CMS Publishes Program Year 2020 Open Payments Data Program Year 2020 Highlights Additional Information – Program Year 2013 Data Now Archived Contact Us CMS Publishes Program Year 2020 Open Payments Data Applicable manufacturers and Group Purchasing Organizations (GPOs) collectively reported $9.12 billion publishable payments and ownership and investment interests to physicians and teaching hospitals in Program Year 2020. Program Year 2020 accounts for payments or transfers of value made between January 1, 2020 and December 31, 2020. Today, the Centers for Medicare & Medicaid Services (CMS) published Open Payments Program Year 2020 data, along with newly submitted and updated payment records for previous program years. The data is accessible at https://openpaymentsdata.cms.gov/. Open Payments is a national disclosure program that promotes transparency and accountability by making information about the financial relationships between applicable manufacturers and group purchasing organizations (GPOs) and physicians and teaching hospitals available to the public. Through this program, the public has access to a more transparent and accountable healthcare system. (Back to top) Program Year 2020 Highlights For Program Year 2020, CMS published $9.12 billion in payments and ownership and investment interests made by applicable manufacturers and GPOs to physicians and teaching hospitals. This amount is comprised of 6.38 million total records attributable to 487,152 physicians and 1,213 teaching hospitals. Payments are reported in three payment categories: general payments, research payments, and ownership or investment interests. Payments in the three major reporting categories for Program Year 2020 are: $2.03 billion in general (i.e., non-research related) payments $5.97 billion in research payments $1.12 billion of ownership or investment interests held by physicians or their immediate family members Over the past five years, there have been consistent trends in the data. The research payment category consistently leads in total dollar value reported across the three payment categories followed by general payments and ownership and investment interest, payment categories respectively. While these trends were also the case for Program Year 2020, there was a noticeable difference in the reported dollar value within general payment category. CMS is scheduled to refresh the Open Payments data in early 2022 to reflect updates to the data made since this publication. For more information and resources, please visit: https://www.cms.gov/openPayments (Back to top) Additional Information – Program Year 2013 Data Now Archived Beginning with the June 2021 data publication, the Program Year 2013 data is closed and archived. Here is some information on the closing and archiving process. The Open Payments team evaluated the Open Payments Final Rule and determined that after a program year reaches its fifth full year of publication it will be closed and archived. Closed means that the specific program year will no longer be eligible for edits or data submission. For example, Program Year 2013 was closed during calendar year 2020 and reporting entities were not able to submit new records related to program year 2013. Now, Program Year 2013 is archived. When a program year is archived, it is no longer refreshed or searchable on the Open Payments Search Tool. Archived program years are still publicly accessible with the full dataset available for download on the Open Payments Dataset Download Page. (Back to top) Contact Us For program related questions including registration, review and dispute and data submission questions contact our Help Desk at openpayments@cms.hhs.gov or by phone at 1-855-326-8366 (TTY Line: 1-844-649-2766). The Help Desk is open Monday through Friday, from 9:00am to 5:00pm (ET), excluding federal holidays. Please note that all press inquiries should be submitted to the CMS’ Press Office. (Back to top) Get CMS news at cms.gov/newsroom, sign up for CMS news via email and follow CMS on Twitter @CMSGov. Creating Public Transparency of Industry-Physician Financial Relationships.

Centers for Medicare & Medicaid Services (CMS) has sent this update. To contact CMS go to our Contact Us page.

CMS Updates Medicare COVID-19 Snapshot

Connecting People With Data

Today, the Centers for Medicare & Medicaid Services (CMS) released a monthly update of data that provides a snapshot of the impact of COVID-19 on the Medicare population. The updated data show over 4.3 million COVID-19 cases among the Medicare population and over 1.2 million COVID-19 hospitalizations.  The updated snapshot covers the period from January 1, 2020 to April 24, 2021. It is based on Medicare Fee-for-Service claims and Medicare Advantage encounter data CMS received by May 21, 2021. To view the updated snapshot visit: https://www.cms.gov/research-statistics-data-systems/preliminary-medicare-covid-19-data-snapshot All of the above data assets are also catalogued on Healthdata.gov:  http://www.healthdata.gov/dataset/search The Data Navigator development team welcomes your feedback. Write to us at DataNavigator@cms.hhs.gov.

CMS released updated data quality information to the Data Quality Atlas Tool

View in browser | Distributed by Center for Medicaid and CHIP Services (CMCS) Today, the Centers for Medicare & Medicaid Services (CMS) released updated data quality information to the Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) Data Quality (DQ) Atlas tool for calendar years 2017 and 2018.  DQ Atlas is a tool that allows anyone to review the quality and usability of TAF Research Identifiable Files (RIF) and determine if the data can meet their research needs.  Learn more here: https://www.medicaid.gov/dq-atlas/welcome

 

Stay connected with Medicaid.gov and CMS:

Staying Safe in Extreme Heat A large part of the United States has been experiencing extreme heat conditions (high heat and humidity with the temperatures above 90 degrees for several days). During extreme heat, the body works extra hard to maintain a normal temperature. Heat-related distress can occur quickly and without warning.  Extreme heat can be dangerous for all, but especially for older adults and people with chronic conditions. Take steps to prepare and stay safe using these tips from Ready.gov: Find air conditioning. Avoid strenuous activities. Wear light clothing. Check on family members and neighbors. Drink plenty of fluids. Watch for heat cramps, heat exhaustion, and heat stroke. Never leave people or pets in a closed car. See more information about extreme heat from Ready.gov, the Centers for Disease Control and Prevention, and the National Institutes of Health.

On the Record 06 30 2021

"You can imagine that the burden will be borne disproportionately, and it will play out exactly the way you think it will: The folks who currently struggle most with access to health care are just going to be the greater proportion of those who will struggle in the future."

— Michael Dill, director of workforce studies at the Association of American Medical Colleges, spoke with AIS's Health Plan Weekly about how payers can work to address the looming threat of a physician shortage.

 

Subscribers may read the Health Plan Weekly article in which this quote appeared online. Learn more about subscribing to AIS Health's publications.

The FDA last week granted...

 ...Roche's Actemra an emergency use authorization to treat both adult and juvenile patients hospitalized with COVID-19. The arthritis drug was previously approved for compassionate use, but can now be administered to COVID patients who require oxygen support, in tandem with corticosteroids. For the treatment of rheumatoid arthritis, the intravenous form of Actemra holds covered or better status for 93% of all insured lives under the medical benefit.

SOURCE: MMIT Analytics, as of 6/28/21

Experts Predict Home Delivery of Rx Drugs Will Increase

by Peter Johnson

 

Mail-order pharmacies garnered a larger-than-ever share of the prescription drug business due to the pandemic.

Mail order will increase:

• "We're seeing a steady increase of mail order," says Brian Anderson, a principal at Milliman Inc. He expects that, in the next few years, delivered medication will account for half of all fills, with at least 20% of total volume originating from mail-order pharmacies.
• Anderson says Milliman's clients have seen mail order grow and remain high. He adds that fills overall are up. In particular, there are notable "increases in mental health categories, [like] antidepressants," Anderson says.

Data varies:

• Steve Johnson, vice president of health outcomes at Blue Cross Blue Shield affiliate-owned PBM Prime Therapeutics, says via email that Prime has seen prescription dispensing return to a pre-pandemic baseline in various categories.
• "For some of our Rx Collaborative employer clients, mail order utilization has either remained flat or continues to trend slightly downward since 2Q20. On average, our employers are seeing a gradual decrease of 5 percentage points of mail prescriptions since 2Q20," Chantell Sell Regan, Pharm.D., national pharmacy practice clinical lead at Willis Towers Watson, wrote in an email.

Rethink retail pharmacies:

• Anderson says that it's helpful to understand the shift to mail order as a move to home delivery away from a strict retail experience rather than a transition to mail-order pharmacy dispensing. He expects that many fills will still originate in a retail pharmacy but will be delivered after being filled.
• Ashraf Shehata, national sector lead for life sciences at KPMG, says that PBMs have essentially become mail-order retailers, and need to start thinking in a consumer-centric manner. A challenge for the sector, he explains, "is rationalizing retail versus PBM" operations.

From RADAR on Drug Benefits

From the blog: Meeting the Unique Needs of LGBTQ+ Older Adults

Meeting the Unique Needs of LGBTQ+ Older Adults A guest blog by Paula Basta, M.Div., Director, Illinois Department on Aging Aging can be a challenge for any community. But the lives of LGBTQ+ older adults bring distinct challenges. It is estimated that 4.3% of the adult population of Illinois identify as LGBTQ+. The Illinois Department on Aging’s (IDoA) mission is to provide high-quality, person-centered care to all older Illinoisans, and support efforts to empower older adults and caregivers in remaining independent, connected, and aging well. However, LGBTQ+ older Illinoisans face a unique set of challenges that are not yet widely understood or addressed in our society, and the numbers of LGBTQ+ older adults are difficult to track. As a 2009 Chicago LGBT Hall of Fame Inductee, 2019 SAGE Pioneer Award winner, and now IDoA Director, it has been a priority of mine to enhance our data collection efforts and create a welcoming, safe, and LGBTQ+-affirming space among IDoA’s service providers to encourage honesty and trust so that clients can be their authentic selves. The face of aging is really growing much more diverse - at a faster rate than anybody realizes. LGBTQ+ older adults are often invisible in aging service demographics, resulting in an inability to evaluate the effectiveness of existing services, and inefficient planning for future programmatic expansions. In addition, LGBTQ+ older adults have often lived through discrimination, social stigma, and the effects of prejudice, resulting in poor health outcomes and greater risk for chronic illnesses and mental illnesses. In terms of the issues facing LGBTQ+ older adults in Illinois, the biggest hurdle is them being able to access services like getting a homemaker, meals on wheels, and/or going to their local senior center, since some people might be anti-LGBTQ+. Because of this, IDoA will now soon include LGBTQ+ identity questions in all of our referral and intake processes. Specifically, when an individual calls the IDoA Senior HelpLine and completes the referral and intake process for services under the Community Care Program (CCP), the questions asked as part of the demographics section will now include how the individual identifies their sexual orientation and gender identity. Like all demographic questions, the gender identity and sexual orientation questions are completely optional and allow for an older adult to self-disclose. However, collecting this data is essential as we learn more about LGBTQ+ older Illinoisans and develop a person-centered plan of care that fits everyone. The services provided by our 13 Area Agencies on Aging (our contracted regional providers in the state) are diverse, and not all of the culturally competent services and supports we offer are available in every area, but all are working to make sure that Illinois continues to be a leader and an example for other states to follow when it comes to LGBTQ+ older adult inclusion in aging programming. To that end, at the end of January 2020, IDoA hosted a mandatory webinar for all of our Area Agencies on Aging, as well as our 45 Care Coordination Units (collectively called our Aging Network). The webinar explained the terms lesbian, gay, bisexual, and transgender, examined why LGBTQ+ older adults may hide their identity when accessing aging network services, as well as how to incorporate LGBTQ+ concerns into person-directed care and connect to local and national resources. I am proud to say that more than 25% of the staff at our provider agencies -- and all of our IDoA staff -- participated in the webinar, earning the Illinois Aging Network the SAGECare Bronze credential. The SAGECare credential reflects our ongoing commitment to providing culturally competent care and fostering a welcoming environment for LGBTQ+ older adults, and it offers prospective clients the reassurance that our management and staff have been trained in working with LGBTQ+ people.   I know I don’t just speak for IDoA when I say we are constantly seeking ways to improve the care we provide. I encourage others in the aging network to become SAGECare credentialed providers as one step toward ensuring that we, as a national network, are meeting the needs of all of the people we serve. The National Resource Center on LGBT Aging offers webinars and training, as well as links to SAGECare training, through which organizations can qualify for the credential. Some of the SAGECare trainings are free to AAAs, state units on aging, and other organizations in ACL’s aging and disability networks. It is incredible to see the trajectory from Stonewall 50 years ago to where we are today, but there is still so much work to do. IDoA is committed to supporting all our older Illinoisans with diverse programs and services, and we look forward to continuing to strengthen our outreach and education efforts as we help every LGBTQ+ older adult successfully age with dignity and respect. We owe it to our elders to respect yesterday, support today, and plan for tomorrow.

Stars and Stripes Daily Headlines

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June 29, 2021

 

US forces in Syria attacked by rockets, return fire following Sunday airstrike The attack came a day after President Joe Biden directed U.S. forces to conduct airstrikes on facilities used by Iran-backed militia groups near the Iraq-Syria border that were conducting drone attacks on U.S. personnel and facilities in Iraq. READ MORE

New Marine officer shot by stray bullet in New York’s Times Square 2nd Lt. Samuel Poulin, 21, was struck by the bullet at about 5:15 p.m. while walking near the intersection of West 45th Street and Broadway with family members, according to the New York Police Department. READ MORE

Marines no longer have to send 360-degree tattoo photos to the Corps The Marine Corps has done away with a tattoo policy rule requiring its members to submit 360-degree photos of themselves when seeking enlisted retention, or special assignments such as embassy guard or drill instructor. READ MORE   Fort Hood seeks help locating soldier last seen Wednesday Spc. Abram Salas II failed to report to duty, and he is considered “absent-unknown,” according to Fort Hood officials, who first asked for the public’s assistance Saturday. READ MORE   USS Mustin to be replaced by USS Ralph Johnson after a busy 15 years in Japan The USS Mustin, which departed its former homeport of Yokosuka last week, is bound for San Diego, where it’s slated to join 3rd Fleet following a maintenance and modernization period. READ MORE

Sikorsky lands $879 million Navy heavy-lift helicopter contract as it faces criticism over cost, delays The contract, which will cost $97.6 million for each of the next-generation helicopters, will deliver the aircraft in 2024 as part of a 200-aircraft program into the next decade for the U.S. Marine Corps. The next lot reduces the cost to $94.7 million. READ MORE   Aircraft carrier Dwight D. Eisenhower plays key role in Afghanistan drawdown The planners had about a week to figure out routes and refueling for Carrier Air Wing 3 for the long haul from USS Dwight D. Eisenhower to the front lines in Afghanistan, on the mission to protect American soldiers through this summer’s drawdown. READ MORE   Pilot Jack DeTour, who flew bombing missions in WWII, dies at 97 Jack DeTour piloted B-25 Mitchell bombers in the Southwest Pacific during World War II, helping perfect the technique of attacking at 300 to 350 mph at very low altitude with multiple .50-caliber machine guns blazing. READ MORE   Ukraine, NATO launch joint Black Sea drills The Sea Breeze 2021 maneuvers that began Monday and will last for two weeks are set to involve about 30 warships and 40 aircraft from U.S. and its NATO allies and Ukraine. READ MORE   Marine vet to walk 2000 miles in support of deported veterans Ramon Castro, who served in the Marine Corps for eight years and was in Kuwait during Operation Iraqi Freedom, is walking the border to focus attention on non-citizen U.S. veterans who have been deported for committing crimes. READ MORE   Fire captain — an Air Force vet — saw veteran struggling with PTSD on flight: ‘I’ll try to help her’ Passengers aboard an American Airlines flight from New Orleans to Dallas earlier this month had no idea what they were about to witness. A veteran in need. Another ready to help. READ MORE

 

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