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Friday, 1 April 2016

Princess Health and April 1st, 2016 As Planned. Princessiccia

Princess Health and April 1st, 2016 As Planned. Princessiccia

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April 1st, 2016 As Planned

There are times when the occasional Tweets Only edition doesn't really give much insight/context into a particular day--it only shows the consumption of food, water and coffee.

Tonight's edition offers a little more in the Tweets. I look forward to elaborating on the experience of the last two days, much more, in tomorrow night's edition. Tonight, I must drop in bed.

I'm looking forward to sharing certain maneuvers that were pivotal in insuring my success at the broadcasting convention. It was a a wonderful experience.

The best thing for me was making the decision to confirm sugar-status with each chef prior to meals. My abstinence from refined sugar is the single most important nutritional element of my maintenance plan. I confirmed, once again--if I politely ask for what I need, people are generally happy to help.

Until tomorrow night's recap of the experience--I'll simply say without question, everything went as planned.

My Tweets Today:














































Thank you for reading and your continued support,
Strength,
Sean

Princess Health and Bevin gets bill to create third-party appeals process for denied Medicaid claims, which sponsor says are all too common. Princessiccia

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By Melissa Patrick
Kentucky Health News

A bill to create an independent process for Kentucky health-care providers to appeal claims denied by Medicaid managed-care organizations is on its way to the governor's desk for his signature.

Sen. Ralph Alvarado
The only appeals process for providers now is through the MCOs themselves, and the only recourse for denied claims is through the courts.

"We are looking at almost 20 percent of the claims that are out there through Medicaid being denied to providers," the bill's sponsor, Republican Sen. Ralph Alvarado of Winchester, told Kentucky Health News. "So with that there are millions of dollars that all of those providers are losing out on. This finally gives them an opportunity to keep the MCOs accountable."

WellCare of Kentucky, one of the MCOs Alvarado targeted last year while trying to get a similar bill passed, denied that it has so many disputed claims, but says it will work with the Cabinet for Health and Family Services if Senate Bill 20 is enacted.

"WellCare of Kentucky rarely disputes claims for medical necessity, with only 1 percent of claims being denied for this reason," spokesperson Charles Talbert said in an e-mail. "We are supportive of initiatives that help to ensure our members get the right care, at the right time, in the right setting."

Another MCO that Alvarado targeted last year as having a high rate of denied claims, Aetna Better Health of Kentucky, formerly CoventryCares, said in an e-mail, "We work tirelessly, along with our network of providers to improve access to and quality of care for our Medicaid members and we are committed to continuing these valuable collaborations."

CareSource, another MCO, declined to comment.

Kentucky implemented managed care in 2011 mainly as a way to save money. In managed care, an MCO gets a lump sum per patient, a system that encourages them to limit payments to providers. Providers have complained about denied claims and slow payments, causing some to suggest that managed care creates an incentive to deny care.

"Kentucky Medicaid MCOs have a denial rate that is four times the national average," Alvarado said in an e-mail. "These MCOs, in general, are garnering massive profits on the backs of our providers by simply not paying for services; and then claiming that they are 'managing care'."

MCOs serve about 1.1 million Kentuckians and account for about 69 percent of the state's Medicaid budget, according to a state news release.

Last year the state renegotiated all MCO contracts in hopes of decreasing the number of disputes over rejected claims, but health-care providers told the Senate Health and Welfare Committee Jan. 13 that this is still an ongoing problem, especially with behavioral health.

Nina Eisner, CEO of The Ridge Behavioral Health Systems, told the committee that there are examples all over the state of patients with homicidal thoughts unable to get their care paid for by MCOs.

Senate Bill 20 says that after providers exhaust an MCO's internal appeals process for denied claims and a final decision has been made, the provider can then seek a third-party review from an administrative hearing tribunal in the cabinet. The appeals process would apply to all contracts or master agreements entered into or renewed on or after July 1, 2016.

Alvarado said the proposed appeals structure is very similar to the one for commercial insurance appeals at the Department of Insurance. He noted that Kentucky's commercial denial rates are around 6 percent, which are close to the national average, and said he hopes this independent appeals process will bring the MCO denial rates more in line with this.

"If we go from 20 percent to 6 percent, I think most providers will accept that," he said. "This is fair. It is fundamentally American to have an appeals process and it is needed."

Alvarado sponsored a similar bill last year, but it died in the House. A similar bill passed both chambers in 2013, but then-Gov. Steve Beshear vetoed it. Alvarado said he is confident Gov. Matt Bevin will sign this year's version.

Alvarado said that once this "fractured relationship between providers and Medicaid" has been mended "it might actually open up the door for more providers to participate with Medicaid."

Sheila Schuster, a Louisville mental-health advocate, agreed, and said that while Medicaid reimbursement rates are "not great," not being paid at all for services rendered is not acceptable and has been a deterrent for providers to participate.

She said the Kentucky Mental Health Coalition and the National Alliance on Mental Illness support SB 20 because "they want providers to be fairly treated and to be able to provide the services that they need."

Princess Health and Dr. Rice Leach, outspoken leader in public health at the local, state and national levels, dies at 75. Princessiccia

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RICE LEACH, M.D. (Lexington Herald-Leader photo)
Lexington Health Commissioner Rice Leach, a national, state and local leader in public health, died Friday of lymphoma. He was nine days short of his 76th birthday.

Lexington Mayor Jim Gray called Leach "a great man in every way: compassionate, committed, determined."

Leach had been Lexington�s health commissioner for five years, leading it to national accreditation, and medical director and executive director of the local health department�s primary-care center for six years before that. He was Kentucky commissioner of public health from 1992 to 2004, and before that chief of staff to the U.S. surgeon general. He spent 26 years with the U.S. Public Health Service, mostly with the Indian Health Service, but also worked in Bolivia, Panama and Guatemala.

Leach's outspoken nature endeared him to public-health officials who were not as disposed to strong public statements. His last campaign was for the establishment of needle exchanges to prevent the spread of hepatitis C and HIV through needle sharing by users of heroin and abusers of prescription drugs. Citing research, he stoutly rebuked elected officials who said the exchanges promote drug abuse.

"He was intrepid in another explosive landscape, the one where science and politics intersect," recalled Jamie Lucke of the Lexington Herald-Leader. "I was reminded of this by a recent report about states where propagandistic misinformation riddles the state-ordered briefing that women receive before an abortion. Kentucky is not one of them. I hesitate to publicize this because some politician will rush to change it. But our �informed consent� briefing is dispassionate, nonjudgmental and, above all, informative � much like Leach, who oversaw its drafting after the legislature enacted the mandate in 1998."

Lucke added, "As admirable as all of that is, none of it accounts for why the people who worked for and with him loved him so very much. That would be his kindness and unfailing sense of fun. . . Nowadays you hear that doctors are demoralized by the business demands of their profession. Perhaps Leach�s fascinating life and and profound legacy will serve as a beacon guiding them back to public health � it might be less lucrative but potentially more fun and rewarding."

Leach's last recognition was the 'hero" award from the Lexington-Fayette County Board of Health, which renamed it the Dr. Rice C. Leach Public Health Hero Award. The award is usually given during National Public Health Awareness Week, which this year is April 4-10, but was presented in March because of his medical condition.

Leach is survived by his wife of 50 years, Mireille, whom he met in Guatemala; two sons, George, of Louisville, and John, of Frankfort; two grandchildren, Nicolas Cowan Whitcomb and Alyse Marie Whitcomb; and a brother, George Brown Leach, Jr. He was preceded in death by a daughter, Mary, who died of cancer in 2007.

His Mass of Christian Burial will take place in the Good Shepherd Catholic Church in Frankfort at 1:30 p.m. Tuesday, April 5, with visitation beginning at 10:30 a.m., Rogers Funeral Home in charge. In lieu of flowers, contributions are suggested to the church, 72 Shepherd Way, Frankfort KY 40601.
Princess Health and Adults 62-85 are often taking combinations of drug or dietary supplements that could be deadly; risk nearly doubled in 5 years. Princessiccia

Princess Health and Adults 62-85 are often taking combinations of drug or dietary supplements that could be deadly; risk nearly doubled in 5 years. Princessiccia

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Update: 4/4/16, This story has been updated to reflect that the study says the number of adults using at least five prescription drugs a day has increased and not the average older American is using at least five prescription drugs a day.

The number of older Americans at risk of potentially life-threatening drug interactions almost doubled between 2005 and 2011, according to a study from the University of Illinois at Chicago.

"One in six older adults now regularly use potentially deadly combinations of prescription and over-the-counter medications and dietary supplements, a two-fold increase over a five year period," says the release.

More than half the potentially deadly interactions involved a non-prescription medication or dietary supplement such as a vitamin. The study found that older adults have increased their use of vitamins and supplements, despite limited evidence of their clinical benefit.

The study, published in JAMA Internal Medicine, examined changes in medication use in more than 2,000 adults aged 62 to 85 between 2005 and 2011.

Fifteen potentially life-threatening drug combinations of the most commonly used medications and supplements were identified, and the study found nearly 15 percent of older adults in 2011 used at least one of these dangerous combinations, up from 8 percent in 2005.

The study found that older adults have grown more fond of non-prescription medications and supplements: 63.7 percent of older adults used them in 2011, up from 51.8 percent in 2005. Older adults using at least five prescription medications increased to 35.8 percent from 30.6 percent in the same time period.

The most common life-threatening interaction identified by the study was cholesterol-lowering drugs (statins), drugs used to prevent blood clots (anti-platelet drugs) and omega-3 fish oil supplements.

�Many older patients seeking to improve their cardiovascular health are also regularly using interacting drug combinations that may worsen cardiovascular risk,� one of the researchers said in a news release.

The researchers encourage health-care providers to carefully consider adverse effects of combining prescription and nonprescription medications when treating older adults, and to counsel patients about the risks. Older adults should also ask their pharmacists about potential drug interactions.

Princess Health and Invincible Coffee: The Next Evolution of Joe. Princessiccia

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Warning -- Satire -- old April Fools post!

You've heard of Bulletproof Coffee, that mixture of coffee and butter that keeps you lean and supercharges your mental focus.

The problem with Bulletproof Coffee is that the butter forms a greasy oil slick on top of your coffee. Yuck! Is there any way to rescue Bulletproof Coffee?


Enter Invincible Coffee, the next evolution of Joe.

Read more �

Thursday, 31 March 2016

Princess Health and March 31st, 2016 From The OAB Convention. Princessiccia

Princess Health and March 31st, 2016 From The OAB Convention. Princessiccia

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March 31st, 2016 From The OAB Convention

Today was another full day--thank goodness tomorrow will be slower. I'm at the annual Oklahoma Association of Broadcasters Convention in Tulsa. It's been an extremely busy day--and full of challenges! My stress level was super high as I tried to get everything done I needed to complete before heading this way. It was crazy.

I handled my food very well. Tonight's dinner selection was full of sauces with refined sugar. I asked for what I needed and received it without issue. I was the only one in the room eating something different, but I didn't mind. My commitment to maintaining abstinence from refined sugar is 701 days strong. I take it very seriously. I'd rather pass and eat something later, if that's what I need to do. I'll not starve--that's for sure. The staff was happy to accommodate my request and all was well.

I was out of eggs this morning. That's how insanely busy yesterday was--so much, I didn't make sure I had what I needed! I had plenty of calories tonight, so I did get some eggs with a veggie and mozzarella omelet.

The OAB Poker tournament (with play chips) was a big deal this evening. The final table included Bill--the man who owns the broadcasting company where I work. He and I became the last two players, head to head--and he took just a few hands to finish me second.

The day will be a little slower tomorrow. Much slower, actually. And that's a very good thing!

I really enjoyed Live Tweeting the day.

MyFitnessPal said I'm on track to be under 200 pounds within five weeks. That's not my plan. We'll see how this goes.

I'll let the Tweets take it the rest of the way...

My Tweets Today:










































Thank you for reading and your continued support,
Strength,
Sean

Princess Health and Obama joins Rogers at National Rx Drug Abuse and Heroin Summit, says it's time to focus on treatment over incarceration. Princessiccia

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By Melissa Patrick
Kentucky Health News

The fifth annual national summit on prescription drug abuse, started by U.S. Rep. Hal Rogers of Kentucky, was the largest, broadest and highest-profile yet.

A non-prescription drug was added to the title of the four-day event, making it the National Rx Drug Abuse and Heroin Summit. It drew more than 1,900 to Atlanta, including President Barack Obama, who joined an hour-long panel to talk about new ways to deal with a growing opioid and heroin epidemic.

U.S. Rep. Hal Rogers
"The rapid growth of this summit is truly a testament to the power of unity. Everyone here has one common goal - to save lives from the dark clenches of drug abuse," Rogers, a Republican from Somerset, said in a news release.

The summit was hosted by Operation UNITE, a Kentucky non-profit created by Rogers that leads education, treatment and law enforcement initiatives in 32 counties in Southern and Eastern Kentucky. The acronym stands for Unlawful Narcotics Investigations, Treatment and Education.

According to the federal Centers for Disease Control and Prevention, in the U.S. someone dies every 20 minutes from an opioid overdose and Kentucky has one of the nation's highest rates, with more than 1,000 deaths a year from it.

(On Monday, April 4, KET's "Kentucky Tonight" will have a report on the summit and a look back at the network's coverage of drug addiction issues. For a preview from host Bill Goodman, click here.)

The University of Kentucky and UK HealthCare, which helped sponsor the summit, sent a delegation of executive, clinical and research leaders, including President Eli Capilouto as one of the keynote presenters, according to a UK news release.

�Too many Kentucky families are too often confronted by the dark and painful scourge of prescription drug abuse and opioid addiction," Capilouto said. "It�s an epidemic that penetrates communities across the nation, both urban and rural, but has especially intractable roots in Appalachia and the regions served by the University of Kentucky.�

Obama opened his remarks on the panel by thanking Rogers,who is also co-chair of the Congressional Caucus on Prescription Drug Abuse, and UNITE, "the organization that has been carrying the laboring oar on this issue for many years now. We are very grateful to them."


Obama focused some of his comments on broadening access to medication-assisted treatments for addiction, most successfully with counseling and behavior therapy.

"What we do know is that there are steps that can be taken that will help people battle through addiction and get onto the other side, and right now that's under-resourced," the president said.

Obama's administration recently proposed doubling the number of patients a health-care provider can treat with buprenorphine, one of the drugs used to fight addiction, to 200 from 100.

He said the opioid and heroin epidemic is a public-health issue and not just a criminal-justice problem, which is the only way to reduce demand. "In this global economy of ours that the most important thing we can do is to reduce demand for drugs," he said.

Because the opioid and heroin epidemic is touching everybody and not just poor people and minorities, there is now more emphasis on treatment over incarceration, Obama said: "This is not something that's just restricted to a small set of communities. This is affecting everybody -- young, old, men, women, children, rural, urban, suburban."

The president also noted that there has been a significantly increase in opioid abuse in rural areas, which often suffer from an under-resourcing of treatment facilities and mental health services.

"And that's why, for all the good work that Congress is doing, it's not enough just to provide the architecture and the structure for more treatment. There has to be actual funding for the treatment," he said.

The president has proposed $1.1 billion in his upcoming fiscal year 2017 budget request to fund drug-treatment programs in counties all across the country.

Agriculture Secretary Tom Vilsack announced two rural initiatives at the summit: town hall meetings in rural areas hit hardest by drug abuse, including Appalachia, "to raise awareness of the issue and discuss possible solutions," and an extension of the Rural Health and Safety Education competitive grant program to include $1.4 million in grants that will now be available to rural communities to fight heroin and painkiller abuse, according to a press release.

The president also announced several other new initiatives: establishing a Mental Health and Substance Disorder Parity Task Force; implementing mental health and substance use disorder parity in Medicaid; releasing $11 million for the purchase and distribution of the opioid-overdose reversal drug, naloxone; expanding an initiative that improves local partnerships between law enforcement and public health; a $7 million investment for community policing to address heroin; and providing guidelines for the use of federal funds to implement or expand needle-exchange programs.

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