BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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Posted on January 13, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
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By Eric Bricker MD
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Why Are Certain Medications Non-Formulary?
What Are Formulary Tiers and Its Rules?
Formularies Have Many Rules AssociatedWith Them:
1) Prior Authorization – Approval Must Be Given by the Health Insurance Company/PBM Before They Agree to Pay for a Medication.
2) Step Therapy – Certain Less Expensive Generic Medications Have to Be ‘Tried’ First and Fail Before a Doctor Can Prescribe a More Expensive Brand-Name Medication.
3) Mandatory Generics – If a Brand Name Medication Has A Direct Generic Equivalent, Then the Insurance May Only Agree to Pay for the Generic and Not the Brand.
4) Mandatory Mail Order – Certain Chronic Medications That Are Filled for 90 Day Supplies Must Be Filled via Mail Order and Not at the Retail Pharmacy.
Posted on January 11, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
BY ERIC BRICKER MD
With 43 Million Americans Having Lost Their Job at Some Point During the Pandemic and About 1/2 Those Jobs Providing Health Insurance… the 1st Group–People Who Do Not Have Health Insurance–Needs to Be Aware of How These Programs Work.
In this Video You Will Learn the Patient Assistance Program Process for:
1) 2 of the Most Common Types of Insulin
2) The Highest-Revenue Medication in America: Humira
**Note: At the Time of the Video’s Recording, the Unemployment Rate in the US was 15%. As of November 2021, the Unemployment Rate is 4.2%.
DEFINITION: Stablecoins are blockchain-based digital currencies that have been created with the aim to have a stable value. Stablecoins achieve price-stability through various different methods such as a peg against a fiat currency or a commodity, through collateralization against other cryptocurrencies or through algorithmic coin supply management.
Every stable coin includes a specific set of mechanisms that mostly behave in the same way. In general, stable coins keep collateral of the asset and manage the supply. In this way, they incentivize the market, which allows trade of the coin for no more or less than $1.
A stable coin can be considered the best depending on several factors: It should be stable. PAX is one the most stable stablecoin. It should be liquid and available on most exchanges. It should be backed by FIAT. PAX is 100% collateralized in US bank accounts. It should be regulated. It should be redeemable.
Instead of straining your eyes, you can strain your ears and listen to the following articles. I’m providing links to my pieces on the inflation landscape (read, listen) and how we invest in inflation (read, listen).
Posted on December 31, 2021 by Dr. David Edward Marcinko MBA MEd CMP™
The Common Bridge
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Entering the Last Chapter of Covid, From Omicron and Beyond – With Dr. James R. Baker, Jr., M.D.
Richard Helppie welcomes back University of Michigan Professor Emeritus of Internal Medicine, and Virologist, Dr. James R. Baker, Jr., M.D., who brings words of both encouragement and warning as the world comes to what he feels is the beginning of the final throws of the Covid-19 pandemic.
Dr. Baker has been a valued guest on the Common Bridge since the beginnings of the coronavirus over a year ago, and brings thoughtful, scientific, data-driven analysis to the most significant health issue of our lifetime.
Posted on December 29, 2021 by Dr. David Edward Marcinko MBA MEd CMP™
Wendell Potter is a Famous Ex-Executive from Cigna Who Left His High Paying PR Job in 2007 to Reveal the True Story Behind Health Insurance Carrier Public Relations.
On December 2, 2021, the U.S. Department of Justice (DOJ) announced that it had entered into an $18.2 million settlement with Flower Mound Hospital, a 91-bed hospital located northwest of Dallas, to resolve claims that the hospital had violated the Stark Law, the Anti-Kickback Statute (AKS), and the False Claims Act (FCA) by making improper inducements to referring physicians. This Health Capital Topics article will review the facts underlying the settlement. (Read more…)
Posted on November 19, 2021 by Dr. David Edward Marcinko MBA MEd CMP™
Hospitals Must Treat All Patients
BY ERIC BRICKER MD
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The Emergency Medical Treatment and Active Labor Act is an act of the United States Congress, passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act
Posted on November 18, 2021 by Dr. David Edward Marcinko MBA MEd CMP™
Harm from Physicians and Health caRE
By Eric Bricker MD
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Iatrogenesis is the causation of a disease, a harmful complication, or other ill effect by any medical activity, including diagnosis, intervention, error, or negligence.
Posted on November 15, 2021 by Dr. David Edward Marcinko MBA MEd CMP™
By THCB
Today on Health in 2 Point 00, Jess DaMassa claims to be blameless for the drama between Jonathan Bush and Glen Tullman. On Episode 198, we talk about Microsoft buying Nuance for $16 billion and $3 billion in debt – is Microsoft taking over healthcare, and is this going to slow Nuance down?
IPOs
Cohere Health raises $36 million in a Series B, working on improving prior authorizations between health plans and providers. We wrap up with a lightning round of IPO rumors regarding Privia Health, VillageMD, and Bright Health.
Health Insurance Companies Paid for Hospital Outpatient Services at an Even Higher Average Rate of 293% of Medicare.
A Detailed Look at the RAND Analysis Reveals that the ‘Basket’ of Services at Each Hospital Had Very Little Data.
For Example, the RAND Study’s Data for the Baylor Scott & White Hospital System in Dallas – Fort Worth Represented Only 0.4% of the Hospital’s Total Revenue.
For the Texas Health Hospital System Also in Dallas – Fort Worth, the RAND Study’s Data Only Represented 0.96% of the Hospital’s Total Revenue.
That Sample Size Is Likely Too Small to Make Accurate Comparisons from One Hospital System to Another Regarding their Commercial Insurance Prices Relative to Medicare.
ASSESSMENT: Your thoughts and comments are appreciated.
Posted on October 27, 2021 by Dr. David Edward Marcinko MBA MEd CMP™
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The right to repair electronics refers to proposed legislation that would provide the practical means for equipment owners to repair their devices, and not a new legal right. The implications for medicine are huge.
Advocates observe that while repair is legal under copyright law and patent law, owners are often prohibited from making their own repairs or hiring technicians they trust to help by manufacturer limitations on access to repair materials such as parts, tools, diagnostics, documentation and firmware.
Support our online development, and advance our onground research initiatives in free market economics, as we seek to showcase the brightest Next-Gen minds.
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