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ABL Healthcare Member News & Industry Trendletter * June 2, 2020
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Cybercrime: Non-Personal
and Potentially Deadly

Guest Post by Oli Thordarson, President/CEO of Alvaka Networks;
Intro by Mimi Grant

Mimi's Intro: Last Tuesday, I spotted an article headlined, "Red Cross Urges Halt to Cyberattacks on Healthcare Sector Amid COVID-19." Must admit, my suspicious genes came to attention based on what I've been hearing for the past 25 years from ABL Member Oli Thordarson. So, I immediately wrote him: "Oli, hope I'm not being too cynical, but it doesn't seem likely to me that this will help... What do you think?"

Oli's immediate reply was so impressive, that I asked him to please elaborate; and here it is. BTW, the hackers' quotes are unedited; while English is typically not their first language, you'll get the idea. Mimi

Oli's Post: My reply is more jaded and cynical than Mimi's I bet.

I, too, am perhaps jaded. I don't think this will help one bit. Calling upon international law, etc. is just "blah, blah, blah" to these guys. Even if a few say they won't hit hospitals, which a few have, why should they be trusted, especially when they get a lucrative hit.

Also, there are hundreds upon hundreds of these gangs. Even if one gang found something and passed, another gang is sure to find the vulnerability. Lastly, most of these hits are automated bots. Once they find a vulnerability the ransomware process starts and the gang doesn't know until they get a response from the ransomware victim. Sure they can give them the keys for zero dollars, but the ransom is a small portion of the damage and disruption that hurts everyone.

I offered to write a short blog on the topic. I did some quick research to confirm my stance. Sure enough, www.bleepingcomputer.com, had good information as they always do. Bleeping Computer contacted several hacking groups and only two replied that they would attack hospitals or nursing homes. I can tell you for a fact that they have done so in the past two months, as Alvaka Networks has worked with affected healthcare providers.

One group replied -

"We never attacked hospitals, orphanages, nursing homes, charitable foundations, and we won't. commercial pharmaceutical organizations are not suitable for this list; they are the only ones who benefit from the current pandemic."

Perhaps the attackers were not this particular group, but I can assure you there were many ready to step in their place. By the way, they have been hitting charitable organizations, too. Unfortunately, they don't care. It is the goal of ransomware hackers to inflict as much pain and suffering as they can. This way they get the maximum payout quickly from their victims.

Another hacking group replied with -

"We always try to avoid hospitals, nursing homes, if it's some local gov – we always do not touch 911 (only occasionally is possible or due to missconfig in their network). Not only now.

If we do it by mistake - we'll decrypt for free. But some companies usually try to represent themselves as something other: we have a development company that tried to be small real estate, had another company that tried to be a dog shelter. So if this happens we'll do double, triple check before releasing decrypt for free to such things. But about pharma - they earn a lot of extra on panic nowadays, we have no wish to support them. While doctors do something, those guys earn."

Again, I can personally testify that healthcare providers, local governments, and 911 systems are getting hit. We helped a 911 system in the Midwest just last week, but they try to pose as though they have an ethic. They will decrypt healthcare for free... I have not seen it happen yet for any one company. If those hackers sat in my seat and saw the pain, turmoil, and losses I have seen, they will realize that decrypting for free is the least of the pain inflicted. In a real-life story, we recently helped a small chain of non-profit clinics. The CIO contacted Alvaka for our help on a Tuesday. I spoke to him over the next couple of days asking him, "How are you doing... take a deep breath," like I so often do as I could tell he was maxed stressed. He responded in a different stoic tone, "I am fine." The following Friday one of his direct reports told me that the CIO was in a coma from a massive stroke he incurred the day before, on his birthday. This gets very personal... and sometimes deadly.

Another one promised only temporary safe harbor -

"We also stop all activity versus all kinds of medical organizations until the stabilization of the situation with the virus."

Another included schools as safe from ransomware, yet Alvaka is helping a school district recover after thousands of systems were attacked by ransomware demanding a multimillion-dollar ransom.

If you want to be safe from ransomware, the time to start preparing is now. There are some basic steps you can take to improve your security posture and recoverability several-fold. Some of those tips are covered in Alvaka blogs and we also do webinars every month. If you want some tips to keep on hand in case you are hit by ransomware, check out our What to Expect During a Ransomware Recovery blog and/or What to expect during a Ransomware Recovery Process - Alvaka NetSecure Team video.

Here is the link to Mimi's Reuters story - Red Cross urges halt to cyberattacks on healthcare sector amid COVID-19

Here is the Bleeping Computer article - Ransomware Gangs to Stop Attacking Health Orgs During Pandemic

 
EXPANDED ARTICLES
ABL-HEALTH MEMBER NEWS
Anthem Blue Cross Expands Access to Home Delivered Meal Program for Medi-Cal Members

Anthem Blue Cross has expanded a recently launched home delivered meal program to address increased food insecurity and nutritional needs that are emerging amid the ongoing pandemic. Last December, Anthem partnered with Mom's Meals and Project Open Hand to launch a medically tailored meal program for its Medi-Cal members in the Central Valley, Los Angeles, and the Bay Area who face chronic disease and complex health challenges. Now, because COVID-19 has increased referrals, Anthem has responded by expanding the program to make home-delivered meals available to Anthem Medi-Cal members across the state to ensure that eligible members receive at least one ready-to-eat meal a day, seven days a week. (David Pryor, MD, LA)

Bayer Supports Harvard Study to Evaluate Trust in Science, Including in COVID-19 Pandemic

With the public debate on the merits of scientific data throughout the COVID-19 pandemic, Bayer announced its support for a new, multi-year Harvard Data Science Initiative (HDSI) research effort. The research fund supports the advancement of trust in science through data-driven, actionable insights. Its first undertaking will be to study the public response to scientists and scientific findings in the wake of COVID-19, with other trust in science topics addressed in the future. These findings can guide future activities that strengthen the role of science and facts in decision making. Bayer has committed to support this multi-year research initiative with a total of $1 million. (Rama Penta, SV)

Cigna Adds Services to Support Patients During this Challenging Time

Cigna is expanding its digital capabilities to help customers by partnering with Collective Medical to identify customers, in real-time, checking into emergency care settings with COVID-19 symptoms. With this information, Cigna Care Advocates can quickly engage these customers and connect them with programs to support whole person health, such as care management, remote patient monitoring, and behavioral health support. Also, Cigna has launched the Cigna Care Card to help clients provide financial assistance to keep employees healthy and supported during this challenging time. The new offering will make it easier for employers to support the well-being and peace of mind of employees and their families by designating a tax-free dollar amount to cover expenses incurred as a result of COVID-19. Meanwhile, Cigna's 14 million customers enrolled in employer-sponsored plans can now talk and text with licensed therapists, who are available on-demand via TalkSpace. In addition, customers who are facing issues related to anxiety, depression and burnout, and/or who are experiencing substance use or obsessive compulsive disorders, will have broader access to virtual treatment services through an expanded network of providers. (Chris De Rosa, OC)

Covered California Sees 123,000+ Consumers Sign Up for Coverage During Pandemic

More than 123,000 people have signed up for healthcare coverage through Covered California since March 20, when the exchange announced a special-enrollment period in response to the COVID-19 pandemic. Overall, since Covered California ended its open-enrollment period on January 31, 191,380 people signed up for coverage through May 16, which is nearly two times as many as seen during the same period as last year. (Kathy Keeshen, JD, SF)

Elemeno Health Featured in Recent Podcast & Industry Journal

Arup Roy-Burman, MD, CEO of Elemeno Health, was recently interviewed on The Handoff podcast, discussing how EHRs, facility guidelines, and clinical innovations have led to a massive increase in complexity across the healthcare industry. Arup recounts how, as a physician, he saw firsthand that this led to deviations from best practices that resulted in errors. Wanting a solution, and drawing inspiration from Salesforce, Arup sought to use technology as an enabler and founded Elemeno to deliver just-in-time micro learnings for frontline clinicians. Elemeno also uses gamification to drive adoption and accountability within a unit. Also, Medical Device and Diagnostic Industry (MD+DI) magazine spotlighted Elemeno Health in its recent article: App Puts an Expert in Nurses' Pockets to Reduce Medical Errors . . . now customized for COVID-19. (Arup Roy-Burman, MD, OAK)

Health Coach Institute Offers New Videos
Home Safety Services Provides Virtual Showroom Tours

As a result of California's recent shelter-in-place orders, Home Safety Services has been providing public access to its Home Modification Solution Center via Zoom and Facebook video chats - virtually opening its showroom to share the most up-to-date in-home fall prevention solutions. (Martin Simenc, SV)

Irvine Health Foundation Reports on OC Community Resilience Fund & Greater Opportunities

In Our Community During the Pandemic: OC Strong, Irvine Health Foundation (IHF) describes the OC Community Resilience Fund, a coordinated effort to focus resources, reduce duplicative efforts, and maximize impact by focusing on the most immediate needs faced by community-based organizations operating in Orange County who have been severely impacted by the COVID-19 pandemic. Between March 12 and April 13, $3.2 million was raised for the fund. And, in Scaling Up "Impact" in a Post-COVID Society, IHF publishes an article that lays out an "opportunity for foundations in Orange County to lead California, and the U.S., to help reshape a post-Covid society. . . in a joined-up approach. . . focusing on achieving clear societal outcomes rather than financial ones. . . This could be an opportunity for Orange County, and California, to give back and again lead the agenda around the next stage of capitalism." (Ed Kacic, OC)

King & Spalding Provides Healthcare Organizations with "Coronavirus Recovery Tools"

To help healthcare companies address the challenge of both resuming and continuing work in the context of the ever-changing "new normal," King & Spalding has created tools for healthcare organizations to use to assess and strengthen their recovery response: COVID-19 Recovery Response Assessment for Healthcare Organizations and Coronavirus Business Recovery - Return to Work Hub. (Marcia Augsburger, JD, San Francisco, & Travis Jackson, JD)

LigoLab Hosts Discussion on COVID-19 Testing - Download is Available

LigoLab recently presented a roundtable discussion focused on COVID-19 testing, with the participation of a group of experts and customers cumulatively running over 20,000 daily COVID-19 samples. This Fireside Chat Recording and Slide Deck are available for download, as is LigoLab's Guide to Managing Laboratory Operations During Uncertain Times. (Suren Avunjian, LA)

MayView Community Health Center Clinics Acquired by Ravenswood Family Health Network

The South County Community Health Center, dba Ravenswood Family Health Network in East Palo Alto, announced their successful acquisition of MayView Community Health Center Clinics, serving north Santa Clara County in Palo Alto, Mountain View, and Sunnyvale. Ravenswood will brand their combined sites as "Members of the Ravenswood Family Health Network." Initially, the expanded Ravenswood network, employing around 300 staff, including 50+ clinicians, is expected to serve 27,000 low income patients with approximately 100,000 patient encounters each year. (Ken Graham, SV)

Nelson Hardiman Addresses Legal & Practical Issues of Reopening Healthcare Organizations

In Getting Ready to Reopen: What Healthcare Providers Need to Know, Nelson Hardiman's Harry Nelson presents a webinar offering insights and recommendations on navigating the legal and practical issues in preparing for the "new normal" in healthcare. (Harry Nelson, JD, LA)

PreludeDx Publishes Video & Report About DCISionRT

PreludeDx has published a video about how its DCISionRT helps to prioritize DCIS patients during COVID-19. Also, PreludeDx shares a recent report: "Independent validation of DCISionRT in a Kaiser Permanente Northwest cohort of 455 patients validated the test to be prognostic for 10-Yr DCIS recurrence risk assessment." (Dan Forche, OC)

Royal Ambulance EMTs Step Up to Work in SNFs Overwhelmed with COVID-19

A recent article - Calif. EMS agency deploys providers to overwhelmed nursing facilities - details how Royal Ambulance sent 30 of its EMTs to staff eight skilled nursing facilities that were overwhelmed due to COVID-19 illnesses among staff and patients, to help with daily care of elderly and vulnerable residents. The facilities were in San Francisco, San Mateo, Santa Clara, and Alameda. The Royal EMTs worked with SNF employees in the role of a CNA, helping with tasks such as bathing and feeding, and showing care and compassion to the residents. (Steve Grau, SV)

Savi Group Spotlights Sumit Mahendru

Sumit Mahendru is featured in Savi Group's recent Expert Series interviews, noting his focus on innovation, data-based decision making, and financial best practices. Sumit discusses how technology is helping the healthcare industry, why data is so important, and more. (Sumit Mahendru, OC)

Servicon Team Achieves Infection Control Risk Assessment Certification

Stacey Wong of Servicon, along with several team members, recently earned Infection Control Risk Assessment certification from the Construction Infection Control Training Institute, providing Servicon's environmental services technicians with additional critical techniques. Meanwhile, Servicon has shared some articles of interest, including Buildings Closed by Coronavirus Face Another Risk: Legionnaires' Disease and Post-pandemic changes coming to the workplace. (Stacey Wong, LA)

Vital Link Debuts YouTube Video

Vital Link has published a new 30-second video about its medical alert system. (Art Hoffman, OAK)

Wipfli Addresses the Impact of COVID on Critical Access & Rural Hospitals

On June 4, at 11 a.m. Pacific, Wipfli will present a webinar - The impact of COVID-19 on Critical Access Hospitals - in which leaders from such hospitals will participate in a 30-minute Q&A session with Wipfli's healthcare industry specialists. Topics will include financial funding opportunities; Medicare cost reporting implications; and accounting and tracking of stimulus funding. Also, Wipfli has published an article, Wipfli helps rural hospital manage COVID-19 patients. (Jeff Johnson & Steve Rousso, OAK)

ABL-TECH MEMBERS' WFH TIPS & HEALTHCARE NEWS
PeopleG2 Featured in Inc. for Virtual Meeting Expertise

Inc. magazine's recent article - What One Founder Learned Running 100,000 Virtual Meetings - features Chris Dyer, CEO of PeopleG2, describing his tactics that have worked best for his team, which are instructive for any leader newly struggling with virtual meetings. Chris has run his Brea, CA-based company, with 35 full-time employees and 3,000 contractors, remotely for nearly 11 years. In that time, he estimates PeopleG2 has held 100,000+ virtual meetings. There's an art to it, Chris says - and that's especially true in uncertain times. You need to call enough meetings to stay up to date, but not so many that employees spend the whole day on videoconference calls and can't get work done. You also need to keep those meetings efficient and professional, but acknowledge that many participants are dealing with caregiving responsibilities, subpar work-from-home setups, and their own physical and mental health. In the article, Chris shares his playbook for running effective and compassionate virtual meetings. (Chris Dyer, ABL-Tech LA)

Electrosonic on: AV's Significant Role in the New Normal

In Entering the New Normal: A Reshaped Technological Landscape, Electrosonic discusses how audiovisual solutions can help facilitate a safe return to the workplace and have a hand in reshaping the way we live, work, and play. Robust virtual and augmented reality, as well as cloud solutions and command centers will all play significant roles. Effective videoconferencing tools and meeting spaces, in particular, will be critical. Electrosonic delves further into this topic in How Can Augmented Reality and AI Better Help us Adapt to the New Normal and The Role of Security, Access Control and More in the New Normal. (Bryan Hinckley, LA)

DarioHealth Adds Behavioral Health Coaching + Self-Test Blood Glucose Meters Can Now Be Used in Hospitals

DarioHealth Corp. has expanded its offering on its chronic care platform application to include behavioral health coaching for stress, anxiety and loneliness, conditions which have recently escalated due to COVID-19 social distancing restrictions. Also, DarioHealth reported that the FDA has recognized that home-use blood glucose meters may be used by hospital patients to self-test using their Dario blood glucose testing strips and smartphone-connected device, or the hospital can issue patients a Dario device upon admission. (Rick Anderson, ABL-Tech WLA)

HEALTHCARE INDUSTRY NEWS & TRENDS
TRENDS
Healthcare Workers Care for Injured Protesters on the Streets; Doctors Relay Concerns About COVID-19 Exposure

Many nurses are going directly from their hospital shifts caring from COVID-19 patients to the demonstrations protesting the shooting of George Floyd, to help protesters who've been injured. In Minneapolis, healthcare workers have been bringing water bottles and gallons of milk, to help those hit with pepper spray or tear gas, according to Tweeter @JoshuaPotash. And @steffors tweeted, "I am a licensed nurse with an organized group of frontline medics we are all Healthcare workers (drs,nurses,EMT's) and we provide safe spaces of first aid care for anyone who might have minor injuries." (Read Article: Shape, 6/1/20) Meanwhile, physicians, like Dr. Sujatha Reddy, in Atlanta, expressed concern that the "loud talking, screaming, singing, we've seen can be an easy way to transmit the virus . . . people chanting and shouting, and then add in potentially coughing and sneezing, because of tear gas or pepper spray, and I think we're at risk for a potential spread for coronavirus. When you're exposed to smoke or any other irritant, your natural reflex is to cough, and coughing, sneezing, and then wiping your eyes, touching your face, that absolutely increases the risk of transmission if any of those people had coronavirus." She also said that "anyone who was at the protest should consider getting a COVID-19 test." (Read Article: 11 Alive, 6/1/20)

California Hospitals Struggle Financially After Preparing for COVID-19 Surge that Never Came

As the novel coronavirus tore through Italy and then New York in March, California, anticipating a deadly surge in cases, ordered hospitals to shut down routine procedures and called in thousands of healthcare workers to help patients. But the predicted surge never came. And the cost of all that preparation - setting up field hospitals, doubling the number of intensive care rooms, purchasing protective equipment - dealt a blow to hospital bottom lines, while the ban on all non-emergency procedures cut revenues in half. (Read Article: Reuters, 5/28/20)

48% of Americans Delayed Medical Care Amid Pandemic

48% of Americans said they or someone in their household have postponed or skipped medical care due to the pandemic, according to a poll by Kaiser Family Foundation. The phone survey was conducted May 13-18 among 1,189 U.S. adults. As restrictions ease, many expect to receive the care they delayed over the next three months (68% of those who delayed care; 32% of all adults). (Read Article: Becker's Hospital Review, 5/27/20)

One-Third of Americans Show Signs of Clinical Anxiety or Depression

One-third of Americans show signs of clinical anxiety or depression, according to a U.S. Census Bureau survey cited by The Washington Post. The agency polled adults from 42,000+ households between May 7-12: 24% showed clinically significant symptoms of major depressive disorder and 30% had symptoms of generalized anxiety disorder. These figures demonstrate a large jump from depression and anxiety rates seen before the pandemic. (Read Article: Becker's Hospital Review, 5/27/20)

Apple, Google's Contact Tracing API Goes Live

Roughly a month after first announcing their unprecedented collaboration, Apple and Google have updated their devices' operating systems today with the first component of their contact tracing API. Referred to by the companies as "Exposure Notifications," the technology aims to help public health agencies deploy apps that tell individuals when they may have been exposed to another person with COVID-19. Device owners must opt in to enable the functionality, which according to the companies does not collect location data. The tech companies also noted in their joint announcement that individual users ultimately decide whether or not to report their positive COVID-19 diagnosis through the public health agency's app. (Read Article: mobihealthnews, 5/25/20)

GOVERNMENT
Coronavirus Likely Started Spreading in the U.S. in January: CDC

Scientists at the Centers for Disease Control and Prevention suggest that transmission in the U.S. of the SARS-CoV-2 virus likely began in late January or early February on the West Coast, and that the virus spread undetected for more than a month. Scientists from the agency, and research groups they collaborate with, concluded community transmission in the U.S. began with a single unidentified imported case from China. (Read Article: Stat, 5/29/20)

California Requires Universal Testing at Nursing Homes; Meanwhile, HHS Sending $5 Billion to SNFs Impacted by COVID-19

California's health department has issued new instructions to all skilled nursing facilities to test everybody in their facilities in hopes of slowing the spread of the coronavirus, a move that overrules a more lax testing policy allowed by Los Angeles County. Nursing homes have become ground zero for the COVID-19 pandemic because elderly people with underlying health conditions living in close quarters provide an almost perfect breeding ground for the lethal new virus. (Read Article: Los Angeles Times, 5/28/20) Meanwhile, the U.S. Department of Health and Human Services has begun distributing billions in additional relief funds to skilled nursing facilities to help them combat the devastating effects of COVID-19. This funding, which supplements previously announced provider relief funds, will be used to support nursing homes suffering from significant expenses or lost revenue attributable to the pandemic. (Read: HHS Release, 5/22/20) Also, HHS is working to maximize the Provider Relief Fund to support healthcare providers fighting the COVID-19 pandemic and plans to re-disburse returned funds in future Provider Relief Fund distributions," an HHS spokesperson said. HHS' Office of the Inspector General announced an audit of the $50 billion distribution. (Read Article: Modern Healthcare, 5/22/20)

COVID-19 Antibody Tests are Wrong Nearly Half the Time: CDC

Serologic tests meant to measure past COVID-19 exposure or infection are not accurate enough to use to make policy decisions, the CDC said recently. Healthcare providers should use the most accurate antibody test available and may need to test people twice. If only a small percent of people being tested have been exposed to the virus, even a small margin of error can be significant - if 5% of the population tested has the virus, a test with more than 90% accuracy could still fail to detect half the cases. (Read Article: Becker's Hospital Review, 5/27/20)

CMS Issues Final Rule for MA and Part D Plans Just Ahead of Plan Bidding Deadline

On May 22, CMS issued a final rule for CY 2021 implementing a portion of the Medicare Advantage (MA) and Prescription Drug Benefit (Part D) proposed rule it issued on February 18, 2020. The Final Rule is expected to be published in the Federal Register on June 2, 2020. CMS plans to address the remaining proposed provisions through a second final rule issued at a later date. (Read Article: King & Spalding Health Headlines, 6/1/20)

President Announces Lower Out-of-Pocket Insulin Costs for Medicare's Seniors

CMS has announced that 1,750+ standalone Medicare Part D prescription drug plans and Medicare Advantage plans with prescription drug coverage have applied to offer lower insulin costs through the Part D Senior Savings Model for the 2021 plan year. Participating plans will provide Medicare beneficiaries access to a broad set of insulins at a maximum $35 copay for a month's supply, from the beginning of the year through the Part D coverage gap. (Read: CMS Release, 5/26/20)

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