Despite court ruling, insurers say they will continue to offer ACA-mandated free preventive services

 While a federal judge has struck down some of the preventive care mandates in the Affordable Care Act, insurers said they plan to stay the course on coverage.

Judge Reed O’Connor blocked the enforcement of recommendations made by the U.S. Preventive Services Task Force. The ACA requires no-cost coverage for breast and cervical cancer screenings, diabetes screening, and vision tests for preschool-aged children, and it includes free coverage for pre-exposure prophylactic (PrEP) drugs, which prevent HIV.

"The Braidwood decision, if implemented, would erode access to an entire range of preventive health services—from cancer screening to HIV prevention to preeclampsia screening for expecting mothers," Meg Murray, the CEO of the Association for Community Affiliated Plans told Fierce Healthcare in an email. "Families deserve better than having bedrock protections of the health reform law invalidated with a two-page ruling.”

ACAP represents 78 not-for-profit health plans.

“We call on the Justice Department to appeal this ruling such that this decision can be stayed to give the necessary acts of jurisprudential hygiene time to occur,” said Murray. “In the interim, our Safety Net Health Plans will continue to work to equitably improve the health of all their members—regardless of their sexual orientation or their gender identity.”

O’Connor issued a summary judgment in the case in September. At the time, the decision applied only to the employers that brought the case. Yesterday’s ruling expands that to all employers and insurers nationwide.

O’Connor—of the U.S. District Court for the Northern District of Texas—stated that the Task Force, a body of volunteer primary care experts, isn’t subject to Senate confirmation, which invalidates its coverage recommendations.

The ruling is almost certain to be challenged in the courts, experts said.

David Merritt, the senior vice president of policy and advocacy for the Blue Cross and Blue Shield Association, said in a statement that “the value of preventive services cannot be overstated: Access to no-cost screenings, counseling services and preventive medications is critical to improving overall health, early detection, and breaking down barriers to care.”

Merritt said he wants beneficiaries to know that BCBSA coverage of preventive services will not change because of O’Connor’s ruling.

“Blue Cross and Blue Shield companies strongly encourage the Americans they serve to continue to access these important services to promote their well-being,” Merritt said. “We will continue to monitor further developments in the courts.”

Matt Eyles, president and CEO of AHIP, the health insurance industry’s leading lobbying group, said in a statement that “as we review the decision and its potential impact with regard to preventive services recommended by the U.S. Preventive Services Task Force, we want to be clear: Americans should have peace of mind there will be no immediate disruption in care or coverage.”

Eyles added that AHIP fully expects “that this matter will continue on appeal, and we await the federal government’s next steps in the litigation, as well as any guidance from relevant federal agencies.”

Ceci Connolly, the president and CEO of the Alliance of Community Health Plans, a not-for-profit organization representing health insurance plans and provider organizations, said in a statement that ACHP “has long been supportive of the Affordable Care Act, including the preventive benefits that make care more affordable and accessible to millions of consumers. Cutting these critical preventive benefits, such as zero-cost cancer screenings and immunizations, would have a severe impact on health care across the country.”

Richard G. Stefanacci, of Jefferson College of Population Health at Thomas Jefferson University, told Fierce Healthcare in an email that the “primary reason to have copayments is to prevent moral hazard defined as inappropriate utilization."

"For these types of preventive services where all utilization following guidelines is considered appropriate moral hazard concerns should not apply," he said. "In addition, since there is typically a very positive ROI to insurers for covering preventive services it makes financial sense for them to continue to cover these services without copayments.”

He added that “long-sighted insurers will continue to cover with no copayment.”

https://www.fiercehealthcare.com/payers/despite-court-ruling-insurers-will-continue-offer-aca-mandated-free-preventive-services

10 grocery items most likely to cause food poisoning

 Onions, peaches and cold cuts, oh my — these are just some of the risky foods lurking in your kitchen.

The latest study by Consumer Reports reveals the 10 kitchen staples most often linked to food recalls from 2017 to 2022, and some might shock you.

The report notes that an estimated 48 million people become ill from salmonella, listeria, E. coli or other food-borne bacteria or viruses each year, leading to nearly 130,000 hospitalizations and 3,000 deaths.

“We aren’t saying people need to avoid these foods entirely,” said CR director of food policy Brian Ronholm, who led the analysis.

Instead, consumers should know the “importance of following best food safety practices with all of your foods, including knowing how to track, and respond, to food recalls when they happen.”

Coming out ahead are leafy greens, such as those found in bagged salads, with 11 deaths, 614 illnesses and 50 recalls/outbreaks.

E. coli and listeria are to blame, and CR says the likely culprit is water contaminated with bacteria from animal droppings that’s then used to irrigate crops.

Much of the nation’s lettuce comes from California and Arizona, so one affected facility can lead to widespread problems.

Raw flour, milled in a plant such as this one, poses salmonella risks.

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Leafy greens, such as romaine lettuce and bagged salad mixes, have been linked to 11 deaths, 614 illnesses and 50 recalls/outbreaks.

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“Concentration in the salad processing industry means a greater chance of contamination and larger outbreaks when they happen,” said Dr. Michael Hansen, a CR senior scientist.

It doesn’t help that leafy greens are eaten raw, as heating kills bacteria.

Experts recommend purchasing whole heads of lettuce, instead of bags or boxes of greens, and removing the outer leaves, where bacteria is often found.

Greenhouse-grown lettuce is less likely to come in contact with manure too. Or, ditch the salad altogether and prepare cooked vegetables instead.

Consumer Reports experts called deli cold cuts “nutritional nightmares.”

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The report also lists deli meats and cheeses — such as cold cuts and deli-sliced or soft cheeses — as potential sources of listeria, which can cause a serious (and sometimes deadly) infection.

CR counts seven deaths, more than 400 illnesses and 122 outbreaks/recalls over its five-year timespan.

Experts advise ditching the “nutritional nightmare,” sodium-packed cold cuts entirely.

Packaged ground beef isn’t safe either — 22 outbreaks linked to E. coli and salmonella contamination have been reported.

Specifically, deadly strains of the bacteria can be transferred from the cow’s gut to the meat.

Salmonella is a greater concern, and preparation is key.

Thaw frozen meat in the refrigerator, and cook ground beef and pork to an internal temperature of 160° F and whole cuts, like steak, to 145° F to kill any bacteria. Promptly refrigerate leftovers.

Ground beef could harbor E. coli and salmonella, so it should be cooked properly.

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Onions were a “big surprise” on the CR list. But in 2020 and 2021, batches of red, white and yellow onions were recalled due to salmonella.

Cooking onions kills any bacteria, and choosing unbruised vegetables and storing them out of sunlight are ways to avoid food-borne illness.

Turkey and chicken round out the top six in CR’s report, thanks to salmonella, which the publication blames on sloppy de-feathering and filthy conditions where the birds are raised.

CR recommends cooking chicken and turkey in all forms to 165° F and not rinsing the birds to reduce the risk of spreading salmonella around the kitchen.

Pre-cut fruit such as papayas, peaches and melons — which are eaten raw — also carry salmonella risks.

“When you cut into produce, you increase the risk of transferring bacteria that may be on its surface into its flesh,” said Dr. James E. Rogers, CR director of food safety research and testing.

“In commercial facilities, with fruits and vegetables processed in one place, it can create opportunities for cross contamination.” 

Between papayas, cantaloupes and peaches, there were over 700 reported illnesses and 22 recalls/outbreaks.

Pre-cut fruits such as papayas, melons and peaches could be tainted with bacteria.

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Lastly, and perhaps most shockingly, is raw flour.

While it’s tempting, don’t eat raw batter or dough — though delicious, it can be tainted with bacteria.

Cooking is the only way to kill it and ensure safe eating, and experts recommend thoroughly washing surfaces, dishes and your hands when they come in contact with raw flour.

CR’s findings coincide with an urgent notice from the Centers for Disease Control and Prevention, which warned people this week not to consume raw or uncooked flour due to a salmonella outbreak in 11 states that has hospitalized three people.

“Flour doesn’t look like a raw food, but most flour is raw,” the agency cautioned.

To stay safe from food-borne illnesses, monitor recalls and practice proper cooking techniques, which include diligently washing countertops and anything that comes in contact with raw meat; and cooking foods thoroughly.

https://nypost.com/2023/04/01/10-grocery-items-most-likely-to-cause-food-poisoning-big-surprise/

NJ factory imports cocaine plant that flavors Coca-Cola thanks to DEA arrangement

 Guess you really can’t beat the real thing.

Coca-Cola gets its iconic taste thanks in part to a chemical processing factory in a sleepy New Jersey neighborhood that has the country’s only license to import the plant used to make cocaine.

The Maywood-based facility, now managed by the Stepan Company, has been processing coca leaves for the soft-drink giant for more than a century and had its license to import them renewed by the Drug Enforcement Agency earlier this year.

The coca leaves are used to create a “decocainized” ingredient for the soda and the leftover byproduct is sold to the opioid manufacturing company Mallinckrodt, which uses the powder to make a numbing agent for dentists, DailyMail reported.

It is unclear how much coca leaves the Stepan Company imports annually, although the New York Times reported in 1988 that it brought in between 56 and 588 metric tons of coca leaves from Peru and Bolivia each year, citing DEA figures.

The Stepan Company in Maywood, New Jersey, has the country’s only license to import bulk shipments of coca leaves, which are used to make cocaine.

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One ton of coca leaf costs over $5,500 in Peru, so the Stepan Company would be paying between $308,000 and $3.2 million for the shipment of the illicit leaves if the amount it imports has remained constant over the decades, according to data from agricultural company Selina Wamucii.

Ricardo Cortés, author of 2012’s “A Secret History of Coffee, Coca and Cola,” wrote that he obtained records from the National Company of the Coca, a Peruvian state-owned company, which showed that up to 104 tons of coca leaves were exported to Maywood each year between 2007 and 2010.

Importing coca leaves was banned in 1921, but the legislation left an exemption for Maywood Chemical Works, which ran the factory before Stepan Company bought the site in 1959.

The plant in Maywood has been processing coca leaves for Coca-Cola for more than a century.

Jeffrey Greenberg/UCG/Universal Images Group via Getty Images

Meanwhile, the legal exemption the factory has received helped the Coca-Cola brand to become the massive globally recognized company it now is, with is worth around $265 billion.

“Coca-Cola’s success as the mega-company it is today is due, at least in part, to special privileges granted by government during World War II, and the suppression of potential competitors in the early years of Harry Anslinger’s anti-drug policies,” Australian economics think tank Mises Institute wrote in a 2016 article.

Anslinger was the former head of the Federal Bureau of Narcotics between 1930 and 1962 and is widely recognized as an early proponent of the war on drugs who had a major role in the federal criminalization of marijuana.

The Stepan Company processes the coca leaves to flavor Coca-Cola.

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Cortés wrote in a 2016 blog post that he visited the National Archives and saw letters between Anslinger and Maywood Chemical Works joining forces to deflect a Life Magazine reporter’s story about the coca leaf importation.

“We do not desire the publicity which such an article might bring us,” Maywood Chemical’s President M.J. Hartung wrote to Anslinger in 1949.

The next year, the Federal Bureau of Narcotics filed an internal memo regarding the matter.

“Less publicity of articles about coca leaves and narcotic drugs will be better for the public,” the memo from July 1950 reads, going on to call past coverage of the issue unsatisfactory.

https://nypost.com/2023/04/01/nj-factory-imports-cocaine-plant-for-coca-cola-due-to-dea-arrangement/