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What We’re Reading: Sewage Issue Finally Acknowledged; COVID-19 Still a Leading Cause of Death; Improper Medicare Payments for Psychotherapy
The Biden administration has come to an agreement with the Alabama Department of Public Health to improve sewer services for residents of Lowndes County who have lived with pools of raw sewage; COVID-19 was still a leading cause of death in 2022; Medicare improperly paid providers for some psychotherapy services during the first year of the COVID-19 public health emergency.
Sewage Floods Predominantly Black Residential Area in AL
Following an investigation into failing sewage systems in Lowndes County, Alabama, the Civil Rights Division of the US Department of Justice and the US Department of Health and Human Services have decided that the Alabama Department of Public Health in Lowndes County participated in a “consistent pattern of inaction and/or neglect” and did not take meaningful action to fix the issues despite their knowledge of them, reported NBC News. These failing sewage systems disproportionately affected Black and low-income residents, according to the administration’s findings. State and county agencies have agreed to take actions to rectify the situation.
COVID-19 Still a Leading Cause of Death in Americans in 2022
COVID-19 was the fourth leading cause of death in the United States last year, dropping from third place in 2020 and 2021 when deaths from the virus were surpassed only by heart disease and cancer, reported the National Center for Health Statistics on Thursday, according to The New York Times. The country’s third leading cause of death were unintentional injuries that categorizes events like drug overdoses and car accidents. Fatalities from both heart disease and cancer rose in 2022 compared with 2021.
Medicare Improperly Paid Providers for Some Psychotherapy Services
The US Office of Inspector General conducted a nationwide audit of Medicare Part B payments for more than 13.5 million psychotherapy services from March 2020 through February 2021 to see if compliance issues identified before the COVID-19 public health emergency occurred in this time frame, according to HHS Office of Inspector General.
The audit revealed that there were high rates of improper payments. Namely, providers did not meet Medicare requirements and guidance when billing for some psychotherapy services, including those through telehealth, and it was estimated that of the $1 billion that Medicare paid for psychotherapy services, providers received $580 million in improper payments for services that did not comply with Medicare requirements.
Urticaria Diagnosis Challenged by Overlapping Pruritic Skin Conditions
April 23rd 2025Urticaria is complicated to diagnose by its symptomatic overlap with other skin conditions and the frequent misclassification in literature of distinct pathologies like vasculitic urticaria and bullous pemphigus.
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New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
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ACOs’ Focus on Rooting Out Fraud Aligns With CMS Vision Under Oz
April 23rd 2025Accountable care organizations (ACOs) are increasingly playing the role of data sleuths as they identify and report trends of anomalous billing in hopes of salvaging their shared savings. This mission dovetails with that of CMS, which under the new administration plans to prioritize rooting out fraud, waste, and abuse.
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