Medic Buzz Sat, 18 Sep 2021 03:54:00 +0000 en-US hourly 1 Medic Buzz 32 32 Why didn’t FDA advisers want to recommend Covid-19 booster injections for everyone? Sat, 18 Sep 2021 01:25:00 +0000 They recommended a more limited step: emergency use authorization for people 65 years of age and older and for people at high risk of serious infection. Then they came back and added health workers and others at high risk of getting infected at work – even if they weren’t at particularly high risk for serious illness.

But why not just go ahead and say anyone who wants a booster can get one? Members of the Advisory Committee on Vaccines and Related Biologics spoke effusively as to why.

“The stated purpose of this vaccine has been to protect against serious disease,” said Dr. Paul Offit, professor of pediatrics at Children’s Hospital of Philadelphia, at the meeting. “The data shows that these vaccines do just that,” he added. “This is exactly what you would expect.”

Even Pfizer said its vaccine is still very successful in preventing serious illness, hospitalizations and death in the United States, with an effectiveness of over 90%. The company argued that it might not last longer, but many VRBPAC members did not buy it.

They don’t see enough evidence to warrant booster shots for everyone

“In my opinion, we need this in our arsenal – a booster now, especially for the elderly and (those with) other high-risk conditions – but I share my colleagues’ angst about the issue. the paucity of safety data, ”said Dr. Mark Sawyer, professor of clinical pediatrics at the University of California, San Diego.

“I hope the CDC will roll this out gradually.”

Dr Michael Kurilla, an infectious disease specialist at the National Center for Advancing Translational Sciences, said he suspected Pfizer was going too far in extrapolating data on the elderly to a younger population.

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“So it’s not clear that everyone needs strengthening except for a subset of the population who would clearly be at high risk for serious illness,” Kurilla said. “It’s not clear to me that the data we’re seeing right now is applicable to the general population.”

They would like a lot more data and a chance to look for the wrong conclusions

Dr Philip Krause, deputy director of the FDA’s Office of Vaccine Research and Review, noted that Pfizer was using data that had not been reviewed by experts.

“One of the problems is that much of the data that has been presented and discussed today is not peer reviewed and has not been reviewed by the FDA,” Krause said.

Krause, along with another FDA vaccine official, Marion Gruber, signed an article published by The Lancet earlier this week, saying it was too early to start giving people reminders.

Kurilla noted that Pfizer’s studies relied heavily on antibody measurements, without examining other important aspects of the immune response.

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“It’s a little disappointing that there have been very few reports on cellular immune responses and that the focus is entirely on neutralizing antisera,” Kurilla said. Immunologists point out that lasting protection comes from immune cells called B cells and T cells, and Pfizer only presented data on the antibody response.

“We lack data, including solid data on the vaccine doses that were administered,” said Dr. Hayley Ganz, professor of pediatrics at Stanford University Medical Center.

They worry about young adults and teens

“We are being asked to approve this as a three dose vaccine for people 16 years of age and older, without any clear evidence, the third dose for a younger person, compared to an older person, has value.” , Offit said. .

“If it is not of value, then the risks may outweigh the benefits. And we know that the 16 to 29 year old is at higher risk for myocarditis,” he added.

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Dr Doran Fink of the FDA told the meeting that the agency was not sure either. “We really don’t have enough data yet to know what the risk of myocarditis or pericarditis would be following a booster dose,” he said. Studies have shown that young adults and older adolescents, especially men, are at a higher risk for this rare heart inflammation after receiving an mRNA vaccine like that from Pfizer, although the problem resolves quickly with a fast processing.

Details on that risk might not come out, however, Fink said, until the booster doses have been administered more widely.

“We have discussed the need for such surveys with vaccine manufacturers,” Fink said.

“I don’t think we would feel comfortable giving it to a 16 year old for all the reasons everyone has mentioned,” said Dr Eric Rubin, chair of the Department of Immunology and Diseases. infectious diseases from the Harvard TH Chan School of Public Health.

They think it’s more important to get more people vaccinated the first time

Dr Cody Meissner, professor of pediatrics at Tufts University School of Medicine, said he didn’t think boosters would significantly help control the pandemic.

“It is very important that the main message that we are still sending is that we have to get two doses for everyone. Everyone has received the primary series,” he said. “This booster dose is not likely to make much of a difference in the behavior of this pandemic.”

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“It’s a frustrating place when we have more than enough vaccine stocks in the United States and yet we have not been able to achieve the level of coverage that would better control the pandemic than we have,” said Dr Melinda Wharton, director of the division of immunization services at the U.S. Centers for Disease Control and Prevention.

“Boosters are probably not the action that will have the greatest impact on health in the United States,” she said.

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JBER leaders declare public health emergency, urge staff to avoid areas without masks or distancing Sat, 18 Sep 2021 00:12:59 +0000

Military chiefs at Joint Base Elmendorf-Richardson declared a public health emergency on Friday and urged staff to avoid areas off the base that do not require masks or social distancing, given the growing number High COVID-19 cases and strained hospital capacity in south-central Alaska.

“This statement reflects the continuing reality that JBER is experiencing sustained community transmission of COVID-19,” said Air Force Col. Kirsten Aguilar, 673d Air Base Wing and Commander JBER, in a prepared statement. “It will remain in effect for 30 days, but can be extended or shortened depending on conditions.”

The base moved to Bravo health protection condition. The change means Aguilar has more authority to take action that would protect the base against COVID-19.

“If the situation continues to worsen, additional measures to protect the force will be implemented, including restricting access to off-base establishments,” JBER officials said in a statement.

In a letter sent to staff on Friday, Lt. Gen. David Krumm, a senior military commander responsible for the air force in Alaska and the homeland defense mission for the state, said most exposures to the virus among the military occur off JBER.

“Unfortunately, the lack of off-base mitigation has resulted in alarming rates of infection, hospitalizations and deaths in our community,” Krumm wrote. “The current cases of COVID on JBER have not yet reached the point of compromising our preparedness, but they are increasing, and our data indicates that off-base exposure is the primary source of infection for our military personnel and their families. “

Although the base does not apply any immediate restrictions, Krumm said he is asking service members and families to avoid facilities that do not require masks, physical distancing and other mitigation measures.

At this time, neither Anchorage nor the Mat-Su have in place mask requirements or capacity restrictions for businesses or gatherings. In Anchorage, Mayor Dave Bronson continued to refuse to take such action.

COVID-19 cases and hospitalizations in Anchorage and statewide have risen sharply in an outbreak brought on by the highly contagious delta variant. Alaska recorded the nation’s third-highest COVID-19 case rate per 100,000 people in the past two weeks on Friday.

[Alaska is now 3rd in the nation for highest case rate as state reports nearly 900 cases and 1 death Friday]

The situation has become so dire that the state’s largest hospital, Providence Alaska Medical Center in Anchorage, this week began rationing care under crisis care protocols. Other hospitals in the city and state are reporting similar levels of stress on staff and capacity.

The Department of Defense and federal facilities like JBER require masking and social distancing at all indoor facilities if they are located in a high transmission area, Krumm said.

Krumm said restrictions, like those adopted by JBER in October 2020 that prevented service members from visiting certain off-base facilities, could be enacted if there is no improvement soon.

“It’s a message to our military and their families that we should be doing it on purpose just to help our community and help the force,” Krumm said in an interview on Friday. “Also, to let them know that if the situation worsens, we will do absolutely everything in our power to protect the force.”

All members of the Department of Defense departments are required to receive the FDA-approved COVID-19 vaccine, and Krumm said in an interview that the Air Force unit on JBER is approaching 95% vaccine coverage.

“We always encourage everyone who is eligible for the vaccine to take it as soon as possible,” Krumm said. “We have a lot of vaccines available. And we have an open door policy for anyone here on base to come in and get the shot. “

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Big insurers prepare to take advantage of Democratic proposal to expand Medicaid Fri, 17 Sep 2021 20:46:40 +0000

But it’s not entirely clear what would happen in the three non-expanding states that do not have MCOs, although the legislation gives HHS the ability to contract with a “third-party plan administrator.” North Carolina, another state that has not extended Medicaid, recently contracted with several MCOs, including Centene Corp. and UnitedHealth Group, to manage their program. Major national carriers Centene, UnitedHealthcare, Anthem, Molina Healthcare and Aetna have contracts to cover 60% of the Medicaid managed care market, according to an analysis by KFF.

Hempstead said there had been significant entry into the ACA markets in states without expansion, with insurers that operate OLS potentially anticipating that those states will eventually expand Medicaid or that Congress will act to close the gap. blanket.

Insurers may think this gives them an advantage of already serving clients in the marketplace or in Medicaid when the time comes to submit offers, she said.

This is what the regional and local plans are worried about.

Regulators must ensure that community plans operating only in a certain region of the state are not disadvantaged in their bidding process, said Dan Jones, vice president of federal affairs at the ‘Alliance of Community Health Plans. Local and regional MCOs control around 40% of the market, according to KFF.

“If you only had two offerings across the state with no expansion, we have plans that work in parts of the state,” Jones said. “So it looks like they would be at a disadvantage if that was the path they would take.” The legislation states that the secretary of the HHS can contract with more than one MCO or plan administrator in each geographic gap in coverage.

While the idea of ​​offering a federal Medicaid option has been debated since at least the creation of the Affordable Care Act, the proposal to privatize the service is new, Jones said.

In the past, managed care organizations have been criticized for charging more for administering the plans than traditional, fee-for-service Medicaid. The ACA allows plans to keep 15% of premiums collected for administration – the rest must be spent on members’ medical care, which insurers measure through their medical loss ratios. Some states have said local regulators manage the program more effectively than private companies.

In the run-up to privatizing health care for the state’s most vulnerable population, the Oklahoma Health Care Authority, which has supported the shift to managed care, said its administrative costs of running Medicare at the deed amounted to only 5%, for example. The decision to privatize Oklahoma’s Medicaid program, named SoonerSelect, ultimately failed.

“In terms of what they count for administrative costs, what benefits are included? What type of care coordination is provided to improve health outcomes and reduce costs? Jones said. “I just think there are a lot of variables that go into looking at the value provided by private companies.”

Medicaid managed care organizations have also gained the attention of regulators recently. The federal government this week unveiled a whistleblower lawsuit accusing Aetna of lying about her provider network to secure Medicaid contracts in Pennsylvania this week, although the Hartford, Connecticut-based insurer denies the claims. Aetna is owned by CVS Health.

The legislation gives the Secretary of HHS the power to set supplier prices, network suitability standards, quality requirements, and any other standards he deems necessary. Contracts should also include a minimum MLR and a requirement for “timely” payments to suppliers.

“I don’t think it’s universally true that managed care entities do things right,” said Dr Vikram Bakhru, chief medical officer at managed care startup Medicaid Circulo. “Sure, you know, there are cases of failure.”

But he believed that the introduction of private companies into the market would add a level of competition that would benefit government and registrants, and that the experience of care management companies in managing costs and care would translate into ultimately reduced costs across the program, compared to traditional fees. service option. As an example, he highlighted the success of the lucrative and growing market for Medicare Advantage, a private alternative to paid health insurance that covers 26.7 million seniors, or more than 42% of all seniors. eligible, according to the most recent federal report. July data.

In 2021, member satisfaction with their Medicare Advantage program increased for the third year in a row, according to a report by data analytics firm JD Powers. But as satisfaction increased, federal spending also increased. The cost per beneficiary is rising faster for people on Medicare Advantage than for people on traditional Medicare and Part D drug plans, according to MedPAC. Medicare Advantage also accounts for a larger portion of the federal budget, at 46%, than the enrolled population it serves, according to KFF.

“Is the private option a guaranteed solution? No, of course not,” Bakhru said. “But this represents an option that brings competition to the landscape, and I think it’s a healthy component of the ecosystem.”

While privatizing a federal Medicaid plan would offer a short-term boost to the companies chosen to run the program, the long-term proposal could have a negative impact on insurers as it could cause a small portion of commercial members to drop out. switch to Medicaid, which offers lower benefits. margins, said Glenn Melnick, professor of health finance at the University of Southern California.

In 2020, Medicaid managed care registrants offered insurers the lowest profit margin of any type of plan, according to KFF.

“If you want to bid and you only have one buyer, which is the federal government, they have the power to negotiate a contract,” Melnick said. “I guess all things being equal, corporations would prefer their members to remain commercial.”

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Clover Health uses MedArrive to vaccinate home-confined AH members Fri, 17 Sep 2021 20:03:10 +0000

Photo by fstop123 / Getty Images

Clover Health partners with MedArrive to deliver COVID-19 in-home vaccines to its Medicare Advantage members.

MedArrive’s platform serves payers and providers who can use it to send emergency medical service (EMS) providers to patients’ homes to perform basic clinical services. If necessary, home providers can virtually call on the patient’s physician for additional monitoring.

As an insurance provider for the elderly, some of Clover’s members are housebound and may find it difficult to get vaccinated themselves. The company has partnered with MedArrive to begin sending its network of EMS providers to members’ homes for immunization.

The program kicks off in New Jersey, according to the announcement.


Even now, as more than 75% of adults in the United States have received their first dose of a COVID-19 vaccine, new cases are on the rise. In fact, the United States is reporting the highest rate of new COVID-19 cases since the peak of last winter, according to data from the Centers for Disease Control and Prevention.

This creates problems for unvaccinated seniors, who are at increased risk of serious illness, hospitalization and death, according to the CDC.

But beyond the risk that unvaccinated seniors could put themselves at risk by delaying getting the vaccine, there is the burden they would place on the U.S. health care system if they got sick and needed care. For example, between June and August, $ 5.7 billion was spent on hospital care for unvaccinated COVID-19 patients, according to the Kaiser Family Foundation.

The KFF says that despite the high cost of developing and administering vaccines, the injections will ultimately save the health care system money by avoiding costly hospitalizations.

The partnership between Clover Health and MedArrive aims to combat these risks by providing patients with the care they need at home.

“Many Clover members have disabilities or face other challenges that may prevent them from leaving their homes, even to obtain life-saving medical care like the COVID-19 vaccine,” said Kumar Dharmarajan, deputy chief medical officer. of Clover Health, said in a report.

“This service allows our most vulnerable members to get essential care in the fastest and most convenient way possible, which we believe will ultimately improve their quality of life, reduce hospitalizations and reduce costs. health care costs. “


Clover manages care for Medicare beneficiaries in 11 states, including Arizona, Georgia, Kansas, Mississippi, New Jersey, New York, Pennsylvania, South Carolina, Tennessee, Texas and Vermont .

Last year, the company went public after completing a merger with specialist acquisition firm Social Capital Hedosophia Holdings Corp. III.

Around the same time it hit public markets, Clover announced it was teaming up with Walmart to bring MA plans to Georgia. The deal marked Walmart’s first foray into insurance.

But this summer, when Clover announced plans to expand its geographic footprint, the company also announced it was ending its partnership with the retail giant. In its announcement, Clover said there would be no material change in the benefits of these plans or any disruption in service.

Twitter: @HackettMallory
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HHS allocates $ 25.5 billion to cover financial losses from COVID-19 Fri, 17 Sep 2021 12:00:00 +0000

The Department of Health and Human Services (HHS) has taken three steps to help physician offices and other health care entities that suffered financial losses during the COVID-19 pandemic, including unlocking a new allowance of 17 billion dollars from the Supplier Relief Fund (PRF).

These HHS actions, which will focus on small rural health care entities, include:

  • Make a total of $ 25.5 billion available to doctors’ offices, hospitals and other healthcare facilities that have suffered financial losses and additional expenses related to COVID-19.
  • Simplify the process for requesting help.
  • Provide a 60-day extension to the reporting requirements for a previous PRF allocation.

This new FRP allocation, called “Phase 4”, will cover losses incurred between July 1, 2020 and March 31, 2021. Doctors and others can apply for funding for Phase 4 of the FRP from September 29 through a health center. health resources and services. PRF Administration Reporting Portal (HRSA).

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The FRP Phase 4 allowance will include bonuses for those serving those enrolled in Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP). Premiums will be billed at Medicare rates.

An additional $ 8.5 billion will be made available from US bailout funds to provide resources to physicians and others who provide health services to rural patients enrolled in Medicare, Medicaid or CHIP, with payments on Medicaid and CHIP claims related to Medicare rates “with limited exceptions,” according to HHS.

“Funding will be distributed on an equitable basis, to ensure that providers serving our most vulnerable communities receive the support they need,” HHS Secretary Xavier Becerra said in a press release.

Find out how WADA’s new policies provide pragmatic action to address the complex challenges of rural health care.

Doctors can seek help from either funding source in a single request through the HRSA Reporting Portal starting September 29.

HRSA will speed up the process by using existing Medicaid, CHIP, and Medicare claim data to calculate payments.

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As previously reported, physicians who received PRF payments between April 10 and June 30, 2020, greater than $ 10,000 in total, had until September 30 to file a report through the HRSA PRF reporting portal.

HHS, however, has announced that it will not seek a clawback or initiate enforcement action for failing to meet the September 30 deadline before a 60-day grace period from October 1 to November 30. .

The creation of the grace period was made in response to the challenges physicians and other healthcare entities face as a result of COVID-19 outbreaks and natural disasters suffered from coast to coast.

Doctors’ offices that received $ 10,000 or less in payments between April 10 and June 30, 2020 do not have to report their use of these relief funds.

Learn more about the financial impact of COVID-19 on physician practices. Also read WADA’s Physician Practice Support Guide (PDF) and find out how the implementation of the Coronavirus Aid, Relief and Economic Security Act (CARES) affects physicians.

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Afghans face delays in the United States Fri, 17 Sep 2021 09:23:39 +0000

WASHINGTON – Weeks after their dramatic escape from Kabul, tens of thousands of Afghans hoping to be resettled in the United States remain on military bases across the country and abroad as medical and security checks slow the process.

A small but worrisome measles outbreak has contributed to the delays, causing evacuation flights to halt as federal officials scramble to contain cases and vaccinate new arrivals against disease and other illnesses, including the coronavirus .

As of Tuesday, approximately 64,000 evacuees from Afghanistan had arrived in the United States. The vast majority were in danger under the Taliban after the United States withdrew from the country last month. Nearly 49,000 people live on eight national military bases, awaiting relocation to the United States, according to an internal federal document obtained by The New York Times. Around 18,000 are on bases abroad, mainly in Germany. Some go away in a few weeks, but most stay longer.

The projections, which involve an array of federal agencies, follow a condensed and frenzied evacuation effort last month shortly before the United States completed its withdrawal from Afghanistan. About 100 Americans who want to leave and an unknown number of vulnerable Afghans remain in the country.

Secretary of State Antony Blinken defended the Biden administration’s evacuation operation for hours of testimony in Congress this week, which included calls from critical Republican officials for his resignation and accusations that the administration failed had not adequately planned for the collapse of the Afghan government against the Taliban.

Blinken said there was no deadline to get the locals out and that “in the end, we completed one of the biggest airlifts in history, with 124,000 people evacuated instead. sure”.

As Afghan evacuees escaped the Taliban, their lives remain in limbo, with children restless and little to do on bases across the United States, including Fort McCoy in Wisconsin, where more than 12,700 people were hosted last week, and Fort Bliss in Texas, which received more than 9,700.

“We’ll be here a month or more,” said Milad Darwesh, who arrived at Joint Base McGuire-Dix-Lakehurst in New Jersey on Saturday after traveling for days to reach the United States. There are nearly 8,000 evacuees at the base.

Darwesh said he and his family narrowly escaped in Kabul on a grueling journey with the Taliban at their heels to the airport gates. They spent four days in Doha, Qatar, along with thousands of other evacuees, with little water to drink or wash. He and his family were then transported to an aircraft hangar at a base in Italy before finally making their way to Fort Dix.

“It’s good here,” said Darwesh, a former military translator who has been waiting two years for his visa to be processed. “We now have our own room.”

Many evacuees have arrived at Dulles International Airport in Virginia, and state hospitals have complained to the federal government of being overwhelmed by Afghans in need of medical attention. Healthcare providers have asked for financial help, and Virginia Senators Mark Warner and Tim Kaine, both Democrats, sent a letter to officials in the Biden administration calling for better coordination.

“Virginia ambulances and hospitals, already busy with the regular needs of patients and coping with the added stress of covid-19, have done a remarkable job of partnering with the federal agencies managing this treatment effort and ensuring that the emergency health needs of our Afghan partners are being met, “said Katie Stuntz, spokesperson for Kaine. “Healthcare providers deserve reimbursement for this work, and Senator Kaine is working with all stakeholders to make sure this happens.”

Refugee groups rushed for weeks to prepare to welcome large numbers of Afghan refugees, but so far have seen only a small number of people ready for resettlement.

“In the past few weeks, we have served over 100 people,” said Krish O’Mara Vignarajah, CEO of Lutheran Immigration and Refugee Service, a resettlement agency that has branches in 22 states. “Some come with little more than a backpack. We know the importance of an orderly system that treats and prepares these new Afghan arrivals, helping them make informed decisions about where they ultimately want to relocate. . “

[RESETTLING EVACUEES: Map of the United States not appearing above? Click here »]

Ned Price, a spokesperson for the State Department, said Wednesday that the administration was trying to move evacuees out of military bases “as quickly and efficiently as possible.”


The United States should not accept Afghan refugees, including translators and others who helped the United States military during the 20 Years War, said Republican Senate candidate Jim Lamon, taking a tough stance against a a group of immigrants who received broad support. of both parties.

Rather than bringing them back to their homeland, the United States should help Afghans who participated in the war flee the Taliban and resettle in the Middle East, Lamon told The Associated Press on Wednesday.

“They should go to countries that are friends with them and with us,” Lamon said. “We cannot continue to be the refugee camp of the world.

Lamon shows up in a crowded Republican primary to take on Democratic Senator Mark Kelly.

His stance on refugees comes as GOP candidates across the country wonder how to balance grassroots skepticism about immigration with broad public support to provide refuge for Afghans who have risked their lives. helping the United States.

While many Republicans questioned whether the refugees were sufficiently controlled or suggested that the United States was accepting too many Afghans, few said that even those who helped American troops the most should be excluded.

His position puts him at odds with others in the GOP who say that accepting refugees is in line with Christian teachings.

Gov. Doug Ducey and Arizona House President Rusty Bowers, both Republicans, issued a joint statement last month hailing the “fair share” of Arizona refugees and pledging that the Refugee Resettlement Office of the state would help them settle.

“They helped our military in their country, and now we are ready to help them in ours,” said Ducey and Bowers.

Lamon said the United States has spent billions of dollars in the Middle East, including Oman, the United Arab Emirates and Saudi Arabia, and these countries “must have brought them and helped us in this regard.”

“What I would have suggested is that those who helped us, we help them move to neighboring countries,” Lamon said.


Refugee and human rights groups on Thursday called on the European Union to step up aid to those trying to flee Afghanistan, accusing the bloc of not doing enough to help those living in fear of the Taliban regime.

More than 100,000 people were airlifted out of Kabul in a chaotic exodus late last month after President Joe Biden announced the withdrawal of US troops and the Taliban took control of Afghanistan torn apart by conflict in just a few weeks. Thousands of other Afghans want to leave.

In new figures released on Thursday, the EU’s asylum agency said asylum claims from Afghans numbered 7,300 in July – before the government fell – an increase of 21% from June and the fifth consecutive monthly increase. Almost 1,200 were unaccompanied minors, the European Asylum Support Office reported. More than half of Afghan asylum claims in Europe are rejected.

“The EU should share, rather than shirk, the responsibility to provide them with protection,” said the 24 non-governmental organizations, including Amnesty International, Caritas Europa, the International Rescue Committee, Oxfam and the Red Cross, in a statement.

The groups have warned that 18 million people are in urgent need of humanitarian assistance in Afghanistan, nearly half of the population. More than 630,000 people have been driven from their homes this year due to violence and drought.

There was no immediate reaction from the European Union.

Meanwhile, Dutch Foreign Minister Sigrid Kaag resigned Thursday after the lower house of parliament passed a motion of no-confidence against the government for its handling of evacuations from Afghanistan as part of the takeover of Taliban.

During a parliamentary debate on Wednesday evening, Kaag acknowledged that the government’s slow or confused response to warnings about the situation in Afghanistan meant that some local staff and people who had worked as translators for Dutch troops in the country no had not been evacuated.

After the motion was passed on Thursday, Kaag immediately announced that she would submit her resignation, saying Parliament had ruled “the Cabinet had acted irresponsibly.”

“I can only accept the consequences of this judgment as the minister with the ultimate responsibility,” she added.

Information for this article was provided by Jennifer Steinhauer and Eileen Sullivan of the New York Times; and by Jonathan J. Cooper, Lorne Cook and Mike Corder of the Associated Press.

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Healthcare providers to receive $ 25.5 billion in relief funds – Food, medicine, healthcare, life sciences Fri, 17 Sep 2021 07:30:00 +0000

United States: Healthcare providers to receive $ 25.5 billion in relief funds

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On September 10, the Biden-Harris administration, in conjunction with the Department of Health and Human Services (HHS), announced that $ 25.5 billion in relief funds will be distributed to healthcare providers by the through the Health Resources and Services Administration (HRSA). The American Rescue Plan (ARP) will provide $ 8.5 billion in funding and an additional $ 17 billion will be distributed as Phase 4 Provider Relief (PRF) funds.

HHS Secretary Xavier Becerra said “funding will be distributed on an equitable basis, to ensure that providers who serve our most vulnerable communities receive the support they need.” The distribution of funds will follow the guidelines of the Coronavirus Response and Relief Supplemental Appropriations Act of 2020 (CARES Act) on the distribution of lost income and expenses of providers between July 1, 2020 and March 31, 2021. Smaller providers that serving rural and vulnerable populations will be the key target group for these additional Phase 4 funds and will include bonuses for those serving Medicaid, CHIP and / or Medicare patients. All Phase 4 ARP and PRF distributions received between July 1, 2021 and December 31, 2021 must be used by December 31, 2022.

Request for ARP and PRF funds

ARP and PRF applicants will begin the application process through the same application and attestation portal used in the previous PRF distribution phases. Rural ARP providers can use the HRSA Rural Health Grant Eligibility Analyzer to determine their qualification as a rural provider. The application portal opens on September 29, and HRSA will use existing Medicaid, CHIP, and Medicare claim data to calculate payments in addition to bonus payments.

Phase 4 of the PRF distribution methodology

The Phase 4 distribution will allocate lost revenue and expenses related to COVID based on the following guidelines:

  • 75% of the phase 4 allocation will be based on lost income and expenses related to COVID.
  • Large vendors will receive a minimum payout amount based on a percentage of their lost revenue and COVID-related expenses.
  • Medium and small providers will receive a base payment plus a supplement, with smaller providers receiving the highest supplement, as smaller providers tend to operate on low margins and often serve vulnerable or isolated communities.
  • HHS will determine the exact amount of base payments and supplements after analyzing data from all claims received to ensure that we are on budget and that funds are distributed fairly.
  • No supplier will receive a Phase 4 payment in excess of 100% of their losses and expenses.
  • HHS will continue to use risk mitigation and cost containment measures during Phase 4 to protect program integrity and preserve taxpayer dollars.
  • 25% of the Phase 4 allocation will be used for bonus payments based on the amount and type of services provided to Medicaid, CHIP and Medicare patients.
  • HHS will rate Medicaid and CHIP claim data at Medicare rates, with some exceptions for certain services provided primarily in Medicaid and CHIP.

Rural health fund under the ARP

The Health Resources and Services Administration (HRSA) will facilitate PRF and ARP distributions. The $ 8.5 billion ARP funds will be available to rural Medicaid providers, CHIP and / or Medicare patients. Rural ARP distributions will be made to all providers serving patients who live in rural areas, as defined by the Federal Office of Rural Health Policy at HHS. The language of the ARP generally follows the PRF, which provides funding to providers for health care-related expenses and lost income attributable to COVID-19 but not reimbursed from another source.

FRP Phase 3 Compliance and Reviews

Any FRP beneficiary that has been the subject of a merger or acquisition must report to the Secretary of HHS and will likely need to be audited to confirm the proper use of funds for COVID-related costs. -19 which are compatible with an overall risk-based audit strategy. PRF Phase 3 suppliers who believe their Phase 3 payments were incorrect will now have the option to file a review. HRS provided a detailed methodology on how the Phase 3 payments were calculated.

Finally, HHS announced a 60 day final grace period (expiring 9/30/21) for any PRF vendor who must comply with PRF reporting requirements. This grace period does not affect reporting of PRF use or reporting requirements, but will remain any HHS enforcement or collection activity for non-compliant suppliers.

What it means for you

All providers who received PRF distributions in any of the other phases may be eligible to receive additional funding as part of the last phase 4 distributions. In addition, providers only need to serve patients. rural areas to be eligible for ARP payments. Husch Blackwell can help you determine your qualification and guide you through the PRF and ARP application process. Suppliers who have received Phase 3 PRF distributions and have questions about how they were reimbursed under the Phase 3 methodology or who believe their payment should be reconsidered can also contact Husch Blackwell for further assistance. help in solving these complex problems.

The content of this article is intended to provide a general guide on the subject. Specialist advice should be sought regarding your particular situation.

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GST Council Meeting Today Agenda Gasoline and Diesel Prices Swiggy Zomato Covid Medicines Pan Masala Fri, 17 Sep 2021 06:03:06 +0000

New Delhi: Union Finance Minister Nirmala Sitharaman is chairing a crucial meeting of the Goods and Services Tax (GST) Council today in Lucknow. The 45th GST Council meeting is expected to review the tax rate of more than four dozen items and discuss tax breaks on 11 Covid drugs. The meeting is attended by all state and UT finance ministers and senior officials from central and state governments.Also Read – Taarak Mehta’s Nidhi Bhanushali Will Enter Salman Khan’s Bigg Boss 15? This is what we know

The key issues of taxing gasoline and diesel under the single national GST tax and a proposal to treat food delivery apps such as Zomato and Swiggy like restaurants and collect a tax from 5% on the GST on the supplies they make would be considered by the board at its meeting, PTI reported. Also Read – Garena Free Fire Redeem Codes August 26, 2021: Check Latest Codes, How To Redeem, Multiple Rewards

“The Minister of Finance Smt. Nirmala Sitharaman will chair the 45th GST Council meeting at 11 a.m. in Lucknow today. MOS Shri Pankaj Chaudhary will attend the meeting, in addition to state and UT finance ministers and senior government and state union officials, ”the finance ministry tweeted. Also Read – Monsoon chaos in UP kills 38 people in two days, heavier rains likely

Price of gasoline, diesel

  • In light of the Kerala High Court order, the Council will also discuss the taxation of gasoline and diesel under the GST, a decision that could require huge compromises from central and central governments. state on the income they receive by taxing these products, according to the PTI report.
  • In June, the Kerala High Court, on the basis of a lawsuit, asked the GST Council to decide whether to include gasoline and diesel within the scope of the GST.

Online meal delivery Swiggy, Zomato

  • To combat tax evasion, the proposal to make food delivery platforms like Swiggy and Zomato responsible for paying the goods and services tax on catering services provided through them would also be considered by the Council, according to the PTI report.
  • Once approved by the GST Council, food delivery applications will be required to collect and file GST with the government, in place of restaurants, for deliveries made by them. There would be no additional tax burden for the end consumer.

GST rate on 32 items

  • The council will also review and clarify GST rates on 32 goods and 29 services, according to the PTI report.
  • The items examined are the drugs Zolgensma and Viltepso for personal use, solar photovoltaic modules, copper concentrate, soft drinks with fruit juice, coconut oil, sweet scented supari, oncology drugs and locomotives. diesel-electric.

Medicines against Covid

  • The GST Council will deliberate on the proposal to extend the current structure of concessional tax rates on Amphotericin B, Tocilizumab, Remdesivir, and blood thinners like Heparin, until December 31, 2021, from the 30 current September.
  • The tax rate for amphotericin B, tocilizumab was lowered to “Nile,” while remdesivir and heparin were reduced to 5% in June 2021, PTI reported.
  • He could also discuss the proposal to reduce the GST from 12% to 5% on seven additional drugs until December 31, 2021. These are itolizumab, posaconazole, infliximab, bamlanivimab and l ‘etesevimab, casirivimab and imdevimab, 2-deoxy-D-glucose and Favipiravir.

Pan Masala, brick ovens

  • The Council will also discuss the interim report of a state ministerial group on the capacity-based taxation of pan masala and the composition scheme of brick kilns and stone crushers, in accordance with the report of the PTI.
  • The Panel recommended a special composition regime in the brick kiln sector with effect from April 1, 2022, prescribing a 6% GST rate, without ITC, similar to the service sector rate.
  • He also suggested raising the GST rate on the supply of bricks from 5% to 12% (with ITC), effective April 1.
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Independence Fund and Loyal Source launch call center in Afghanistan | Thu, 16 Sep 2021 22:58:00 +0000

CHARLOTTE, North Carolina, September 16, 2021 / PRNewswire / – Today, The Independence Fund and Loyal Source launched the Independence Line, a call center designed to help US veterans, Afghans, their friends and family resolve issues with the Afghanistan Withdrawal. This call center will be staffed with highly trained and highly trained clinicians, to provide assistance to both Afghans currently in United States who have served side by side with our American servicemen and the American veterans themselves who may struggle in these difficult times.

The “Independence Line” to help American veterans, Afghans, their friends and family.

“With tens of thousands of Afghan men, women and children arriving in the United States,” noted the CEO of The Independence Fund, Sarah verardo, “It is absolutely necessary to help these refugees navigate the complex United States refugee and asylum systems and ensure that American veterans get the care and benefits they need, where and when they need it. need. “

This call center will sort through incoming requests for help related to housing, food, mental health, healthcare, clothing, legal aid and a host of other matters. The call center will do full assessments and work with our case management team to find the best and fastest services to fill the gaps in the current system and The Independence Line will not turn anyone away.

Sarah verardo, CEO, The Independence Fund, also pointed out that, “We want Veterans, Afghans, their families and friends to know that the Independence Fund is there for them. We recognize your service and are ready to help you navigate a complex system to get the care and service you need.

Brian moore, CEO, Loyal Source, stressed the importance of providing assistance to Afghans, their friends and family: “We are delighted to partner with the Independence Fund in this crucial mission. The call center is a natural progression of our existing work with refugees across the country. “

The Independence Line toll-free number is 1-855-341-5456 and will start taking calls on Tuesday, September 21, 2021.

In August, The Independence Fund, along with the Mighty Oaks Foundation, formed the Save Our Allies Coalition, dedicated to saving our Afghan allies who served side-by-side with the U.S. armed forces and ensuring our veterans receive the care they deserve. they need after courageously serving our nation. As Save Our Allies settles into Phase 2, the partnership between The Independence Fund and Loyal Source was created as the next step in the holistic approach to helping US veterans and Afghans.

The Independence Fund:

Founded in 2007, the Independence Fund is committed to empowering our nation’s catastrophic, injured and ill veterans to overcome the physical, mental and emotional injuries suffered in the line of duty. We are committed to improving the lives of our Veterans and their families. Thanks to our Mobility, Caregiver, Advocacy, Case work, Operation RESILIENCE, [email protected] and family programs, the Independence Fund works to bridge the gap in the unmet needs of Veterans and their caregivers. Prior to joining the coalition, The Independence Fund had programs in place to include Afghan SIVs and their families in its programming, including Operation RESILIENCE, a veteran mental health-focused retreat to combat veteran suicide. by bringing together combat units that have served and fought together and includes their performers living in United States through the Afghan Special Immigration Visa (SIV) program.

Faithful Source:

Loyal Source, founded in 2009, is a comprehensive workforce solutions provider providing medical, behavioral health, rapid response and technical solutions to military, civilian and private customers in all 50 states and the ‘foreigner. We pride ourselves on supporting our clients’ most difficult and urgent missions, helping military members, military families, veterans, law enforcement, refugees and underserved populations. Loyal Source also provides military readiness services for all branches of the military and has a travel nursing division that has been instrumental in the current COVID response.

Media contacts:

Lexie rock, communication director

[email protected]

(980) 254-2295

Ashley skinner, Communication manager

[email protected]

(704) 712-5380

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SOURCE The Independence Fund

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Federal government pushes back Oklahoma residency requirement for disability assistance Thu, 16 Sep 2021 22:24:16 +0000

A federal official said Oklahoma was “not allowed” to enforce a new law that requires people with intellectual or developmental disabilities to live in the state for five years before they can apply for certain services funded by the. State via Medicaid.

In a letter sent Thursday, a Centers for Medicare and Medicaid Services official said the law is unconstitutional based on previous US Supreme Court rulings that determined that the 14th Amendment to the Constitution requires states to treat new residents the same as long-term residents.

Federal regulations also prohibit state Medicaid agencies from denying eligibility if a person has not lived in the state for a specified period, wrote Daniel Tsai, deputy director and administrator of CMS.

“Thus, the imposition of a 5-year residency requirement for receipt of HCBS waiver services (home and community services) is not permitted,” he wrote in a letter to the legal director of the National Health Law Program, which fights for access to health care for low-income and underserved people.