By  Brenda Baletti, Ph.D.

Documents reveal that the federal government and insurers incentivized healthcare providers in Kentucky and California to vaccinate Medicaid patients against COVID-19 by offering bonuses based on the percentage of patients successfully vaccinated.

“[This is] truly sickening and I am embarrassed for my profession by this,” Dr. Meryl Nass, an internist and biological warfare epidemiologist, wrote on her Substack, where she posted several documents relating to the COVID-19 vaccine provider incentive programs.

The documents help to draw a picture of the broader effort at the federal, state and local levels to unleash a range of strategies targeting low-income and people-of-color communities, which tended to have lower vaccination rates.

The strategies included providing hundreds of millions of dollars for the creation of “culturally tailored” pro-vaccine materials and for training “trusted” and “influential messengers” to promote COVID-19 and flu vaccines to communities of color in every state.

Nass’ revelations showed these efforts went beyond advertising, fear campaigns, payments to patients and payments to trusted community actors and included, in some cases, direct financial incentives to healthcare providers.

Kentucky: Medicaid paid doctors up to $250 per vaccinated Medicaid patient

Anthem Blue Cross and Blue Shield Medicaid in Kentucky told physicians in 2021 it would “recognize your hard work by offering incentives for helping patients make the choice to become vaccinated.”

The more people vaccinated, the higher the per-person incentive.

For physicians who treated an Anthem Medicaid cohort with a minimum of 25 patients in their practice, Anthem Medicaid offered incentives for vaccination by Sept. 1, 2021, that ranged from a $20 bonus per vaccinated person for physicians who vaccinated 30% of the cohort, to $125 per vaccinated person for those who vaccinated 75% of the cohort, with several incremental steps in between.

As time went on, the rates increased.

Between Sept. 1 to Dec. 31, 2021, physicians received payments ranging from $100 per newly vaccinated person for those who vaccinated 30% of their patient cohort, to $250 per newly vaccinated person for those who vaccinated 75% of their patient cohort.

In 2022, the Anthem provider incentive program changed to a flat rate. Providers received $50 per newly vaccinated Medicaid patient. This included children ages 6 months to 4 years and kids 12 and older vaccinated between Jan. 1 and Dec. 31, 2022, and children ages 5 to 11 vaccinated between June 1 and Dec. 31, 2022.

Medi-Cal: $350 million in incentives to vaccinate low-income children, people of color

The California Department of Health Care Services (DHCS) on Aug. 6, 2021, announced $350 million in incentive payments — $250 million to providers and $100 million for direct non-monetary payments, such as gift cards, to vaccine recipients — to encourage vaccination among Medi-Cal’s 14 million beneficiaries.

Of the $350 million, $175 million came from state general funds and $175 million from federal funding. The funding period lasted from Sept. 2, 2021, through Feb. 29, 2022.

The program offered incentives to managed care plans in the name of “health equity.” In the press release, DHCS Director Will Lightborne said that raising rates among Medi-Cal beneficiaries was essential because “California will only be safe when everyone is safe.”

Nass noted that this program was rolled out one day after Centers for Disease Control and Prevention Director Rochelle Walensky told CNN the vaccines don’t prevent virus transmission. “That’s clearly a contradiction,” Nass told The Defender.

The funding targeted Medicaid recipients with low vaccine uptake — the homebound, communities of color, youth ages 12 to 25 and people ages 50 to 64 with multiple chronic conditions — and incentivized outreach and vaccination activities for providers and pharmacies.

At the time of the announcement, only 45.6% of Medi-Cal beneficiaries age 12 and over had received at least one dose of the COVID-19 vaccine, compared to over 76% of Californians overall.

The DHCS funding included payments to community-based organizations, food banks, advocacy groups and faith-based organizations. This key strategy of funding grassroots leaders to act as “grassroots” proxies spreading the federal government’s vaccine message was widespread throughout the pandemic.

Providers could also couple this grant with a CAIRVaxGrant, which offered providers up to $10,000 to enter all of their historical electronic health record immunizations into the California Immunization Registry (CAIR).

The grant stipulated that after startup costs, payments would be directly tied to “meeting specific vaccination goals,” similar to the Kentucky program.

The incentive payment structure under the California plan was complex, paying a financial reward to healthcare providers who met particular benchmarks that varied by county and demographic but overall increased the percentage of vaccinated patients among their Medicare beneficiaries.

Under this incentive structure, providers had to meet particular vaccination targets in order to get paid. Those who were especially successful in increasing vaccination rates in the target groups would be entered into a “high performance pool,” receiving extra money for substantially moving the vaccination rates for Medicaid recipients 75% higher than baseline or within 10% of a given county’s general rate.

In the equation that determined the incentive payment structure, different demographic groups were weighted differently. For example, vaccine recipients ages 12 to 25 were weighted more highly than older recipients and those in the two racial/ethnic groups with the lowest uptake were also given greater weight.

By Jan. 21 of this year, despite this $250 million push, Medi-Cal vaccination had only increased to 52.9%.

Medicaid pays doctors more to administer COVID vaccines than other shots

As part of the American Rescue Plan Act, the Biden administration fully funded the COVID-19 vaccination program, making vaccines free regardless of health insurance status.

To cover the costs of the uninsured and underinsured, the Health Resources and Services Administration (HRSA) paid provider costs of vaccine administration through an Uninsured Program and a COVID-19 Coverage Assistance Fund.

Reimbursements were based on national Medicare rates, but the Centers for Medicare & Medicaid Services (CMS), which sets those rates, increased the reimbursement rate over time. Through March 14, 2021, HRSA paid $28.93 for a single-dose vaccine or for the second dose in a series of 2, and $16.94 for the first dose in a series of two.

On March 15, 2021, those rates increased to $40 per dose and $75.50 for an “in-home” dose of the vaccine.

Nass said the initial payments were in line with Medicaid payments for other vaccines, but the increased payment marked a departure from the usual reimbursement structure.

Usually, all CMS changes to Medicare payments for specific services must go through notice and comment rulemaking, but “to save time during the COVID-19 pandemic, the agency bypassed that route before increasing payments for administering the vaccines,” JAMA reported.

CMS said the higher payments were meant to help expand COVID-19 vaccination, supporting “actions taken by providers, such as growing existing vaccination sites, conducting patient outreach and education, and hiring additional staff,” Healthcare Finance News reported.

[…]

Via https://childrenshealthdefense.org/defender/doctors-bonus-payments-covid-vaccine-medicaid/

In a move that shifts liability for COVID-19 vaccine injuries from the government to physicians, Switzerland said it is not recommending COVID-19 vaccines for spring and summer, even for those people considered to be high risk.

Switzerland is the latest European country to stop recommending the COVID-19 vaccine for the general population.

A new set of guidelines issued by the country’s Federal Office of Public Health (FOPH) and Federal Commission for Vaccination does not recommend the vaccine for individuals, including those considered at high risk, for the spring and summer seasons.

According to Medical Daily, Swiss medical authorities cited the high level of immunity in society, either via vaccination or natural immunity, as the basis for their new recommendations.

“In principle, no COVID-19 vaccination is recommended for spring/summer 2023,” the FOPH said. “Nearly everyone in Switzerland has been vaccinated and/or contracted and recovered from COVID-19. Their immune system has therefore been exposed to the coronavirus.”

Swiss seroprevalence data from mid-2022 indicates more than 98% of the country’s population had developed antibodies against COVID-19, The Epoch Times reported.

According to Swiss Info, “In Switzerland, about 70% of the population have had at least one COVID [vaccine] dose, a figure that has barely moved over the past year. Only 11.5% got a booster jab in the past six months.”

Swiss public health officials also said data indicate COVID-19 will circulate less this year, with newer variants that cause milder illness than previous strains.

The decision to not recommend the vaccines will be reevaluated for the autumn and winter seasons, according to public health authorities. Medical Daily reported that the new recommendations would be “adjusted if a new wave of infection were to emerge.”

Liability for vaccine injuries shifts to doctors

According to Swiss outlet Report 24, as per the new recommendation, doctors can only administer the COVID-19 vaccines on a case-by-case basis and under certain conditions.

Medical Daily, citing the FOPH, reported that high-risk individuals, including those 65 and older, the immunocompromised and pregnant women, can still receive a COVID-19 vaccine, but only after an individual consultation with their doctor.

When a vaccine is recommended, it is advised that it be administered at least six months after the last vaccination or last-known COVID-19 infection.

The FOPH further advised:

“Even particularly vulnerable people are currently not recommended a COVID-19 vaccination. However, you can get a vaccination after individual consultation with your doctor.

“Vaccination may be wise in individual cases, as it improves protection against developing severe COVID-19 for several months. This applies regardless of the number of vaccinations you have already received.”

However, the FOPH also noted that the efficacy of the COVID-19 vaccines against current variants is diminished and short-lived, especially in individuals who are considered at-risk, according to Report 24.

The FOPH also found that the adaptation of mRNA vaccines has not kept pace with the evolution of new COVID-19 strains.

The new recommendations also have important implications relating to issues such as payment for the vaccines and vaccine-related liability.

“By no longer recommending the vaccines, this would mean that vaccination is not covered by the government anymore,” Medical Daily reported. “Non-high-risk individuals who want to get the vaccine or the booster would have to pay for it.”

For high-risk individuals advised to be vaccinated, health insurance would cover the cost of vaccination.

Under the new recommendations, there is a shift in vaccine-related liability as well. According to guidelines implemented by the FOPH on Nov. 29, 2022, the Swiss government provides compensation to vaccine-injured individuals only in cases where the vaccination is recommended by public health authorities.

As a result, liability now shifts to the doctors administering the vaccines. According to Report 24, this “should mean that their willingness to vaccinate will decrease significantly.”

Swiss Info reported that on Jan. 23, Dr. Christoph Berger, head of infectious diseases at Children’s Hospital Zurich and chair of the Federal Commission for Vaccination, said the COVID-19 vaccines achieved the Swiss government’s goals of protecting the vulnerable and easing pressures on the healthcare system.

However, despite arguing that “vaccination benefits far outweigh the risks,” Berger qualified this statement by saying “It is clear that there are undesirable vaccination symptoms, including severe ones. We must take these people and their suffering seriously and help them too.”

“There is as yet no clear diagnosis of this post-vac syndrome. The term is a collective pot for various symptoms that could at least have a temporal connection with the vaccination. Maybe the connection is causal or not,” he added.

Similar remarks were made by Germany’s Federal Minister of Health Karl Lauterbach — previously a proponent of a national vaccine mandate who once stated COVID-19 vaccines have “no side effects” — on March 12.

Several countries, WHO also revised COVID vaccine recommendations

Switzerland is not the only European country to stop recommending the COVID-19 vaccines.

In April 2022, Denmark suspended its national COVID-19 vaccination campaign and shifted to a targeted approach. And as of Feb. 12, the U.K. stopped recommending boosters for healthy individuals and discontinued free distribution of the primary two-dose series of COVID-19 vaccines.

The World Health Organization (WHO) also made changes to its recommendations.

On March 28, the WHO announced that its Strategic Advisory Group of Experts on Immunization “revised the roadmap for prioritizing the use of COVID-19 vaccines, to reflect the impact of Omicron and high population-level immunity due to infection and vaccination.”

The new roadmap shifts away from a universal COVID-19 vaccination recommendation, instead categorizing individuals into one of three “priority-use groups,” with the ongoing administration of boosters recommended only for the “high priority group.”

This group includes “older adults; younger adults with significant comorbidities (e.g. diabetes and heart disease); people with immunocompromising conditions (e.g. people living with HIV and transplant recipients), including children aged 6 months and older; pregnant persons; and frontline health workers.”

“The public health impact of vaccinating healthy children and adolescents is comparatively much lower than the established benefits of traditional essential vaccines for children,” the WHO stated.

The revised recommendations come as the U.S. Food and Drug Administration continues to recommend the primary series of COVID-19 vaccines for unvaccinated individuals and, according to Medical Daily, is set to authorize a second bivalent booster in the coming weeks.

[…]

Via https://childrenshealthdefense.org/defender/switzerland-stops-covid-vaccines-immunity/

A report published last week by the Environmental Working Group (EWG) examines how the “mining” process behind popular cryptocurrencies including Bitcoin, Dogecoin and Monero creates a wide range of pollution that is harming communities and fueling the climate emergency.

The EWG report — entitled “Proof of Problems: Bitcoin Mining’s Pollution Toll on U.S. Communities” — profiles six case studies of adverse effects of the cryptocurrency mining process known as “proof-of-work.”

“This report vividly shows how proof-of-work crypto-mining operations are contributing to increased air, water, and noise pollution in many communities across the U.S.,” EWG policy director and report co-author Jessica Hernandez said in a statement.

“It amplifies the voices of those who are fighting to save their homes and livelihoods from the bitcoin mines invading their communities,” Hernandez added. “The industry cannot continue to turn a blind eye to the real-world harm it is causing or greenwash the problem away.”

As an executive summary of the report details:

“Not all Bitcoin mines are alike. Some rely on the resurrection of dormant fossil fuel power plants, some find low-cost high-pollution fuel sources like burning coal waste in Pennsylvania, and others flare gas from oil wells to generate the necessary electricity, like the mines blighting Montana’s scenery.

“They all use the same technology, individual computer hardware no bigger than a shoe box or two, all competing to solve the same puzzle and earn a few bitcoin. But it takes thousands of these mining computers, called rigs, to become competitive in the mining industry. That’s why some companies are placing multiple shipping crates full of Bitcoin mining rigs in communities across the U.S.

“What these mines have in common is their use of proof-of-work, which is wasteful by design. This system, a type of software to record and manage Bitcoin transactions, has proven highly inefficient, requiring massive amounts of fossil fuel-generated electricity to operate.

“Proof-of-work is a source of constant noise, a blight in communities across the country, and a hotbed of fraud and corruption that bilks consumers and ratepayers out of billions of dollars.”

“Despite staunch opposition nearly everywhere bitcoin is mined, Wall Street bankers and other large financial backers manage to continue this assault on climate and communities across the country,” the report states. “Change is needed, and it’s needed urgently.”

One of the report’s case studies shows how a Blockstream mining center in Adel, Georgia created so much noise that the residents of one nearby house spent thousands of dollars to install 11 layers of insulation as the constant din damaged their hearing and kept them captive in their own home.

“It sounds like 1,000 jet engines taking off at one time. You can hear it five miles away from here,” said Annette Tiveron, who lives in the house. “It ripples our pond from the vibration with the machines. It’s literally shaking your brain.”

[…]

Via https://childrenshealthdefense.org/defender/crypto-mining-operations-air-water-noise-pollution-cd/?utm_id=20230410

by Brian Shilhavy
Editor, Health Impact News

We are living in unprecedented times. I think it is safe to say that nobody alive today has ever seen such a massive realignment of countries in the Middle East coming together to put aside their differences and start working together to try and stop the endless wars, and work together for economic prosperity.

And the two countries that are spearheading the uniting of these Middle Eastern countries, are China and Russia.

This was a historic week of new meetings between countries in the Middle East, many of which have been bitter enemies with each other, sometimes for hundreds, if not thousands of years.

Here is a brief summary of these historical events that took place this past week:

• Top Iranian, Saudi envoys meet in China in restoration of diplomatic tiesby Bernard Orr and Aziz El Yaakoubi Reuters

Excerpts:

BEIJING/RIYADH (Reuters) – The foreign ministers of Iran and Saudi Arabia met in Beijing on Thursday for the first formal gathering of their top diplomats in more than seven years, after China brokered a deal to restore relations between the top regional powers.

After years of hostility that fuelled conflicts across the Middle East, Iran and Saudi Arabia agreed to end their diplomatic rift and reopen diplomatic missions in a significant deal facilitated by China last month.

In brief footage broadcast on Iranian state TV, Prince Faisal bin Farhan Al Saud and his Iranian counterpart, Hossein Amirabdollahian, greeted each other before sitting down side by side.

Saudi Arabia and Iran, the Gulf’s dominant Sunni Muslim and Shi’ite Muslim powers respectively, said in a joint statement they would launch arrangements to reopen embassies and consulates within the two-month period stipulated in the deal.

“The era of the United States’ involvement in this region is over … The regional countries are capable of preserving security and stability in the Middle East without Washington’s interference,” another Iranian official said. (Source.)

• Moscow Hosts Meeting Aimed at Syria-Turkey Normalization by Dave DeCamp AntiWar.com

The deputy foreign ministers of Syria, Turkey, Iran, and Russia wrapped up two days of talks in Moscow on Tuesday that were aimed at working toward a normalization deal between Ankara and Damascus.

There’s no sign a breakthrough was made, but a follow-up meeting at the foreign minister level is expected to happen soon. A Turkish Foreign Ministry source told Russia’s TASS news agency that the four sides agreed to continue consultations and are planning to hold a foreign ministers meeting.

Russian Foreign Minister Sergey Lavrov said that Moscow had proposed dates for the meeting of the top diplomats from the four countries. The talks this week built on a meeting between Syria and Turkey’s defense ministers hosted by Russia in December 2022, marking the first time the two countries held talks at that level since 2011.

Read the full article at AntiWar.com.

• Saudi, Omani delegations arrive in Yemen for talks with Houthi leaders Reuters

Saudi and Omani delegations arrived in Yemen’s capital Sanaa, Houthi-run media said on Sunday, to negotiate a permanent ceasefire deal with Houthi officials.

The visit indicates progress in the Oman-mediated consultations between Riyadh and Sanaa, which run in parallel to UN peace efforts. Peace efforts have also gained momentum after Saudi Arabia and Iran agreed to reestablish ties in a deal brokered by China.

The envoys, who landed late on Saturday, will meet with the head of Houthi Supreme Political Council, Mahdi al-Mashat, to hold talks on ending hostilities, Houthi news agency SABA reported.

Sources have told Reuters that the Saudi-Houthi talks are focused on a full reopening of Houthi-controlled ports and Sanaa airport, payment of wages for public servants, rebuilding efforts and a timeline for foreign forces to exit the country.

A Houthi official said on Saturday the group had received 13 detainees released by Saudi Arabia in exchange for a Saudi detainee freed earlier, ahead of a wider prisoner exchange agreed by the warring sides.

At talks in Switzerland last month attended by the United Nations and the International Committee of the Red Cross, the Yemeni government and the Houthis agreed to free 887 detainees.

The 13 prisoners are part of that agreement, Houthi official Abdul Qader al-Mortada said.

Read the full article at Al Arabiya Network

• Saudi delegation arrives in Iran to discuss diplomatic missions after historic deal in Beijing by Agence France-Presse

A Saudi delegation arrived in Tehran on Saturday to discuss reopening its diplomatic missions in the Islamic republic, two days after a historic meeting in Beijing between their foreign ministers.

The visit follows the unprecedented meeting between their heads of diplomacy in China on Thursday after they agreed last month to restore diplomatic ties.

The Saudi diplomatic delegation arrived in Iran to discuss the reopening of its missions after a seven-year absence, Riyadh’s foreign ministry said.

Cited by the official Saudi Press Agency (SPA), the minister called the visit part of “implementing the tripartite agreement” reached on March 10 between the two regional powers, brokered by China, to restore ties ruptured in 2016.

The two long-time Middle East rivals have now pledged to work together.

When Saudi Foreign Minister Prince Faisal bin Farhan and his Iranian counterpart Hossein Amir-Abdollahian met in Beijing on Thursday they vowed to bring security and stability to the turbulent Gulf region.

Read the full article at Agence France-Presse.

• Iran appoints first UAE ambassador since 2016 as Gulf relations improve

CAIRO, April 4 (Reuters) – Iran said on Tuesday it had appointed an ambassador to the United Arab Emirates for the first time since 2016, amid a realignment of relations between Gulf states and Iran.

The move comes after the UAE in August moved to upgrade ties and said it was returning its ambassador to Tehran.

The UAE downgraded relations with Iran after Saudi Arabia severed ties with Iran in January 2016 after Iranian protesters stormed the Saudi embassy in Tehran following Riyadh’s execution of a prominent Shi’ite cleric.

In a steep change to years of hostility between Iran and Saudi Arabia that had threatened stability and security in the Gulf and helped fuel conflicts in the Middle East from Yemen to Syria, Riyadh last month said it would re-establish relations with Tehran in a China-brokered deal.

The UAE, which has business and trade ties with Iran stretching back more than a century, started re-engaging with Tehran in 2019 after attacks in Gulf waters and on Saudi energy sites.

The UAE’s Dubai emirate has long being one of Iran’s main links to the outside world.

Iran’s newly appointed ambassador Reza Ameri had served as the director general of the Iranian expatriates office in the foreign ministry, Iranian state media said.

Read the full article at Reuters.

[…]

Via https://healthimpactnews.com/2023/beijing-and-moscow-are-uniting-the-middle-eastern-oil-rich-countries-sunni-and-shia-muslims-making-peace/