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HHS OIG — Medicare Paid for HIV Drugs for Deceased Beneficiaries

October 31, 2014 Comments off

Medicare Paid for HIV Drugs for Deceased Beneficiaries
Source: U.S. Department of Health and Human Services, Office of Inspector General

WHY WE DID THIS STUDY
Under the Medicare Part D program, CMS contracts with private insurance companies, known as sponsors, to provide prescription drug coverage to beneficiaries who choose to enroll. OIG has had ongoing concerns about Medicare paying for drugs and services after a beneficiary has died.
Drugs that treat the human immunodeficiency virus (HIV) can be a target for fraud, waste, and abuse, primarily because they can be very expensive. Although this report focuses on HIV drugs, the issues raised are relevant to all Part D drugs.

HOW WE DID THIS STUDY
We based this study on an analysis of Prescription Drug Event (PDE) records for HIV drugs in 2012. Part D sponsors submit these records to CMS for each drug dispensed to beneficiaries enrolled in their plans. Each record contains information about the drug, beneficiary, pharmacy, and prescriber. We used the Beneficiary Enrollment Database, the Social Security Administration’s Death Master File, and Accurint’s Death Records to identify beneficiaries’ dates of death.

WHAT WE FOUND
Medicare paid for HIV drugs for over 150 deceased beneficiaries. CMS’s current practices allowed most of these payments to occur. Specifically, CMS has edits (i.e., systems processes) in place that reject PDE records for drugs with dates of service more than 32 days after death. CMS’s practices allow payment for drugs that do not meet Medicare Part D coverage requirements. Most of these drugs were dispensed by retail pharmacies.
This review looked only at HIV drugs, which account for one-quarter of one percent of all Part D drugs in 2012. However, our findings have implications for all drugs because Medicare processes PDE records for all drugs the same way. Considering the enormous number of Part D drugs, a change in practice would affect all Part D drugs and could result in significant cost savings for the program and for taxpayers.

WHAT WE RECOMMEND
We recommend that CMS change its practice of paying for drugs that have a date of service within 32 days after the beneficiary’s death. CMS should eliminate or-if necessary for administrative processing issues-shorten the window in which it accepts PDE records for drugs dispensed after a beneficiary’s death. Such a change would prevent inappropriate payments for drugs for deceased beneficiaries and lead to cost savings for the program and for taxpayers. CMS concurred with our recommendation.

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HHS OIG — Penetration Test of the Food and Drug Administration’s Computer Network

October 29, 2014 Comments off

Penetration Test of the Food and Drug Administration’s Computer Network
Source: U.S. Department of Health and Human Services, Office of Inspector General

We conducted an external penetration test of the Food and Drug Administration’s (FDA) network and information systems. Although we did not obtain unauthorized access to the FDA network, we identified the following issues: Web page input validation was inadequate, external systems did not enforce account lockout procedures, security assessments were not performed on all external servers, error messages revealed sensitive system information, and demonstration programs revealed sensitive information. These could have led to (1) the unauthorized disclosure or modification of FDA data or (2) FDA mission critical systems being made unavailable. We recommended that FDA implement necessary corrective actions to address the specific cybersecurity vulnerabilities that we identified during this audit.

Recommended Practices, Protecting Temporary Workers

October 29, 2014 Comments off

Recommended Practices, Protecting Temporary Workers
Source: National Institute for Occupational Safety and Health (NIOSH)

OSHA and NIOSH recommend the following practices to staffing agencies and host employers so that they may better protect temporary workers through mutual cooperation and collaboration.

Ebola Virus Disease: Information for U.S. Healthcare Workers

October 24, 2014 Comments off

Ebola Virus Disease: Information for U.S. Healthcare Workers
Source: U.S. Department of Health and Human Services, Health Resources and Services Administration

National Call on Preparing Nurses to Safely Care for Patient with Ebola recording and transcript, plus information from the CDC, curated by CDC experts.

MedlinePlus Mobile Update: Full Access from Your Phone

October 24, 2014 Comments off

MedlinePlus Mobile Update: Full Access from Your Phone
Source: National Library of Medicine

The National Library of Medicine (NLM) released new versions of the MedlinePlus and MedlinePlus en español mobile sites in October 2014. The mobile sites can be accessed at http://m.medlineplus.gov and http://m.medlineplus.gov/spanish/, respectively (see Figure 1).

Like the original 2010 versions, these newly redesigned sites are optimized for mobile phones and tablets. Unlike the original mobile sites that contained only a subset of the information available on MedlinePlus, the new sites have all the content that you will find on MedlinePlus and MedlinePlus en español. They also have an improved design for easier use on mobile devices.

Estimating the Future Number of Cases in the Ebola Epidemic — Liberia and Sierra Leone, 2014–2015

October 24, 2014 Comments off

Estimating the Future Number of Cases in the Ebola Epidemic — Liberia and Sierra Leone, 2014–2015
Source: Morbidity and Mortality Weekly Report (CDC)

The first cases of the current West African epidemic of Ebola virus disease (hereafter referred to as Ebola) were reported on March 22, 2014, with a report of 49 cases in Guinea. By August 31, 2014, a total of 3,685 probable, confirmed, and suspected cases in West Africa had been reported. To aid in planning for additional disease-control efforts, CDC constructed a modeling tool called EbolaResponse to provide estimates of the potential number of future cases. If trends continue without scale-up of effective interventions, by September 30, 2014, Sierra Leone and Liberia will have a total of approximately 8,000 Ebola cases. A potential underreporting correction factor of 2.5 also was calculated. Using this correction factor, the model estimates that approximately 21,000 total cases will have occurred in Liberia and Sierra Leone by September 30, 2014. Reported cases in Liberia are doubling every 15–20 days, and those in Sierra Leone are doubling every 30–40 days. The EbolaResponse modeling tool also was used to estimate how control and prevention interventions can slow and eventually stop the epidemic. In a hypothetical scenario, the epidemic begins to decrease and eventually end if approximately 70% of persons with Ebola are in medical care facilities or Ebola treatment units (ETUs) or, when these settings are at capacity, in a non-ETU setting such that there is a reduced risk for disease transmission (including safe burial when needed). In another hypothetical scenario, every 30-day delay in increasing the percentage of patients in ETUs to 70% was associated with an approximate tripling in the number of daily cases that occur at the peak of the epidemic (however, the epidemic still eventually ends). Officials have developed a plan to rapidly increase ETU capacities and also are developing innovative methods that can be quickly scaled up to isolate patients in non-ETU settings in a way that can help disrupt Ebola transmission in communities. The U.S. government and international organizations recently announced commitments to support these measures. As these measures are rapidly implemented and sustained, the higher projections presented in this report become very unlikely.

See also:
Importation and Containment of Ebola Virus Disease — Senegal, August–September 2014
Control of Ebola Virus Disease — Firestone District, Liberia, 2014
Ebola Virus Disease Outbreak — Nigeria, July–September 2014
Ebola Virus Disease Outbreak — West Africa, September 2014
Frequently Asked Questions About “Alternative” Therapies for Ebola (NCCAM)

Vaccination Coverage Among Children in Kindergarten — United States, 2013–14 School Year

October 22, 2014 Comments off

Vaccination Coverage Among Children in Kindergarten — United States, 2013–14 School Year
Source: Morbidity and Mortality Weekly Report (CDC)

State and local vaccination requirements for school entry are implemented to maintain high vaccination coverage and protect schoolchildren from vaccine-preventable diseases (1). Each year, to assess state and national vaccination coverage and exemption levels among kindergartners, CDC analyzes school vaccination data collected by federally funded state, local, and territorial immunization programs. This report describes vaccination coverage in 49 states and the District of Columbia (DC) and vaccination exemption rates in 46 states and DC for children enrolled in kindergarten during the 2013–14 school year. Median vaccination coverage was 94.7% for 2 doses of measles, mumps, and rubella (MMR) vaccine; 95.0% for varying local requirements for diphtheria, tetanus toxoid, and acellular pertussis (DTaP) vaccine; and 93.3% for 2 doses of varicella vaccine among those states with a 2-dose requirement. The median total exemption rate was 1.8%. High exemption levels and suboptimal vaccination coverage leave children vulnerable to vaccine-preventable diseases. Although vaccination coverage among kindergartners for the majority of reporting states was at or near the 95% national Healthy People 2020 targets for 4 doses of DTaP, 2 doses of MMR, and 2 doses of varicella vaccine (2), low vaccination coverage and high exemption levels can cluster within communities.* Immunization programs might have access to school vaccination coverage and exemption rates at a local level for counties, school districts, or schools that can identify areas where children are more vulnerable to vaccine-preventable diseases. Health promotion efforts in these local areas can be used to help parents understand the risks for vaccine-preventable diseases and the protection that vaccinations provide to their children.

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