advises on spotting dangerous pregnancy complication
Preeclampsia -- a condition where blood pressure in a pregnant woman can
rise to life-threatening levels -- is a key complication obstetricians try
and predict early in pregnancy.
While commercial tests are being marketed for use in the first trimester to
predict the risk of early onset preeclampsia, new recommendations from the
American College of Obstetricians and Gynecologists (ACOG) say there's a
lack of evidence that the tests offer any benefits, and they may do more
harm than good.
Instead, ACOG is holding to its position that taking a detailed medical
history to assess a woman's risk factors in the first trimester is still the
recommended screening approach for early-onset preeclampsia.
This approach should remain the only method of screening for preeclampsia
until studies can prove that aspirin or other treatments reduce the
incidence of preeclampsia among women who are considered at high risk, based
on predictive tests conducted in the first trimester, ACOG said.
Preeclampsia occurs in 5 percent to 10 percent of pregnancies and can lead
to preterm birth, complications and death in mothers, and also increase
women's long-term risk of heart disease, the group noted. (HealthDay)
Visit NIH for the report.
Medicare fraud is
committed well beyond U.S. borders
On the streets of Managua, the shuttle bus wrapped in a giant ad for free
healthcare stood out. âMedicare for people living abroad,â it proclaimed
above the image of a cheerful older woman playing golf. But Medicare, the
American public health insurance program for the elderly and disabled, isnât
available in Nicaragua or anywhere outside the U.S., except in emergency
circumstances. The clinic advertised, Nostrum Medical Center, had a way
around that: Patients were required to provide a U.S. address, so their
visits could be billed to American taxpayers.
Before the Nicaraguan scheme and a related one in the Dominican Republic
were shut down last fall, the U.S. government paid out $25 million from 2011
to 2014 for medical care received by more than 1,000 foreign residents who
signed up using post office boxes, mail-forwarding services, or the
addresses of friends or relatives in Florida to conceal that they lived
Ten people, including a Managua physician and his son, have pleaded guilty
in the swindle; one remains at large. Four conspirators, including two
executives at Florida Healthcare Plus, one of the companies that billed
Medicare for the patients seen abroad, will be sentenced in Miami on
Aug. 27. (Florida Healthcare wasnât accused of wrongdoing.) The
investigation is ongoing, with the HHS inspector general, the FBI, and the
U.S. Department of State looking at other countries where Medicare scammers
are recruiting patients.
The foreign-enrollment dodge is a new twist on Medicare fraud, which costs
American taxpayers billions of dollars a year, according to FBI estimates.
For years, the Centers for Medicare and Medicaid Services (CMS), which
administers Medicare, had relied on the pay-and-chase method, paying claims
first and going after those that looked suspicious after the fact. Recently,
the government has increased efforts to boost detection before cheaters can
start collecting reimbursements for falsified bills.
Ramped-up screening under the Affordable Care Act has resulted in the
revocation of Medicare billing privileges for about 34,000 providers, says
Medicare spokesman Tony Salters. Medicare also fingerprints some applicants
and makes unannounced site visits to providersâ and suppliersâ offices to
weed out scammers.
The U.S. has recouped only $1 million in the Nicaragua case. When the
defendants were arrested last October, one was leasing six new Mercedes-Benz
sedans and living in a 14,000-square-foot Miami mansion, according to
investigators. Only one of the 11âthe son of the Managua doctorâreported
significant assets, about $429,000 in a bank. Four told the court they
couldnât afford lawyers. Eight cooperated with the investigation, according
to the U.S. Department of Justice. Six have already been sentenced and
received prison terms ranging from 15 months to four years.
The scammers primarily enrolled people into a Medicare Advantage Plan run by
Coral Gables-based Florida Healthcare Plus, which was liquidated earlier
The companyâs Medicare contract covered just a few Florida counties, so
recruiters told prospective patients they couldnât get the free medical care
without an address in one of the counties. Along with the bus ads, Nostrum
and other clinics in Managua drummed up interest with full-page newspaper
ads and informational sessions at local hotels. American expats who saw the
promotions, which promised care with no copays, tipped off U.S. Embassy
officials. Investigators discovered that recruiters collected commissions of
as much as to $300 for every enrollee.
Visit Bloomberg for the article.
shows why Norovirus spreads so fast
Researchers have invented a "vomiting machine" that demonstrates just why
the nauseating norovirus spreads so far and so fast. The nasty stomach bug
can infect hundreds of passengers on a cruise ship, or every single person
who sits at the same restaurant table as a victim. It sticks to silverware
and counters, and survives being dried out for weeks. Scientists had also
suspected that it floats in the air and spreads that way, too. But no one
had actually demonstrated that it could.
Grace Tung-Thompson and colleagues at North Carolina State University and at
Wake Forest University designed a device that they hope would perfectly
replicate what happens when someone vomits, from a feeble dribble of bile to
the explosive projectile vomiting that is one of the hallmarks of a
The device has little tube that replicates the throat, and it's designed to
push out liquids and semi-liquids in the same, downward-facing direction
that people do when they vomit.
"This machine may seem odd, but it's helping us understand a disease that
affects millions of people," says Lee-Ann Jaykus, the N.C. State food
science professor who oversaw the work.
They used a range of materials, including instant vanilla Jell-o pudding, to
replicate various textures. The biggest sticking point was how to replicate
norovirus, which doesn't really like to grow in a lab dish and which the
researchers wouldn't want to risk catching anyway.
They used another virus called MS2 that's similar to norovirus, that doesn't
make people sick and that's easy to grow in the lab.
The researchers estimate that as many as 13,000 virus particles can be
released into the air with a single retch. They made a video that shows how
"There was evidence of aerosolized MS2 after every simulated vomiting
episode," they wrote in their report, published in the Public Library of
Science journal PLoS ONE.
People can be infected with as few as 20 to 1,300 microscopic viral
particles, so their study shows that vomiting could indeed spread the
infection through the air.
"But those airborne particles could also land on nearby surfaces like tables
and door handles, causing environmental contamination. And norovirus can
hang around for weeks, so anyone that touches that table and then puts their
hand to their mouth could be at risk for infection."
The findings help explain a 2012 study that showed how the virus spread on a
plastic bag that had been in a bathroom where a norovirus patient threw up.
Visit NBC for the report.
Wary of Medicaid
overcharging, Gov. Scott orders hospital audits
Playing hardball with Florida hospitals over their rising profits and
growing reliance on government funding, Gov. Rick Scott revealed that he has
ordered state regulators to audit 129 hospitals to ensure they are not
overcharging for patients who have Medicaid, the public health insurance
program for low-income people.
Scottâs office disclosed the number of audits â some of which are under way,
others pending, and still more to be conducted at random â in a letter from
the governor to Florida Attorney General Pam Bondi. Scott first ordered the
audits on Aug. 3, two days after a state-imposed deadline for hospitals and
health plans to certify that their business contracts did not exceed the
Earlier this month, state regulators announced audits for 31 hospitals. It
is unclear from Scottâs letter to Bondi why more hospitals were added, but
the performing the audits will be a challenge. Scott reduced funding for the
stateâs Agency for Health Care Administration, which will conduct the
audits, by $64 million and about 80 positions this year.
âThese agreements may ultimately result in overcharging the state for
Medicaid and other healthcare services; and in some instances, could
constitute Medicaid fraud and even deceptive and unfair trade practices,â
Scott wrote in the letter.
State law caps the rates that hospitals can charge the private insurers that
manage Floridaâs Medicaid program. An estimated 3.5 million Floridians
receive Medicaid through health maintenance organizations, or HMOs, under a
program begun in 2006 and rolled out statewide in 2014.
But Medicaid HMOs reported steep financial losses after the roll out, and
they asked the state for a mid-year pay increase of $400 million, and a 12
percent overall increase in their rates for next year. That led Florida
healthcare regulators to raise concerns that the managed care plans may be
paying hospitals too much.
Visit the Miami Herald for the story.
concerns grow about private Medicare
As some of the nationâs largest health insurers plan to merge, a new report
raises fresh concern over the lack of competition in the private Medicare
market. The analysis concludes âthere is little competition anywhere in the
The report from the Commonwealth Fund, a research group, looked at the
market share of insurance companies offering private Medicare Advantage
plans in 2012. The authors found that 97 percent of markets in United States
counties were âhighly concentrated,â in which a small number of insurers
dominated. The lack of competition was worse in rural markets.
Only one county, Riverside, CA, qualified as a competitive market, according
to the report.
For decades, insurers have offered private plans as an alternative to
traditional Medicare, the government-run program that provides coverage to
about two-thirds of beneficiaries.
UnitedHealth Group, Humana and Aetna are all major players in the private
Medicare Advantage market. While UnitedHealth remains independent, Humana
and Aetna announced this year that they planned to combine forces.
Proponents of these plans say competition from private insurers benefits
consumers by reducing Medicare costs and improving the quality of their
âSeniors are overwhelmingly satisfied with Medicare Advantage because of the
wide range of coverage options available and the overall value these plans
provide,â Clare Krusing, a spokeswoman for Americaâs Health Insurance Plans,
a Washington trade association, said in an email. âThis market remains
competitive, particularly with Medicare Advantage plans demonstrating
improved care delivery for beneficiaries compared to traditional Medicare.â
But the studyâs findings come at a point when the proposed mergers of Aetna
and Humana, as well as that of Anthem and Cigna, could allow the nationâs
largest insurers to gain even more leverage in a market. Consumer advocates
and others have raised concerns over whether individuals will benefit from
the mergers, which reduce the number of the five largest for-profit
companies to three.âš
The effects on consumers are expected to vary widely, depending on the place
and the type of market, and whether policies are sold to individuals, large
employers or Medicare beneficiaries.
Federal regulators will have to determine whether the mergers could result
in higher prices or fewer options for consumers, particularly in some
locations. In Kansas, for example, Aetna and Humana have 90 percent of the
Medicare Advantage market, according to data from the Kaiser Family
The insurers argue that consumers will still have plenty of options, even if
the proposed combinations take place. âThe Medicare space is highly
competitive,â said Cynthia B. Michener, a spokeswoman for Aetna. âA combined
Aetna-Humana would serve only 8 percent of the current 54 million Medicare
beneficiaries, with the remainder being served by the government and more
than 140 private insurers,â she said. The acquisition will allow Aetna to
expand Humanaâs highly regarded model of care to more people, Michener said.
Visit the New York Times for the article.
Regular use of
aspirin, NSAIDs may reduce risk of colon cancer
A new study has revealed that regular use of aspirin and other Nonaspirin
Nonsteroidal Anti-inflammatory Drugs (NSAID) could reduce the risk of
colorectal cancer. In the study, researchers reviewed data on drug use,
comorbid conditions, and history of colonoscopy from prescription and
Based on the prescriptions filled, taking 75 to 150 mg of aspirin
continuously for five years or longer was associated with a 27 percent
reduced risk for colorectal cancer and five or more years of continuous
nonaspirin NSAID use was associated with a 30 to 45 percent reduction in
colorectal cancer risk.
The authors caution that patients with the highest adherence comprised only
about 2 to 3 percent of all low-dose aspirin users in the study population,
and these persons may have a risk profile for colorectal cancer that differs
from that of the general population.
However, a recent comprehensive review concluded that more research is
needed to determine the optimal use of aspirin for cancer prevention.
The study is published in the journal Annals of Internal Medicine.
Visit ZeeNews for the study.
UK Sunshine Rule
for tackling healthcare lobbying corruption needs clarity, says GlobalData
The United Kingdomâs (UK) new Sunshine rule, introduced by Health Secretary
Jeremy Hunt to abolish healthcare industry corruption, has already met with
criticism from some National Health Service (NHS) staff members, and
requires clarity if it is to be successfully implemented from 2016, says an
analyst with research and consulting firm GlobalData.
The new rule follows an investigation by The Telegraph into
pharmaceutical and medical device companiesâ alleged bribery of NHS decision
makers in efforts to lobby for their productsâ promotion over those of their
However, Amendeep Sanghera, GlobalDataâs Analyst covering Medical Devices,
states that such lobbying is not a new issue. It is particularly prominent
in countries with extensive private healthcare systems, such as the US.
Indeed, efforts to stamp out corruption began with the US governmentâs
implementation of the Sunshine Act in 2013, which aimed to lift the curtain
on physician and healthcare firmsâ interactions, especially regarding
financial transactions and gifts.
Sanghera says: âWhile the exact specifics of the UKâs Sunshine rule are
currently unknown, it can be assumed that the new law will closely reflect
its American predecessor.
âGlobalData therefore expects physicians and influential board members to be
more conservative when approached by pharmaceutical and medical device
industry representatives. Due to the threat of an unlimited fine and a
maximum jail sentence of 10 years under the Bribery Act, they should
consider the effects of products on consumers and payers, rather than
chasing a quick payday.â
The analyst adds that if the information provided by the Sunshine rule is
made publicly available, as with the US Sunshine Act, then it will allow
patients to review their doctorâs interactions with drug and device
However, caution must be exercised if publicizing this information, as it
may cause needless damage to the reputations of doctors and healthcare
firms, for whom a positive collaboration is necessary to aid product
development and delivery.
Visit here to read the full Expert Insight on the UK Sunshine rule.
twice as many âsuperbugsâ in conventional hamburger as organic ones
Most people know that you can get sick from eating tainted ground beef. Now
a new report has a lot more detail about the safety of ground beef tested
across the United States. Some of it has bacteria that produces a toxin that
can't be destroyed, even with proper cooking. And it turns out that
conventionally produced beef â the kind sold in most stores â had twice as
many superbugs as beef raised in more sustainable ways. (At the most basic
level, that means beef raised without antibiotics.)
Consumer Reports tested 458 pounds (or the equivalent of 1,832 quarter-pounders)
from 103 grocery, big-box and natural-food stores in 26 cities across the
country. They analyzed the samples from five common types of bacteria found
on beef: Clostridium perfringens, E. coli (including the
deadly O157 and six other toxin-producing strains), enterococcus,
salmonella and Staphylococcus aureus.
All 458 pounds of beef contained at least one of the types of bacteria. Ten
percent of the samples were contaminated with a strain of S. aureus that,
under certain circumstances, can produce a toxin that can make you sick --
and that can't be destroyed with proper cooking. However, other experts say
it would be difficult for these conditions to exist in the average
The meat industry said the findings actually show the overall safety of
beef. Testers did not find the deadly strain of E. coli O157,
according to a statement from the North American Meat Institute.
The U.S. Department of Agriculture says it has implemented tighter food
safety standards than ever before on ground beef and the overall meat
industry. They include measures that include a zero-tolerance policy for six
dangerous strains of E. coli and better procedures for detecting the
source of outbreaks.
One of the most significant findings, said Urvashi Rangan, executive
director of the Center for Food Safety and Sustainability at Consumer
Reports, is that beef from conventionally raised cows was more likely to
have bacteria overall, as well as bacteria that are resistant to
antibiotics, than beef from sustainably raised cows.
Sustainable methods range from the basic, such as beef raised without
antibiotics, to the most sustainable, which is grass-fed organic. Grass-fed
cattle usually don't get antibiotics and spend their lives on pasture, not
feedlots, according to Consumer Reports.
In the past, when the group tested for bacteria in shrimp, ground turkey and
chicken, testers weren't able to obtain large samples of sustainably raised
products, Rangan said. Nor did testers find a big difference in the
prevalence of bacteria between conventional and sustainable meat-production
But this time, Consumer Reports found that of the conventional beef samples,
18 percent were contaminated with superbugs â dangerous bacteria that are
resistant to three or more classes of antibiotics â compared with 9 percent
of beef from samples that were sustainably produced.
Bottom line: If you cook your meat to 160 degrees, that should kill all the
Visit the Washington Post for the article.