Weekend Update

Uncategorized

Weekend Update

David Ermer–Congress, COVID-19, COVID-19 vaccine, OPM, U.S. Healthcare, Uncategorized–

Congress is session this week for committee and floor business. On Tuesday morning the House Energy and Commerce Committee will hold a hearing on “The Future of Telehealth: How COVID-19 is Changing the Delivery of Virtual Care”

The Wall Street Journal reports that

The task of passing a coronavirus relief package now rests with the Senate, where Democrats must grapple with emerging divisions over some components of the plan, including a minimum-wage increase. The House early Saturday morning passed [largely along party lines] President Biden’s $1.9 trillion package, which would fund vaccine distribution, enhance and extend federal unemployment benefits, and send direct checks of $1,400 to many Americans and $350 billion to state and local governments.

As mentioned in last Thursday’s post, the Democrat leadership in Congress is trying to figure out a way for the Senate to pass the entire bill under budget reconciliation which requires all fifty Democrat senators plus the Vice President. The $15 minimum wage provision found in the House bill remains a wild card in the Senate.

The President officially sent Kiran Ahuja’s nomination to be OPM Director to the Senate last Wednesday. Federal News Network forecasts six “challenges” that Ms. Ahuja will need to address once confirmed.

In most excellent news, the Food and Drug Administration gave emergency use authorization to the single dose Johnson and Johnson vaccine yesterday and the Centers for Disease Control seconded this action today. This means that health plans, including FEHB plans, become liable for reimbursing administration costs for the Johnson and Johnson vaccine without member cost sharing in 15 days / March 15, 2021. Per CNN with the blessing of these two agencies

[T]he federal government may then begin distributing the 3.9 million available doses of the vaccine, perhaps as soon as Monday.”I just want to state explicitly how very grateful I am that we now have three highly effective vaccines,” said ACIP member Dr. Matthew Daley of the Institute for Health Research with Kaiser Permanente Colorado.

The company has pledged to have 20 million doses available by the end of March and 100 million doses by summer.The vaccine, made by Johnson & Johnson’s Janssen vaccine arm, can be kept at regular refrigerator temperatures, which experts said would make it much easier to distribute than vaccines made by Moderna and Pfizer/BioNTech.

The Wall Street Journal sums it up for us as follows:

The pandemic has opened a new era for vaccines developed with gene-based technologies, techniques that have long stumped scientists and pharmaceutical companies, suggesting the possibility of future protection against a range of infectious disease.

Johnson & Johnson’s Covid-19 vaccine, which was authorized Saturday for use in the U.S., is at the vanguard of a class of shots designed to mobilize a person’s immune defenses against the disease. It will be the first Covid-19 vaccine administered in the U.S. that uses viral-vector technology, which employs an engineered cold virus to ferry coronavirus-fighting genetic code to the body’s cells.

J&J’s vaccine is the third to be authorized in the U.S. after ones from Pfizer Inc. and its partner, BioNTech SE, and Moderna Inc. In a late-stage trial, J&J’s single-shot vaccine was 66% effective in preventing moderate to severe cases of the disease that has killed more than 500,000 people in the U.S. and about 2.5 million world-wide.

“This is one of those giant leap moments for us. These are fundamental shifts in how we will build vaccines for the future,” said C. Buddy Creech, director of Vanderbilt University’s vaccine research program. “I think this really ushers in a golden age of vaccinology.”

By the way the Centers for Disease Control has created its own COVID-19 vaccine finder website. According to the CDC’s COVID-19 data tracker website, currently nearly 20% of the eligible U.S. population has received at least one dose of the vaccine and 10% have received both doses.

Finally, the Choosing Wisely campaign is offering a information and a webinar that address one of the points in OPM’s recent call letter for 2022 benefit and rate proposals from carriers:

In Building A Better Health Care System Post-Covid-19: Steps for Reducing Low-Value and Wasteful Care, Corinna Sorenson, PhD, Duke-Margolis Center for Health Policy, and colleagues outline the impact of the pandemic on low-value care, and the potential opportunities it presents to create a better health care system post COVID-19. She elaborates further on this topic in her January 2021 Choosing Wisely webinar recording.

Friday Stats and More

David Ermer–Congress, COVID-19, COVID-19 testing, COVID-19 vaccine, Telehealth, U.S. Healthcare, Uncategorized–

Based on the Centers for Disease Control’s COVID-19 Data Tracker website, here is the FEHBlog’s chart of new weekly COVID-19 cases and deaths over the 14th week of 2020 through 8th week of this year (beginning April 2, 2020, and ending February 24, 2021; using Thursday as the first day of the week in order to facilitate this weekly update):

and here is the CDC’s latest overall weekly hospitalization rate chart for COVID-19:

In this regard, Bloomberg reports that

Covid-19 hospital admissions plummeted 72% in a month in the U.S. as the virus ebbed and the vaccination push accelerated.

Americans 85 years old and over saw the most pronounced drop, down 81% from January to February, according to the U.S. Centers for Disease Control and Prevention, which monitors the data through its Covid-19-Associated Hospitalization Surveillance Network.

The rate was 23.4 hospitalizations per 100,000 residents 85 and over for the week of Feb. 7-13, the latest data available. That was down from 120.3 per 100,000 four weeks earlier. The overall rate across age groups was 4.6, down from 16.7.

The FEHBlog has noticed that the new cases and deaths chart shows a flat line for new weekly deaths because new cases greatly exceed new deaths. Accordingly here is a chart of new COVID-19 deaths over the period (April 2, 2020, through February 24, 2021):

Finally here is a COVID-19 vaccinations chart for past ten weeks which also uses Thursday as the first day of the week:

In other COVID-19 vaccination news

  • The Wall Street Journal reports that

Johnson & Johnson’s JNJ -2.64% single-dose Covid-19 vaccine worked safely and should be authorized for use in the U.S., a panel of experts advised federal health regulators Friday.  The advisory committee’s unanimous vote in support of the vaccine’s authorization is the last step before the U.S. Food and Drug Administration issues a decision, which is expected Saturday. 

Yippee!

  • Reuters reports that “The U.S. Food and Drug Administration on Thursday approved storage and transportation of COVID-19 vaccine developed by Pfizer Inc and German partner BioNTech SE at standard freezer temperatures for up to two weeks instead of ultra-cold conditions. * * * “Alternative temperature for transportation and storage will help ease the burden of procuring ultra-low cold storage equipment for vaccination sites and should help to get vaccine to more sites,” Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said.

In other COVID-19 news

  • The AP informs us that “February is usually the peak of flu season, with doctors’ offices and hospitals packed with suffering patients. But not this year. Flu has virtually disappeared from the U.S., with reports coming in at far lower levels than anything seen in decades.” It’s a silver lining in the COVID-19 cloud.  
  • The Centers for Medicare and Medicaid Service released updated guidance today for health plans, including FEHB plans, on coverage of COVID-19 testing and vaccinations.
  • Bloomberg reports that

States should maintain Covid-19 restrictions such as mask wearing and capacity limitations as case numbers halt their decline, the head of the U.S. Centers for Disease Control and Prevention said Friday, citing the circulation of new variants and infection rates that remain alarmingly high.

CDC Director Rochelle Walensky issued a sobering warning during a press briefing Friday, where she said the more contagious B.1.1.7 variant, first found in the U.K., now accounts for an estimated 10% of current U.S. cases, and that variants in California and New York also appear to spread more easily.

“Things are tenuous — now is not the time to relax restrictions,” Walensky said. “The latest data suggest that these declines may be stalling, potentially leveling off at still a very high number. We at the CDC consider this a very concerning shift in the trajectory.”

  • STAT News punctured a CDC recent statistic as follows:

The Centers for Disease Control and Prevention made headlines last week when it announced that Covid-19 had reduced the average life expectancy of Americans in 2020 by a full year. The news seemed to starkly illustrate the devastation wrought by our nation’s worst public health crisis in 100 years.

But there was a problem. The pandemic’s appalling toll could not have reduced life span by nearly that much. My own estimate is that when Covid-19’s ravages in 2020 are averaged across the country’s entire population, we each lost about five days of life.

The CDC’s mistake? It calculated life expectancy using an assumption that is assuredly wrong, which yielded a statistic that was certain to be misunderstood. * * * The CDC’s report boils down to a finding that bears no relation to any realistic scenario. Running the 2020 gauntlet for an entire life results in living one year less on average than running that same gauntlet in 2019.

In other healthcare news, Fierce Healthcare informs us that

Cigna will acquire telehealth platform MDLive, the insurer announced Friday morning.

Cigna has been a longtime partner of and investor in MDLive and will fold it into its Evernorth subsidiary, which houses its health services business. The deal is expected to close in the second quarter of 2021, pending regulatory approvals.

Cigna said that it expects to deliver $20 in earnings per share this year, including impacts of the acquisition, and will present additional details about the deal at its investor day on March 8.

Finally, the FEHBlog has been continuing to review the draft Postal Service bill creating a Postal Service Health Benefits Program. He has updated Wednesday’s post on the topic and he wishes to point out an important clarification on how the bill would treat Postal Service annuitants. Per the Committee staff memorandum:

The bill would require future retirees to enroll in Medicare in order to participate in the Postal Employee Benefits Program (similar to the Federal Employee Health Benefit Program but established as a separate risk pool). However, the bill includes several exceptions:

  • Residents of foreign countries and others without access to Medicare providers would not automatically be enrolled in Medicare; and
  • Retirees who do not have the requisite 40 quarters of creditable service would not be automatically enrolled in Medicare. This would include many Civil Service Retirement System (CSRS) retirees.
  • In addition, current retirees would be granted a three-month grace period from the Medicare penalty for late enrollment but would not be required to enroll.

This helps explain why NARFE is willing to support the bill.

Cybersecurity Saturday

David Ermer–Uncategorized–
Photo by Allie Smith on Unsplash

Cyberscoop reports that

The White House has a message for America: it’s going to take a long time to sort through the fallout from the massive espionage operation spurred on by the SolarWinds breach uncovered late last year.

Deputy National Security Advisor for Cyber and Emerging Technology Anne Neuberger stressed during a White House briefing Wednesday [February 17] that the way the suspected Russian hackers infiltrated a SolarWindsnetwork management software update with malicious code has made it more difficult for federal investigators to track down the details of the compromise.

Meritalk adds that

Officials from the Defense Department (DoD) and the Cybersecurity and Infrastructure Security Agency (CISA) said [on Friday February 19] that creating more effective defenses against sophisticated cyberattacks of the type used in the SolarWinds Orion hack may require further adoption of zero trust security concepts.

That was the news from Bob Kolasky, who heads CISA’s National Risk Management Center (NRMC), and Stacy Bostjanick, director of the Cybersecurity Maturity Model Certification (CMMC) Policy Office for DoD’s under secretary of Defense for Acquisition and Sustainment, who spoke during an online event organized by AFCEA International.

Both officials also discussed the growing likelihood that the CMMC security model will migrate in some form from its present use in ensuring minimum cybersecurity standards in the defense industrial base (DIB) to further areas of Federal government contracting. * * *

Zero trust security concepts incorporate much more rigorous and frequent evaluations of user and endpoint identities to allow access to networks. Kolasky agreed that something closer to a zero trust concept would be useful in that regard.

Discussing how to prevent software exploits, he suggested “really putting extra controls in place on things that have high levels of access, because that is where the risks are.” He continued, “that is where you go closer to zero trust,” adding, “you can’t go zero trust everywhere . . . but you can where the risk is higher.”

From the healthcare interoperability front, Healthcare Dive interviews the Don Rucker, National Coordinator for Health IT during the Trump Administration, and Fierce Healthcare interviews his successor Mike Tripathi.

From the HIPAA Privacy Rule front, the HHS Office for Civil Rights announced earlier this month the fifteenth and sixteenth settlements of HIPAA Privacy Rule individual right to access patient records cases.

Friday Stats and More

David Ermer–CMS, COVID-19, COVID-19 vaccine, OPM, Uncategorized–

Based on the Centers for Disease Control’s COVID-19 Case Tracker website, here is the FEHBlog’s chart of new weekly COVID-19 cases and deaths over the 14th week of 2020 through the 7th week of this year (beginning April 2, 2020 and ending February 17, 2021; using Thursday as the first day of the week in order to facilitate this weekly update):

and here is the CDC’s latest overall weekly hospitalization rate chart for COVID-19:

The FEHBlog has noticed that the new cases and deaths chart shows a flat line for new weekly deaths  because new cases greatly exceed new deaths. Accordingly here is a chart of new COVID-19 deaths, which is a lagging indicator, over the period (April 2, 2020 through February 17, 2021):

Finally here is a COVID-19 vaccinations chart for the past month which also uses Thursday as the first day of the week:

The Wall Street Journal reports tonight that

Efforts to vaccinate the world’s population against Covid-19 got a boost Friday after research showed that some vaccines provide strong, one-dose protection, and that one of the vaccines can now be stored in normal freezers instead of ultra-cold ones.

The vaccine developed by Pfizer Inc. and BioNTech SE generates robust immunity after one dose, according to new research out of Israel, and further data showed that the University of Oxford and AstraZeneca PLC vaccine similarly prevented Covid-19 when doses were spaced three months apart.

The findings could boost arguments in favor of delaying the second dose of the two-shot vaccine, as the U.K. has done. They could also have substantial implications on vaccine policy and distribution around the world, simplifying the logistics of distribution.

Pfizer and BioNTech said they have asked U.S. regulators to allow their vaccine to be stored and transported at temperatures consistent with standard freezing, around minus 20 Celsius, following successful internal stability testing. Similar filings were being prepared in other countries. 

Should Pfizer’s request be granted by regulators, it would mean its vaccine would vastly expand access in rural regions around the world, as well as pharmacies and physician offices, according to industry experts and officials.

The New York Times has a great article on combatting COVID-19 alarmism and the Society for Human Resource Management discusses the uncertain legal state of employer offers of COVID-19 vaccination incentives to their employees in an effort to overcome vaccine reluctance.

In federal personnel news –

  • OPM announced to FEHB carriers today the promotion of Laurie Bodenheimer to Associate Director, Healthcare and Insurance. Ms. Bodenheimer has served as acting Director of Healthcare and Insurance for the past two and half years. The FEHBlog notes that under federal law, 5 U.S.C. § 1102(d)

There may be within the Office of Personnel Management not more than 5 Associate Directors, as determined from time to time by the Director. Each Associate Director shall be appointed by the Director.

So congratulations Laurie for your well deserved appointment.

  • Fierce Healthcare reports that “President Joe Biden has chosen Obama administration veteran Liz Fowler to lead the Center for Medicare and Medicaid Innovation (CMMI), which has authority to shape key payment models, according to a report in Politico.” This powerful position does not require Senate confirmation.

Weekend update

David Ermer–CDC, Congress, COVID-19, COVID-19 vaccine, Uncategorized–
Photo by JOSHUA COLEMAN on Unsplash

Happy Valentines Day.

In the coming week, the Senate is on a State work period and the House of Representatives remains engaged in committee work. Fierce Healthcare reports that last Thursday

The House Ways and Means Committee voted 24-18 along party lines Thursday to approve a section of a $1.9 trillion COVID-19 relief package that includes the [two year long Affordable Care Act] subsidy boost. * * * [Also [t]he House Energy and Commerce Committee released legislation aimed at expanding Medicaid coverage and eligibility. * * * The legislation now moves to the House Budget Committee, which will roll it into the final package and send to the House floor [later this month].

On the COVID-19 vaccination front —

Students as young as first grade [age 6] might be able to get vaccinated against COVID-19 by September, White House chief medical adviser Dr. Anthony Fauci predicted in an interview published by ProPublica on Thursday.

Fauci cited clinical trials now underway in the U.S. from vaccine developers Pfizer and Moderna to test the safety and efficacy of the doses in children. He had said previously that the Food and Drug Administration might allow for vaccinations in American children “by the time we get to the late spring and early summer.” 

  • The Wall Street Journal reports that

Walmart Inc., the U.S.’s largest retailer and private employer, is set to become one of the biggest distributors of the Covid-19 vaccine as the federal government enlists retail pharmacies to accelerate what has been a choppy rollout.

Last week, 21 retail chains and pharmacy networks started administering those doses, including CVS, Walgreens, Kroger and grocers in all 50 states. The government initially plans to give around a million doses a week directly to pharmacies. Around 200,000 of those are going to Walmart, a spokeswoman said.

That is in part because out of the roughly 5,000 U.S. stores under the company’s Walmart and Sam’s Club banners, about 4,000 are located in what the federal government defines as medically underserved areas.

  • The Washington Post informs us about volunteer COVID-19 vaccine hunter who are helping the elderly get their protection. Bravo.
  • According to the CDC’s COVID-19 vaccine tracker, over six million doses COVID-19 vaccines were administered from February 11 through February 13. 38,292,270 Americans have receive their first dose and another 14,077,440 have received both doses of either the Pfizer or the Moderna vaccine. We are likely only two weeks away from the single dose Johnson & Johnson vaccine joining this portfolio.

Thursday Miscellany

David Ermer–COVID-19, U.S. Healthcare, Uncategorized–
Photo by Juliane Liebermann on Unsplash

Today the Department of Health and Human Services (“HHS”) announced that

HHS and Department of Defense (DOD) have purchased an additional 100 million doses of COVID-19 vaccines from both Pfizer Inc. and Moderna Inc. to help meet demand for COVID-19 vaccines in the United States. The orders placed today bring the vaccine purchased by the U.S. government from these two companies to a total of 600 million doses, enough to vaccinate 300 million people. Each company is delivering 300 million doses in regular increments through the end of July 2021. Each company will leverage U.S.-based manufacturing capacity to fill, finish and ship vials as the bulk material is produced.”

The current U.S. population is 333 million and roughly 60 million of those people under age 16 and therefore currently are ineligible for either vaccine. Consequently the government has purchased more than enough of these two vaccines to vaccinate the entire eligible population with both doses. What’s more, 34 million Americans (10% of the entire U.S. population) already has received the first dose of one of these vaccines and another 11 million have received both doses. Also the Johnson and Johnson single dose vaccine should be available early next month. It’s becoming a matter of logistics.

The Wall Street Journal which was the first paper to legally crack into Medicare pricing records has now figured out how to find transparent hospital pricing required by the new HHS rule.

Mayo Clinic offers a search interface at https://costestimator.mayoclinic.org/. The nonprofit hasn’t posted a file covering all of its negotiated rates and says it is working to have one online by this spring.

The hospital chain Sutter Health, on the other hand, is offering downloadable data for all of its hospitals on a single webpage labeled “Healthcare Cost Transparency,” here: https://www.sutterhealth.org/for-patients/healthcare-cost-transparency

Efforts to pull together and standardize data from many hospitals are emerging. Turquoise Health Co. has scoured the websites of every known hospital in the country—more than 6,000 providers—and found disclosures that at least partially meet the requirements for 1,700 hospitals, according to Chris Severn, a co-founder of the company. Consumers can search the data on Turquoise’s website at https://turquoise.health/

“This data was hard to find but it’s incredibly useful and, overall, a large amount of the industry has complied,” Mr. Severn said. “This is a huge step towards cost-informed decision making in health care.”

The American Hospital Association points out that

Leading health providers have come together in unprecedented fashion to unite around the goal of improving the lives of those they serve through data insights. Health provider innovators AdventHealth, Advocate Aurora Health, Baptist Health of Northeast Florida, Bon Secours Mercy Health, CommonSpirit Health, Hawaii Pacific Health, Henry Ford Health System, Memorial Hermann Health System, Northwell Health, Novant Health, Providence health system, Sentara Healthcare, Tenet Health, and Trinity Health have formed Truveta, a new company with a vision to save lives with data. 

Through structuring, normalizing, and de-identifying data from these health providers, a new data platform will be built, with careful protection of patient privacy and security. This new platform, using the power of AI and machine learning, will enable unprecedented insights as providers are able to learn from each other with statistically significant scale and representation of diverse populations. 

Together, these 14 health providers care for tens of millions of patients and operate thousands of care facilities across 40 states. The health providers will govern Truveta’s ethical pursuit of insights from this unprecedented de-identified data set. 

Interesting.

Also the Blue Cross Blue Shield Association announced that

Today, a broad coalition of health care and employer groups called for achieving universal health coverage by expanding financial assistance to consumers, bolstering enrollment and outreach efforts, and taking additional steps to protect those who have lost or are at risk of losing employer-based coverage because of the economic downturn caused by the COVID-19 pandemic. 

The Affordable Coverage Coalition encompasses groups representing the nation’s doctors, hospitals, employers and health insurance providers that collectively serve hundreds of millions of American patients, consumers and employers. The joint commitment by such a broad array of interests is a significant milestone on the path toward universal coverage, which has remained an elusive goal within the U.S. healthcare system. 

The organizations support the following steps to make health coverage more accessible and affordable: 

Protect Americans who have lost or are at risk of losing employer-provided health coverage from becoming uninsured. 

Make Affordable Care Act (ACA) premium tax credits and cost-sharing reductions more generous, and expand eligibility for them. 

Establish an insurance affordability fund to support any unexpected high costs for caring for those with serious health conditions or to otherwise lower premiums or cost-sharing for ACA marketplace enrollees. 

Restore federal funding for outreach and enrollment programs. 

Automatically enroll and renew individuals eligible for Medicaid and premium-free ACA marketplace plans. 

Provide incentives for additional states to expand Medicaid, in order to close the low-income coverage gap. 

Good luck. (Not to be confused with the Council for Affordable Health Coverage which appears to have similar goals.)

Tuesday Tidbits

David Ermer–Congress, COVID-19, Rx coverage, U.S. Healthcare, Uncategorized–

The Wall Street Journal reports tonight that

The most severe surge of the Covid-19 pandemic in the U.S. has weakened significantly, according to key metrics, though public-health experts and epidemiologists urge caution, given the spread of highly contagious new variants.

Newly reported cases have dropped 56% over the past month, based on a seven-day average, marking a significantly steeper fall than the U.S. saw after the spring and summer surges. Hospitalizations have declined 38% since Jan 6. The seven-day average of Covid-19 tests returning positive fell over the past week to 6.93%, the lowest since Oct. 31.

“The concern right now is that while we’re seeing a decline in cases from the holiday surges, as we identify more transmission of the variants within the U.S., this could lead to another surge,” said Saskia Popescu, an assistant professor at the Schar School of Policy and Government at George Mason University.

The American Medical Association reports

[A]s part of its “Understanding Coronavirus in America” study, researchers from the University of Southern California Center for Economic and Social Research recently analyzed data from 6,000 members drawn from its “Understanding America Study.” Data was collected between March 10, 2020, and Jan. 6, 2021, and found that 83% of adults surveyed view wearing a mask as an effective way to stay safe from COVID-19, but that their behavior is inconsistent.

The analysis found:

Two-thirds reported being within less than six feet of someone outside their household in early December, but only half mostly or always wore a mask while doing so.
White people were the least likely to consistently wear a mask when in close contact with people from other households, with 46% reporting wearing a mask compared to 67% of black people, 63% of Latinos and 65% of people of other races.
In rural areas, 42% reported always wearing a mask or wearing one most of the time when they were with people outside of their household. In suburban areas, the number jumped to 52% and it was highest in urban areas at 57%.
Among the 81% who said they went grocery shopping in early December, 90% reported wearing a mask.

This is why the vaccination campaign is so important.

On the Capitol Hill front

  • The Hill explains Sen. Ron Wyden’s plans as the new Chair of the Senate Finance Committee. The Senator has been a critic of high prescription drug prices.
  • The Hill also reports the House of Representatives is developing a COVID-19 relief budget reconciliation bill that would increase and expand the availability of Affordable Care Act subsidies as well as offer 85% subsidies for employer sponsored plan continuation coverage, i.e., COBRA and TCC, during 2021 and 2022.

On the Biden Administration transition front —

  • NPR discusses Office of Management and Budget Director nominee * Neera Tanden’s confirmation hearing before the Senate Homeland Security and Governmental Affairs Committee today. Ms Tanden has a second confirmation hearing scheduled before the Senate Budget Committee tomorrow morning.
  • Federal News Network informs us that President “Biden recently appointed Pam Coleman as OMB’s new associate director for performance management, the agency’s point person on federal workforce issues. * * * Coleman comes from the New Mexico state government, where she led the personnel office for the last two years. Coleman had multiple roles in the Obama administration, including as a leadership development team lead in the White House Presidential Personnel Office and as a liaison to DHS. The OMB associate director for performance management is usually the agency’s go-to on everything from federal pay and benefits to hiring and labor relations. Biden hasn’t yet nominated a new director for the Office of Personnel Management.”
  • STAT News compares the two leading contenders for Food and Drug Administration Dr. Janet Woodcock, the current acting commissioner, “and Josh Sharfstein, a vice dean at the Johns Hopkins Bloomberg School of Public Health who served as the FDA’s second-in-command during the Obama administration.” Dr. Woodcock is an FDA vet while Dean Sharfstein would be “only the second FDA commissioner in modern history to serve as a local public health official. While most FDA commissioners typically come from backgrounds in academic medicine or from other federal agencies, and thus tend to focus primarily on the regulation of drugs, Sharfstein has been far more outspoken about the FDA’s lesser known responsibilities, like regulating cigarettes and food.”

In other tidbits —

  • Beckers Hospital Review lists the HealthGrades top fifty U.S. hospitals for January 2021.
  • Govexec reports on the Postal Service’s latest quarterly financial report and a looming Postal Board of Governors power shift from Republicans to Democrats.
  • The Society for Human Resource Management seeks to keep us up to date on “evolving COVID-19 testing and safety guidelines [for employers] as the pandemic persists.”

Cybersecurity Saturday

David Ermer–Uncategorized–
Photo by Christine Sandu on Unsplash

On Wednesday, CyberScoop reported that Trustwave had found three new critical vulnerabilities in the SolarWinds Orion software for which SolarWinds has offered patches. “[Karl] Sigler, a researcher at Trustwave’s SpiderLabs security division, said his firm plans to release proof-of-concept exploit code for the vulnerabilities on Feb. 9. The goal is to spur people to apply the SolarWinds software patches before malicious hackers use their own exploits.”

The article added that “A SolarWinds spokesperson said the attackers in that breach added malicious software known as Supernova to the Orion software “on a customer’s network.”” In that regard, yesterday, NextGov reported that

Reuters first reported on Tuesday that the department’s National Finance Center, which runs a payroll system serving over 600,000 federal employees across 160 agencies, was penetrated by suspected Chinese hackers exploiting a flaw in SolarWinds’ software.    

The intrusion is separate from earlier reports in December associated with a trojanized update SolarWinds distributed to about 18,000 of its customers, according to Reuters. In response to that hacking campaign, which a number of agencies acknowledged they were affected by, the Cybersecurity and Infrastructure Security Agency directed all agencies to remove certain SolarWinds products from their systems. Government officials have since publicly said Russia is likely behind that event, along with the abuse of authentication configurations in Microsoft’s Office 365 cloud service.

“In compliance with CISA’s emergency directive and to protect USDA systems, USDA notified customers in December that it had removed SolarWinds Orion products from its networks due to the SolarWinds compromise,” the USDA spokesperson told Nextgov. “While we continue to look into it, we have no evidence of a data breach of the USDA National Finance Center.”

Health IT Security points out that this new vulnerability was resolved in the latest SolarWinds Orion software release. Here is a link to the CISA Alert on this Supernova vulnerability.

On Tuesday, the National Institute of Standards and Technology issued a new Special Publication 800-172 intended to assist the government and private entities to address “advanced persistent threats” such as these.

“We developed [NIST] SP 800-171 in response to major cyberattacks on U.S. critical infrastructure, and its companion document SP 800-172 is designed to mitigate attacks from advanced cyber threats such as the APT,” Ross said. “Implementing the cyber safeguards in SP 800-172 will help system owners protect what state-level hackers have considered to be particularly high-value targets: sensitive information about people, technologies, innovation and intellectual property, the revelation of which could compromise our economy and national security.”

The enhanced security requirements are to be implemented in addition to those in SP 800-171, since that publication is not designed to address the APT. The requirements in SP 800-172 apply to the components of nonfederal systems that process, store or transmit [Confidential Unclassified Information] CUI or that provide protection for such components. To further narrow the scope, the requirements are applied only when the designated CUI is associated with a critical program or high-value asset — the highest priority for protection. 

Yesterday, The FEHBlog noticed that

The National Cyber Investigative Joint Task Force (NCIJTF) has released a joint-sealed ransomware factsheet to address current ransomware threats and provide information on prevention and mitigation techniques. The Ransomware Factsheet was developed by an interagency group of subject matter experts from more than 15 government agencies to increase awareness of the ransomware threats to police and fire departments; state, local, tribal, and territorial governments; and critical infrastructure entities.

To reduce the risk of public and private sector organizations falling victim to common infection vectors like those outlined in the NCIJTF factsheet, CISA launched the Reduce the Risk of Ransomware Campaignin January to provide informational resources to support organizations’ cybersecurity and data protection posture against ransomware.

CISA encourages users and administrators to review the NCIJTF Ransomware Factsheet and CISA’s Ransomware webpage for additional resources to combat ransomware attacks.

Friday Stats and More

David Ermer–Congress, COVID-19, U.S. Healthcare, Uncategorized–

Based on the Centers for Disease Control’s COVID Data Tracker website, here is the FEHBlog’s weekly chart of new COVID-19 cases and deaths over the 14th week of 2020 through 5th week of this year (beginning April 2, 2020 and ending February 3, 2021; using Thursday as the first day of the week in order to facilitate this weekly update):

and here is the CDC’s latest overall weekly hospitalization rate chart for COVID-19:

The FEHBlog has noticed that the new cases and deaths chart shows a flat line for new weekly deaths because new cases greatly exceed new deaths. Accordingly here is a weekly chart of new COVID-19 deaths over the same period April 2, 2021 through February 3, 2021:

COVID-19 cases and hospitalizations are dropping, but deaths are not as yet. because deaths are considered to be a lagging indicator. The chart does point to the importance of vaccinating the elderly as soon as possible.

Here is a COVID-19 vaccinations chart for the past month which also uses Thursday as the first day of the week:

The CDC’s Fluview informs us that “Seasonal influenza activity in the United States remains lower than usual for this time of year.” Moreover, “46%: That’s how much U.S. sales of over-the-counter cold, flu, and cough medicine declined in the five week period ending Dec 26, 2020 from the same period last year, according to data from Nielsen, reported by Bloomberg.” These statistics suggest that Americans generally are following the social distancing and masking rules. Nevertheless the CDC recommends how to celebrate Super Sunday safely.

In Capitol Hill news, the Senate last night approved the Democrat’s budget resolution with Vice President Harris breaking the 50-50 vote from the Senators. The Wall Street Journal reports that today

The House approved a budget bill advancing President Biden’s $1.9 trillion relief plan, as Mr. Biden met with top House Democrats and lawmakers dived into crafting the details of the relief package.  The 219-209 vote marked a further step under budget reconciliation, a process that would allow Democrats to pass the relief package without Republican support in the Senate. Now, Democrats will turn to ironing out the details of the package over several weeks, including deciding who will be eligible for $1,400 direct payments and whether or not to raise the minimum wage to $15 an hour. 

The Journal also reports that a New York State court has ordered local authorities to certify the election of Republican Claudia Tenney in the last undecided U.S. House of Representatives race from the 2020 election. “Ms. Tenney is the second New York Republican to unseat an incumbent Democrat in 2020. She will be the 212th GOP House lawmaker, bringing the margin of Democratic control in the House to nine members.”

In healthcare news

  • The American Health Association reminds us that this February commemorates the 57th Heart Month.

Heart disease continues to be the greatest health threat to Americans and is still the leading cause of death worldwide, according to the AHA’s Heart Disease and Stroke Statistics – 2021 Update. The update, published in the association’s flagship journal Circulation, reports that nearly 18.6 million people across the globe died of cardiovascular disease in 2019, the latest year for which worldwide statistics are calculated. That’s a 17.1% increase over the past decade. And 523.2 million cases of cardiovascular disease were reported in 2019, a 26.6% increase over 2010.

During American Heart Month, the AHA and other organizations reinforce the importance of heart health, the need for more research and efforts to ensure that millions of people live longer and healthier. In most cases, heart disease is preventable when people adopt a healthy lifestyle, which includes not smoking, maintaining a healthy weight, controlling blood sugar and cholesterol, treating high blood pressure, getting at least 150 minutes of moderate-intensity physical activity a week and getting regular checkups. 

  • Health Payer Intelligence informs us that

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has introduced a value-based care program that focuses on improving health outcomes for members with kidney disease through coordinated and patient-centered care. The initiative, launched on January 1, is the newest feature in the industry-leading Blue Premier value-based care model. Eligible Blue Cross NC members can enroll in the Blue Premier Advanced Kidney Care program at no additional cost.

Tuesday Tidbits

David Ermer–Congress, COVID-19, COVID-19 vaccine, U.S. Healthcare, Uncategorized–
Photo by Patrick Fore on Unsplash

President Biden announced that his Administration is increasing the weekly COVID-19 vaccine supply released to States, etc., and starting on February 11 to supply partner pharmacies with vaccine to administer the vaccine to customers.

The Society for Human Resource Management brings us to date on OSHA efforts to implement one of the President’s executive orders by issuing “worker safety guidance for coronavirus protection programs on Jan. 29, requiring greater input from employees and enhanced mask protections.”

The Hill provides us with the latest on efforts to pass a sixth COVID-19 relief bill in Congress. Govexec reports that a bicameral, bipartisan push is underway inn Congress to repeal the Postal Service’s unique obligation to refund its employees FEHB coverage in retirement.

In other interesting healthcare news

  • Becker’s Payer Issues reports that “Cigna will no longer require prior authorization for some CT scans of the heart, according to an updated precertification list. The change is effective Feb. 1. * * * In addition, Cigna removed prior authorization for fractional flow reserve-computed tomography. For coverage under the policy, patients must have stable chest pain and an intermediate risk of coronary artery disease. “The favorable policy update shows that Cigna recognizes the use of CTA and FFR-CT as a front-line test which can lead to improved patient outcomes,” Dustin Thomas, MD, chair of the society’s advocacy committee, said in a news release.”
  • Access Management Intelligence informs us that “Ascent Health Services (Ascent Health) is a pharmaceutical group purchasing organization that is part of Evernorth, a subsidiary of Cigna Corporation. Humana has agreed to join Ascent Health in a move that the health insurer says will help drive down its drug costs for its [1.3 million] commercial members. Beginning April 1, Humana will join Ascent Health to give it access to greater discounts from drug makers. Ascent Health manages commercial rebates, the payments that drug makers make to health plans. The agreement covers drug contracting and negotiations for Humana’s commercial business.