nobody checks the models.    BD </p> <p> <hr />The Office of the National Coordinator of Health IT has opened a new application challenge – this one designed to arm patients with technology that helps them manage behavioral healthcare and extend treatment to more patients.</p> <p>But the <a href="http://challenge.gov/ONC/623-behavioral-health-patient-empowerment-challenge">Behavioral Health Patient Empowerment Challenge</a>, conducted with the Substance Abuse and Mental Health Services Administration (SAMSHA) and the National Institutes of Health (NIH, is not so much a developer contest as a call for existing mobile apps — in a rather tight timeframe.</p> <p><a href="http://www.mhealthnews.com/news/onc-launches-behavioral-health-app-challenge">http://www.mhealthnews.com/news/onc-launches-behavioral-health-app-challenge</a></p>

ONC Has Another New Contest–Toss Another App Out to the Consumers, But Hey Around 69% of all Mobile Apps Have Just Been Reported “Dead”…

This may be an odd time for such a contest as you really have to look and see what apps are “really” getting used.  They take time to use an...

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Hospital Lay Offs Coming Around Again…

<p>Here’s a few of what’s been in the news the last few days…<a href="http://www.bizjournals.com/memphis/news/2013/08/28/baptist-health-care-announces-new.html">Baptist in Memphis</a> is laying off 61 employees…</p> <p><a href="http://www.sacbee.com/2013/08/27/5683769/mission-hospital-in-asheville.html">Mission Hospital in Asheville</a> is laying off somewhere around 70 employees and they hope to keep it at less than that number…</p> <p>Big lay off of 500 employees in the <a href="http://www.registerguard.com/rg/news/local/30373308-75/peacehealth-positions-care-health-county.html.csp">Washington state area with PeaceHealth</a>, and<img align="right" alt="image" border="0" height="158" src="http://lh6.ggpht.com/-GNpDSwrsGZY/Uh70WBv7grI/AAAAAAABHhI/Q4qsI5mMfeA/image%25255B3%25255D.png?imgmax=800" style="background-image: none; border-bottom: 0px; border-left: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: right; border-top: 0px; border-right: 0px; padding-top: 0px" title="image" width="195" /> you guessed it right, this is not profit chain.  They employ around 6000 employees total.   The Catholic system is facing their largest budget gap in years and part of it was stated to be due to their Health IT purchases.  It’ not cheap, but they are still projecting a profit when all the layoffs take place.  There was also a mention of an cancelled contract with Kaiser Permanente in the Vancouver area that is also adding to the hardship.   </p> <p><a href="http://iowntheworld.com/blog/?p=200569">Northshore University Healthsystem</a> in Chicago will laying off 130 employees to cut costs.  </p> <p>These are just a few in the news the last couple of days and if you go back to around June 1st, you will find many more.  We have been seeing contracts that doctor sign with insurers that are complex and end up reimbursing them at rates lower than Medicare as the AAFP found.</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>Medicare rates initially were lower as doctors and hospitals made up the different on higher insurance payments, but it’s not that way any longer with Medicare in many areas being the highest payer in town.  Medicare could actually sue the insurers for this I think but the repercussions could be huge as all the Medicare contractors are pretty much all subsidiary companies of health insurance companies. Meantime back at the ranch the profits for health insurers keep growing.  Are we looking at yet another return of “Desperate Hospitals” when it comes to money?  </p> <h5><a href="http://ducknetweb.blogspot.com/2010/03/desperate-hospitals-returns-for-2010.html">Desperate Hospitals Returns For 2010</a></h5> <p>What’s going to be the next move when all the big mergers have taken place?  Health IT costs have definitely gone up and some of the subsidiaries of insurers are cashing in there too…<a href="http://ducknetweb.blogspot.com/2013/07/health-insurance-business-under-radar.html">take a look at the truckloads of subsidiary companies one company has</a>.  </p> <p>As I stated before, banks and insurance companies have pretty much just morphed into being powerful software companies that control a lot of money with math models and complex algorithmic formulas for profit.    </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>

Hospital Lay Offs Coming Around Again…

Here’s a few of what’s been in the news the last few days… Baptist in Memphis is laying off 61 employees… Mission Hospital in Asheville ...

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United Healthcare to End Denial of Speech Therapy Reimbursement in California

<p>This was brought about by the Department of Managed Care as California<img align="right" alt="image" border="0" height="64" src="http://lh6.ggpht.com/-YW248wwaQcE/Uh7qKeLiyZI/AAAAAAABHg4/bm0pKjjs8sU/image%25255B3%25255D.png?imgmax=800" style="background-image: none; border-bottom: 0px; border-left: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: right; border-top: 0px; border-right: 0px; padding-top: 0px" title="image" width="200" /> has 2 entities that over see health insurance.  This division is specific to monitoring HMOs.  With the new agreement patients will be given the care they need for speech therapy when it is medically needed  and many were improperly denied over the years.  Routinely United has denied requests from members.</p> <p>Consumer complaints brought this to light with identifying the patterns of denial.  Patients basically have a year to request reimbursement where they have had to pay out of pocket.  BD</p> <p> <hr />The <a href="http://www.bizjournals.com/profiles/company/us/ca/sacramento/department_of_managed_health_care/3340810">Department of Managed Health Care</a> announced Tuesday it has reached an agreement with UnitedHealthcare to end routine denial of speech therapy services requested by members.</p> <p>Terms of the agreement require the health plan to provide coverage for medically necessary speech therapy services and reimburse members who paid out-of-pocket for these services after they were inappropriately denied. UnitedHealthcare also must revise all current health plan documents to ensure they comply with California law.</p> <p><a href="http://www.bizjournals.com/sacramento/news/2013/08/27/unitedhealthcare-speech-therapy-denial.html?page=all">http://www.bizjournals.com/sacramento/news/2013/08/27/unitedhealthcare-speech-therapy-denial.html?page=all</a></p>

United Healthcare to End Denial of Speech Therapy Reimbursement in California

This was brought about by the Department of Managed Care as California has 2 entities that over see health insurance.  This division is spe...

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FDA Approves A New Drug to Fight HIV From Glaxo

<p>This is not a new approval that has additional claims to do what other drugs can’t do, just one more drug.  It is a once a day pill.  BD</p> <p> <hr />The Food and Drug Administration recently added Tivicay, also known as dolutegravir, to the arsenal of pharmaceuticals available<img align="right" alt="image" border="0" height="119" src="http://lh3.ggpht.com/-QpA872KsNvA/Uh7oH3sl3jI/AAAAAAABHgs/FMChwwYfoHI/image%25255B3%25255D.png?imgmax=800" style="background-image: none; border-bottom: 0px; border-left: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: right; border-top: 0px; border-right: 0px; padding-top: 0px" title="image" width="147" /> to fight HIV-1 infections.</p> <p>The drug is a daily pill meant to be taken along with other standard antiretroviral drugs. According to the FDA, Tivicay hinders HIV multiplication inside the body by obstructing one of the key enzymes essential to the process. </p> <p>“This provides a new option for patients who have HIV,” said FDA spokeswoman Stephanie Yao. “HIV patients are normally treated with a cocktail of three drugs and these drugs are personalized to each patient as they are needed.</p> <p>Four trial studies for the drug involved more than 2,500 participants. Side effects include insomnia and headaches. The drug has been approved for patients 12 and older that weigh at least 88 pounds, and is manufactured by GlaxoSmithKline, in Research Triangle Park, N.C.</p> <p><a href="http://forwardtimesonline.com/2013/index.php/lifestyle/health-beauty/item/417-fda-approves-new-drug-to-combat-hiv-infection">http://forwardtimesonline.com/2013/index.php/lifestyle/health-beauty/item/417-fda-approves-new-drug-to-combat-hiv-infection</a></p>

FDA Approves A New Drug to Fight HIV From Glaxo

This is not a new approval that has additional claims to do what other drugs can’t do, just one more drug.  It is a once a day pill.  BD ...

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Epic Medical Records System Crashes at Sutter–Down for Around 8 Hours

<p>Nobody likes to hear these stories but it happens.  Of course all will be digging through to see what was the cause and it could have been the updates that were recently added.  Even when you do your Windows updates you get one that doesn’t load properly and you have to do a restore and do it again.  This could be the same but on a much larger basis of course.</p> <p>The nurses here with complaining about not wanting electronic records should hang <img align="right" alt="image" border="0" height="72" src="http://lh4.ggpht.com/-GJ7gToW-sKM/Uh55F9tGMXI/AAAAAAABHf0/1_qNriHUvC0/image%25255B3%25255D.png?imgmax=800" style="background-image: none; border-bottom: 0px; border-left: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: right; border-top: 0px; border-right: 0px; padding-top: 0px" title="image" width="194" />up that complaint though and work with it as that’s not going to change.  Again it’s unfortunate but it’s only 5 months from when it was implemented too so there’s something to be said there as well as I would guess there’s quite a bit more “work in progress” happening too.  The Epic system is customized by preferences to meet the needs of the Hospitals and thus so every installation is not exactly the same as far as features and some functionality.  It is amazing that Visual Basic, as what is used on the front end of Epic is still as stable as can be for the most part with MUMPS on the back end.  </p> <p>Sutter is not the first and won’t be the last to experience a crash but as mentioned, a better back up system might be in the picture or maybe that part of the entire program is not finished yet, that can happen too as it takes a lot of time with massive software systems as such.  There has to be a back up system, both with technology and with humans when the crashes show up.  It’s not limited to Healthcare either, as look at the markets last week and this is the world of complexities we live in today.  We don’t like crashes and can’t predict them but the best thing to do is be ready for one at any time or any place and yes there was probably some additional money spent here that wasn’t planned on either, but again not much one can do there.  Not too long ago Sutter created their own HMO as well.  BD</p> <h5><a href="http://ducknetweb.blogspot.com/2012/12/sutter-health-forms-new-hmo-plan.html">Sutter Health Forms New HMO Plan, SignatureValue Alliance and Hires Former OptumInsight (Ingenix-United Healthcare) Executive To Run It</a></h5> <p> <hr />On Aug. 26 at approximately 8 a.m., the Epic EHR system crashed, at which time nurses, physicians and hospital staff had no access to patient information, including what medications patients were taking or required to take and all vital patient history data, according to reports from the California Nurses Association, part of National Nurses United, the largest nurses union in the U.S.</p> <p>Days earlier, the EHR system was also down for eight hours due to a planned upgrade; nurses could still read medication orders and patient histories but had to record new data on paper to then be re-entered into the system later. </p> <p>Gleeson explained that the California Nurses Association continues to oppose the use of health information technology and ultimately misrepresented the situation. "It comes as no surprise given the fact that we are in a protracted labor dispute with CNA," he said.  </p> <p>Kevin Sweat, an emergency room RN at Eden Medical Center, a Sutter affiliate, however, said the blackout is a legitimate issue, explaining that in his 12 years as an RN he has never seen a system fail like this.   </p> <p><a href="http://www.healthcareitnews.com/news/setback-sutter-after-1b-ehr-system%20crashes">http://www.healthcareitnews.com/news/setback-sutter-after-1b-ehr-system%20crashes</a></p>

Epic Medical Records System Crashes at Sutter–Down for Around 8 Hours

Nobody likes to hear these stories but it happens.  Of course all will be digging through to see what was the cause and it could have been t...

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Insurers Certainly Like Consumer/Business Healthcare Apps: Subsidiary of Blue Cross Rolls & Couple Others Out $20 Additional Million in Funding to Audax First Backed by Cigna & Cardinal Health

<p>What’s not to like about getting more data to sell?  I took a look at the Audax Health page and it looks <img align="right" alt="image" border="0" height="87" src="http://lh3.ggpht.com/-ScW_lQyypZQ/Uh5dWW_bssI/AAAAAAABHfU/hgW-fbOe2V8/image%25255B7%25255D.png?imgmax=800" style="background-image: none; border-bottom: 0px; border-left: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: right; border-top: 0px; border-right: 0px; padding-top: 0px" title="image" width="146" />like yet one more of those websites that wasn’t to educate people on how to get healthier.  Don’t we have enough of those yet…guess not when it comes to collecting and selling data and profiles.  Why do you think so many of these keep appearing.  Look at who backed the company from the start, Cigna and Cardinal Health, they sell data and run analytics up the ying yang.  Navigy, the company leading the funding is a wholly owned subsidiary of Blue Cross of Florida and the board of Navigy is interesting with former CEO of Aetna on board as well as the VP of partnerships of Facebook.</p> <p><strong>We need more mobile apps to collect more data?  I just read today to where around 65% of the mobile apps are dead so hey let’s get some more out there, and granted the “dead” numbers included all kinds of apps.</strong>  They have some of the usual data selling device companies as partners here, screenshot below.  I looked around but could not find one of those complex “privacy statements” so I guess the ones from the devices apply?  I don’t know, you tell me.  We have the same pitch on how unhealthy citizens are costing us money and it does but let up on it and keep it in focus and stop the constant pounding on projecting how many dollars will be saved as there will be savings but again stop the investors for trying to bank on these numbers, as they will find too they could be screwed eventually too if they suck it all in.  </p> <p><img align="left" alt="image" border="0" height="101" src="http://lh5.ggpht.com/-x9XVwMVNeqw/Uh5dW6lDZGI/AAAAAAABHfc/IJIjmRh1c8g/image%25255B3%25255D.png?imgmax=800" style="background-image: none; border-bottom: 0px; border-left: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: left; border-top: 0px; border-right: 0px; padding-top: 0px" title="image" width="414" /></p> <p> </p> <p> </p> <p> </p> <p> </p> <p>You have to look at the every day life of a person and how much time do consumers have or want to devote to apps like this?  <a href="http://ducknetweb.blogspot.com/2013/07/quicken-to-sell-intuit-financial.html">We know that Intuit and Quicken Health went away due to that fact.</a>    They are not fun as all the sites say and require some work so it’s up to the individual and this is where the “quantified self” movement fails as the folks writing and developing as well as selling their good forget about this and some think that everyone who doesn’t use their product is not worth much.  What I like to find once in a while too are the executives and company employees that don’t use their own stuff…yeah that’s out there…do what I say and not what I do (grin).  <strong>I’ll give Microsoft credit as they have had this old saying of “eat your own dog food” and they require their employees to use their own software but again for small algorithmic web processes like this who knows.</strong> </p> <p><strong>Not too long ago Blue Cross admitted (their words not mine) that they are buying<img align="right" src="https://encrypted-tbn1.gstatic.com/images?q=tbn:ANd9GcRJsy5_-1cPjzaPKJ1bNbOsyA0E5vLocojVTXPwC_UMW1X2avqTmg" style="display: inline; float: right" /> up your Visa and MasterCard records to see if their members are starting to buy clothes a size larger (grin)..</strong>that’s what they said but anyone who has worked with data knows that once they have this data in house off it goes to the hundred of quants they have on the payrolls to figure out how do query it with other data and do something else to create some new analytics or maybe more data to sell..here’s the link on the data purchasing here and it says United does it too.</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>Not too long after the Credit card purchase story was out we had this to follow up with more purchasing data with wanting to track what junk food you buy, so I said…hmm…are we back to those credit card data bases?  <a href="http://ducknetweb.blogspot.com/2013/04/jawbone-buys-bodymedia-launches-new-up.html">Jawbone</a> did their thing with a new platform too to get more data.  </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> <p>So is it not interesting to see insurers funding so many companies like this?  I would really like to see some hard numbers on how many get sucked in here or are maybe through their employers encouraged to sign up as self insured employers are taking names and keeping track too as many of these types of programs are targeted for employers to roll out. </p> <p><strong>You do wonder how many claims this $20 million could have paid, right?  Maybe it’s just me that thinks this way:)</strong>  If you wonder why insurance premiums keep going up, well here’s one example of why as where does the money come to fund more algorithms to mine data?  If you happen to participate and develop healthier habits, well that’s the side effect of the first focus I seem to think.   Do I get excited about these types of products, nope.  We really do need to start licensing and excise taxing the data sellers to create an avenue of regulation which does not exist today with an IT Infrastructure,  as we have way too many companies out there “flipping algorithms” for profit and it’s not balanced with producing tangibles in the US.  Our biggest fear too as consumers is the fact that <a href="http://ducknetweb.blogspot.com/2013/02/time-has-come-to-license-and-tax-data.html">data may be used “out of context” against us</a> and anyone who has worked with data can tell you how that could and does work. </p> <h5><a href="http://ducknetweb.blogspot.com/2013/02/time-has-come-to-license-and-tax-data.html">Time Has Come to License and Tax the Data Sellers of the Web, Companies, Banks, Social Networks..Any One Making a Profit-Latest Microsoft/Google Privacy War Helping the Cause –Consumers Deserve to Know What Is Being Sold and To Who in a Searchable Format</a></h5> <p>We need both but right now it’s the wild west with selling data and this is also one of the reasons that the amount of flawed data is on the rise, nobody monitors any algorithms or math models that get marketed so we have some sheep in wolves' clothing out there if you will.  </p> <p>At the Medical Quack I started some new links called <strong>“Posts Worth Reading”</strong> to where<img align="right" alt="image" border="0" height="56" src="http://lh4.ggpht.com/-l-GU72nL2Nk/Uh5dXQ2MZ8I/AAAAAAABHfk/8HbTlYC8nZo/image%25255B11%25255D.png?imgmax=800" style="background-image: none; border-bottom: 0px; border-left: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: right; border-top: 0px; border-right: 0px; padding-top: 0px" title="image" width="190" /> I chat about some of the intangible processes that you may not be aware of that run on servers 24/7 behind the scenes to help educate all and to encourage you to ask questions when something doesn’t look right.  This is a big deal today as <strong><u>data selling has reached an epidemic stage</u></strong> and is actually beginning to affect the economy with models that change risk in some areas.  Look for this image on the link bar for more.  BD </p> <p><a href="http://www.audaxhealth.com"> <hr />Audax Health</a>, a digital health startup backed by former Apple CEO John Sculley and other technology and health executives, has raised $20 million in a Series B round of funding.  The round was led by Navigy Holdings, Inc. a wholly-owned subsidiary of Florida’s largest health insurer, and included current board member Jack Rowe, former CEO and chairman of Aetna, Dan Rose, VP of partnerships at Facebook and others.</p> <p>The round follows more than $35 million previously raised from corporate partners Cigna and Cardinal Health, venture capital firm New Leaf Ventures and members of the startups’ board.</p> <p>With the new funding, the company said it plans to invest in product development, build out the company’s mobile and engineering teams and expand partnerships with insurers and providers.</p> <p><a href="http://gigaom.com/2013/08/28/john-sculley-backed-audax-health-nabs-20m-to-help-people-take-healthier-steps/">http://gigaom.com/2013/08/28/john-sculley-backed-audax-health-nabs-20m-to-help-people-take-healthier-steps/</a></p>

Insurers Certainly Like Consumer/Business Healthcare Apps: Subsidiary of Blue Cross Rolls & Couple Others Out $20 Additional Million in Funding to Audax First Backed by Cigna & Cardinal Health

What’s not to like about getting more data to sell?  I took a look at the Audax Health page and it looks like yet one more of those websites...

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Wal-Mart To Offer Health Insurance Coverage for Domestic Partners Next Year With Rules And Parameters to Meet To Qualify

<p>There are some good things in here and specifically where the provisions relate to what a “spouse” or “partner” parameter is.  The company has over a million employees and same sex marriages are recognized. </p> <p><em>“Employees' domestic partners can be covered if they are legal spouses, <img align="right" height="155" src="http://lh4.ggpht.com/-dbewUrd4URs/UPnf8gAg5uI/AAAAAAABDLA/zCku4CVGWNI/image%25255B5%25255D.png?imgmax=800" style="display: inline; float: right" width="205" />not legally separated; or a domestic partner of same or opposite gender in an ongoing, exclusive relationship similar to marriage for at least 12 months with the intention to continue sharing a household indefinitely, he said.”</em></p> <p>You can read below on who the contracts are with for coverage and most notably we have both <a href="http://ducknetweb.blogspot.com/2013/07/united-healthcare-announces-their.html">United</a> and <a href="http://ducknetweb.blogspot.com/2013/06/aetna-individual-policy-consumers-in.html">Aetna</a> participating who have pulled out of the individual insurance policy business in several states, California being most notable for both.  </p> <h5><a href="http://ducknetweb.blogspot.com/2013/07/unitedhealthcare-expands-their-cheap.html">UnitedHealthcare Expands Their Cheap Hearings Aids Subsidiary With Marketing To Add More Profits To the Corporate Bottom Line and Sell More Devices And Policies –Subsidiary Watch</a></h5> <p>It was not too long ago that Wal-Mart speculated on being their own insurance exchange.</p> <h5><a href="http://ducknetweb.blogspot.com/2013/01/everybody-wants-to-be-health-insurance.html">Everybody Wants to be Health Insurance Exchange, Wal-Mart Considering the Idea for Small Companies And Oracle Can Sell You a Software Exchange Platform</a></h5> <p>In addition Wal-Mart has a surgical procedure unit that has contract directly with major Medical Centers for certain types of procedures.</p> <h5><a href="http://ducknetweb.blogspot.com/2012/10/walmart-becomes-next-employer-to.html">Walmart Becomes the Next Employer to Negotiate Surgical Procedures Direct With Major Medical Centers, Just Need More Employees Covered</a></h5> <p>In addition United has the “cheap hearing aides” subsidiary, HiHealthInnovations where they also plan to sell the cheap hearing aide in retail stores and of course the computer test is free for doctors at no charge but Walgreens, Wal-Mart and other majors were mentioned as targets and one would expect some action in this area possibly.  If you haven not figured it out yet with insurers, <a href="http://ducknetweb.blogspot.com/2013/07/health-insurance-business-under-radar.html">subsidiaries is where all the action takes place today</a> as there’s a lot more to the insurers than just claims and policies. </p> <h5><a href="http://ducknetweb.blogspot.com/2011/10/united-healthcare-gets-in-medical.html">United HealthCare Gets In the Medical Device Business–Distributing Cheap Hearing Aides Sold Via Hi HealthInnovations Division –Subsidiary Watch</a></h5> <p>As the Reuters article states here the most popular Wal-Mart plan is the one with the least cost and should run about $18.40 every two weeks for the employee contributions, so the big thing here is to be full time or be an part timer for over a year with 30 or more hours a week worked.  Some who work there can buy the insurance but can’t afford it.  BD </p> <hr />The world's largest retailer, based in Bentonville, Arkansas, also plans to begin to offer vision care to its eligible employees and their dependents, according to information the retailer sent to workers this week. <p>Wal-Mart is the single biggest U.S. employer outside of the federal government. More than half of its 1.3 million U.S. employees are on its health-care plans. The company said it does not know how many workers would use either of the new benefits.</p> <p>Employees' domestic partners can be covered if they are legal spouses, not legally separated; or a domestic partner of same or opposite gender in an ongoing, exclusive relationship similar to marriage for at least 12 months with the intention to continue sharing a household indefinitely, he said.</p> <p>About 1.1 million people, including workers' family members, are currently covered by Wal-Mart health-care plans in the United States. Not all of the company's U.S. employees sign up for coverage. Part-time employees must work for Wal-Mart for one year and work an average of 30 hours a week to qualify.  Wal-Mart's U.S. employees are set to pay 3 percent to 10 percent more for their medical coverage next year, depending on the plan chosen.</p> <p><strong>Wal-Mart's benefits administrators are Aetna Inc, UnitedHealth Group Inc's UnitedHealthcare and Blue Cross Blue Shield, depending on the location of a particular worker.</strong></p> <p><a href="http://in.reuters.com/article/2013/08/27/us-walmart-benefits-idINBRE97Q0QL20130827?feedType=RSS&feedName=health&utm_source=dlvr.it&utm_medium=twitter&dlvrit=309303">http://in.reuters.com/article/2013/08/27/us-walmart-benefits-idINBRE97Q0QL20130827?feedType=RSS&feedName=health&utm_source=dlvr.it&utm_medium=twitter&dlvrit=309303</a></p>

Wal-Mart To Offer Health Insurance Coverage for Domestic Partners Next Year With Rules And Parameters to Meet To Qualify

There are some good things in here and specifically where the provisions relate to what a “spouse” or “partner” parameter is.  The company h...

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American Medical Association Shutting Down AMA News Magazine in September

<p>Both the printed version and the website will close on September 9th.  The magazine has been published for 55 years and there’s a lack of revenue and the inability to show a profit today. <img align="right" alt="image" border="0" height="55" src="http://lh5.ggpht.com/-mIy8u2VbjX0/UhxRFFBs3fI/AAAAAAABHfE/TKaHLz9sgPM/image%25255B3%25255D.png?imgmax=800" style="background-image: none; border-bottom: 0px; border-left: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: right; border-top: 0px; border-right: 0px; padding-top: 0px" title="image" width="260" />Revenue is only a third of what it was 10 years ago.</p> <p>Drop in advertisers was a big drop, especially from the pharmaceutical industry.  The Journal of the American Medical Association is not affected and will continue as usual as their focus is research with information not available in other places on the web.  BD</p> <p> <hr />The <a href="http://www.modernhealthcare.com/section/articles?tagID=968">American Medical Association</a>, the country's largest professional organization for physicians, is shutting down the news magazine it has published for 55 years. <br />The publication, which also operates a website at AmedNews.com, has a print circulation of about 230,000 but has had trouble turning a profit over the last decade, amid declining ad revenue from drug companies, increased competition from other news sources and a steady migration of readers to the Internet. </p> <p>American Medical News will stop publication on Sept. 9, according to the statement. Its website also is shutting down, but the content will be available until the end of the year. The shutdown will affect 20 employees. </p> <p>Pharmaceutical advertising accounted for the bulk of revenue for American Medical News, Mr. Easley said. In addition to having to compete harder for ad dollars, AM News saw revenue slow to a trickle in recent years as several big-selling drugs went off patent and as drugmakers shifted focus to specialty products, rather than more broad-based blockbuster drugs, he added. </p> <p><a href="http://www.modernhealthcare.com/article/20130812/INFO/308129991/ama-to-close-news-magazine?AllowView=VW8xUmo5Q21TcWJOb1gzb0tNN3RLZ0h0MWg5SVgra3NZRzROR3l0WWRMWGJYUHdERWxIeU96eTMyWmVqNW40WUpiV2diUll5eGc0TjdTS1VBUDBpaG1hYW84YXJIOUswVUtvQUE2WUc=">http://www.modernhealthcare.com/article/20130812/INFO/308129991/ama-to-close-news-magazine?AllowView=VW8xUmo5Q21TcWJOb1gzb0tNN3RLZ0h0MWg5SVgra3NZRzROR3l0WWRMWGJYUHdERWxIeU96eTMyWmVqNW40WUpiV2diUll5eGc0TjdTS1VBUDBpaG1hYW84YXJIOUswVUtvQUE2WUc=</a></p>

American Medical Association Shutting Down AMA News Magazine in September

Both the printed version and the website will close on September 9th.  The magazine has been published for 55 years and there’s a lack of re...

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United Healthcare Sues Government Contractor, Paragon for Unpaid Health Insurance Premiums

<p>Here’s yet one more lawsuit from United to where they are stating the company did not pay all their premiums in full.  The company, however says it’s not true and they have moved on to another carrier when<img align="right" alt="image" border="0" height="66" src="http://lh4.ggpht.com/-k_UyfoWGtXY/UhxNT0SAU9I/AAAAAAABHe4/mFbjcLs7OxE/image%25255B3%25255D.png?imgmax=800" style="background-image: none; border-right-width: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: right; border-top-width: 0px; border-bottom-width: 0px; border-left-width: 0px; padding-top: 0px" title="image" width="182" /> the United contract expired at the end of 2012.  The case is for over $200,000 and United states their collection efforts were ignored by Paragon.  Paragon Systems is a subcontractor for companies like L3 Communications and General Dynamics.  </p> <p>Paragon says they fight the battle as high costs and bad service were the reasons they changed.  BD</p> <hr />UnitedHealthcare Insurance Co. sued Sterling-based technology company <a href="http://www.paragon-systems.com/">Paragon Systems LLC,</a> claiming Paragon owes more than $200,000 in unpaid premiums on group health care and life insurance policies — claims UnitedHealthcare denies. <p>Paragon held two UnitedHealthcare policies in 2012 that provided health insurance, life insurance, accidental death, and dismemberment and disability coverage for Paragon employees. According to the complaint, filed in the U.S. District Court in Alexandria Aug. 14, Paragon made payments on premiums "in varying amounts and frequencies" until both policies were canceled Dec. 31, 2012.</p> <p><a href="http://www.bizjournals.com/washington/blog/fedbiz_daily/2013/08/united-healthcare-sues-paragon-systems.html">http://www.bizjournals.com/washington/blog/fedbiz_daily/2013/08/united-healthcare-sues-paragon-systems.html</a></p>

United Healthcare Sues Government Contractor, Paragon for Unpaid Health Insurance Premiums

Here’s yet one more lawsuit from United to where they are stating the company did not pay all their premiums in full.  The company, however ...

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Medicare Admissions Rules Causing Havoc, Need a New Model As It Is Becoming Yet One More Way to Shift Cost to the Patients

<p>We all know about the re-admissions rules and penalties that put the fear of God into hospitals today and they all work to be compliant, however, if better intelligence were used ahead of the game to model some of the unintended circumstances, we might have some better rules come out as now they confuse everybody.  Not only Medicare but the hospitals all have the discretion of insurers in this area as well.  </p> <p>Patients don’t know when they have been officially “admitted” and that’s a good question to ask as noted in this story, if patients are not admitted and <img align="right" alt="image" border="0" height="158" src="http://lh6.ggpht.com/-qtwi6ZGBONc/Uhw_DwdiGDI/AAAAAAABHeo/6LVRYFANmwI/image%25255B3%25255D.png?imgmax=800" style="background-image: none; border-bottom: 0px; border-left: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: right; border-top: 0px; border-right: 0px; padding-top: 0px" title="image" width="225" />spend several days under observation, then any rehab costs get shoved back to the patient.  The model is broken.  Now Medicare is proposing that the status can be changed “after the fact” so again we are talking about shifting money again as the status can be changed up to a year after the time spent in the hospital.  So now what?  Admissions get changed to observation status?  That could happen and again better modeling would help some of this out. </p> <p>If Medicare would follow the money more and create superficial cases that could arise up front, perhaps some of this could be avoided.  There’s also some talk about a rule that would require Medicare to pay for rehab if the patient has spent 3 or more days in the hospital regardless of the status of being admitted or there for observation.  </p> <h5><a href="http://ducknetweb.blogspot.com/2013/01/readmission-analytics-not-much-better.html">Readmission Analytics Not Much Better Than Flipping A Coin, Large and Poorest Hospitals At Risk Of Facing Larger Fines, CMS Needs Some New Math Models and Algorithms</a></h5> <p>It’s sad that everything comes down to shifting the dollar and cost to patients when the analytical opportunities present themselves but we should be ethical as well.  Are the rules being “used out of context”?  One might ask that question when you begin to see 5-10 days of observation billed.  This is what we all fear with data being used “out of context” and it goes beyond hospital admitting too, it’s alive and well in the financial world to where the banks and companies lead the government around by the nose because they can’t model very well.  </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 all know that technology at the top of HHS is lacking and many are<img align="right" height="68" src="http://lh6.ggpht.com/_v3zjJigoAPE/TJcGp1oHKzI/AAAAAAAAhfM/jyY8xKNrAKY/image_thumb%5B4%5D.png?imgmax=800" style="display: inline; float: right" width="183" /> duped into the analytics and the confusion of their policies shows it.  Sure it’s not simple but again when you have folks running an agency that is so tied into technology with complex payment systems, well it just makes the problems worse.  Again if the government would employ some better modelers and query potential loop holes up front, some of this could be avoided and you won’t catch it all but it would be a much better formulated rule to begin with as IT Infrastructure runs every thing today and when people’s lives and livelihoods are involved, it’s time to a better job than  look for the “Algo Fairies” for the rules.  </p> <h5><a href="http://ducknetweb.blogspot.com/2013/03/dead-patients-cant-be-readmitted-as.html">“Dead Patients Can’t Be Readmitted” As Relates to HHS and CMS and the Elusive Search for Some Penalty Assessing Algorithm Fairies…</a></h5> <p>Gee and people wonder what is happening to the money of the middle class?  BD  </p> <p> <hr />Harold Engler recently spent 10 days in a Boston teaching hospital, trying to snap back from complications after urgent hernia surgery. Nurses provided around-the-clock treatment, changing the 91-year-old’s catheter, for example, and pumping him with intravenous drugs for suspected pneumonia.</p> <p>It all seemed like textbook hospital care to his wife, Sylvia. So she was shocked to learn that Beth Israel Deaconess Medical Center had never “admitted” her husband at all.</p> <p>“Mrs. Engler, we have bad news for you. This was marked ‘medical observation,’ ” said a nurse at the nursing home where her husband was sent for rehabilitation. The hospital had decided Harold Engler was not sick enough to qualify as an official “inpatient.”</p> <p>The difference in terminology was not a mere technicality: the observation classification left the Englers with a huge bill. It triggered a mystifying Medicare rule that required the Framingham couple to pay the entire $7,859 cost of his rehabilitation care<b></b> and the medications he needed while at the nursing facility. If Harold Engler, a retired sales executive, had been admitted to the hospital, they would have likely paid nothing. </p> <p>Medicare officials have said they are concerned about patients being observed for days in the hospital without being admitted, and issued regulations this summer they believe will help provide clarity to hospitals. But advocates for the elderly are not so sure.</p> <p><b></b>“They’re contradictory and unclear,’’ Edelman said.</p> <p>The rules, which take effect Oct. 1, allow hospitals to change a patient’s care level up to a year after discharge. One worry is that patients will be switched from inpatient to observation status months after they leave the hospital — and get socked retroactively with a rehabilitation bill.</p> <p><a href="http://www.bostonglobe.com/lifestyle/health-wellness/2013/08/24/despite-long-hospital-stays-some-patients-never-admitted-leaving-them-with-huge-bills/UjD0YLmFZE2XMtBee6KveN/story.html">http://www.bostonglobe.com/lifestyle/health-wellness/2013/08/24/despite-long-hospital-stays-some-patients-never-admitted-leaving-them-with-huge-bills/UjD0YLmFZE2XMtBee6KveN/story.html</a></p>

Medicare Admissions Rules Causing Havoc, Need a New Model As It Is Becoming Yet One More Way to Shift Cost to the Patients

We all know about the re-admissions rules and penalties that put the fear of God into hospitals today and they all work to be compliant, how...

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