Oh, That Brain: It Doesn’t Have A (Complete) Mind of Its Own…

You Are in Control of Your Brain

Sometimes when you make a sudden decision, or feel you are doing something without much thought, you might feel that the brain has a mind of its own.

Well, it kind of does. The brain has collected your past decisions, so you don’t have to overthink, a process called conditioning.

But when it comes to the brain, that’s a simplicity that ends there. You have the power of breaking patterns of behavior and changing your focus.

The brain likes to do things to ensure it keeps going. It’s not specifically interested in the intricacies of what you do. So it may be used to following preconditioned patterns. But some patterns, such as certain behaviors, can hurt you.

But the brain’s ways can be changed, by what scientists call its durability and neuroplasticity, and you have an impact on what you do. You can change your brain’s behavior – and train it, researchers say.

How the Brain Works

Scientists note that different regions of the brain often work on their own, relying on neurons inside that region to do the work. At other times, the regions must cooperate. Each region of the brain contains millions of neurons.

With separate networks in the brain, one area may determine the risk versus reward of individual choices, and another may guidehow you actually behave.

Cognitive Control

It’s cognitive control within the brain that keeps you on track despite distractions, scientists say. “Cognitive control and value-based decision-making tasks appear to depend on different brain regions within the prefrontal cortex,” said Jan Glascher, lead author of the study at the California Institute of Technology at Pasadena, according to Time.

You Guide the Way

You should direct your mind to focus on what you want rather than repeating past mistakes, and that can help you make better decisions.

Break Bad Habits

That’s why it’s important to examine your decision-making process. That could be a key to breaking bad habits or addiction.

“Understanding the neuroscience behind making a decision can be helpful when targeting new behaviors and changing bad habits,” says Psychology Today. “Decision-making is in the locus of your control. You have the power to break patterns of behavior simply by making better decisions.”

Changes in behavior and attitudes can be a powerful way to make your thinking go on a different course.

“Unfortunately, the brain’s responses follow preconditioned patterns regardless if they are good or bad habits, so not all of its functions are serving you for the maximum growth,” according to Psychology Today. “The untrained brain is focused survival, not creativity. This means your brain may continue to repeat old patterns of decision-making to keep you in your comfort zone rather than help you reach your full potential.”

Don’t Over Do!

And yes, the brain gets tired.

“The brain works like a muscle: when depleted, it becomes less effective,” says Time.  “We should take this knowledge into account when making decisions.”

For instance, if we spent a lot of time focusing on a task, exercising self-control, or many choices, you probably shouldn’t make significant decision then, the article states.

Think of Other Parts of Your Body

And maybe don’t over rely on your brain; think about the connections to your body and environment, says Alan Jasanoff, professor of biological engineering at MIT and author of The Biological Mind.

 

“If we want to solve our problems, we shouldn’t reduce them to problems of the brain,” Jasanoff says in an interview with National Geographic.

He adds: “We need to keep a broad view, which recognizes how the brain is connected both to the body and to the environment; and look for solutions wherever they happen to lie.”

“Explaining human behavior in terms of brain function alone stems from a kind of mystical view of the brain and keeps us from advancing in a way that science can encourage us.”

 

REFERENCES:

 

Debra Maldonado, CEO Creative Mind Media, Inc. online. 2018. Want to Make A Better Decision? Start By Understanding Your Brain. Here’s How: Retrieved from: https://www.inc.com/debra-maldonado/want-to-make-better-decisions-start-by-understanding-your-brain-heres-how.html

 

Christopher Bergland. Psychology Today. 2018. The Neuroscience of Making a Decision. Retrieved from: https://www.psychologytoday.com/us/blog/the-athletes-way/201505/the-neuroscience-making-decision

 

Mark Humphries. Medium. How Your Brain Decides What You Are Seeing. 2017. Retrieved from: https://medium.com/s/theories-of-mind/how-your-brain-decides-what-youre-seeing-b9729670ec6d

 

Maia Szalavitz. Time. Making Choices: How Your Brain Decides. 2012. Retrieved from: http://healthland.time.com/2012/09/04/making-choices-how-your-brain-decides/

 

On Amir. Scientific American. How Making Tough Choices Tires Your Brain. 2008. Retrieved from: https://www.scientificamerican.com/article/tough-choices-how-making/

 

Simon Worrall. Book Talk. National Geographic. 2018. Retrieved from: https://news.nationalgeographic.com/2018/03/why-the-brain-body-connection-is-more-important-than-we-think/

 

Dentists Retooling Anti-Opioid Initiatives

While there is much discussion about the opioid crisis, you may not immediately think of dentistry. Yet in the 1990s, dentists were the top clinical prescribers of opioids. With a number of innovative and educational initiatives, prescriptions ordered by dentists dropped more than 50 percent by 2012, according to the Journal of the American Dental Association.

There can be lessons learned by dentists and also physicians and other medical care practitioners. Dentists themselves say they are working to continually improve their oversight of opioid prescriptions to reduce opioid misuse and abuse.

For years, dentists have prescribed opioids, but are routinely making limits on such prescriptions. They prescribe the opioids for different reasons: such as controlling acute pain following dental procedures, including when tooth are extracted, where dental implants are placed. Periodontal and endodontic surgeries are also included, according to Dr. Martha Somerman, director of the National Institute of Dental and Cranofacial Research, Journal of the American Dental Association, and Nora Volkow, director of the National Institutes of Drug Abuse.

Whether it’s prescribed from dentists or physicians, routine use of opioids has resulted in much dependence among American patients, and misuses sparked by such dependence. The results have been catastrophic, what the Trump Administration has called a public health emergency in America.

When dentists were considered the top specialty prescribers of immediate-release opioids, they accounted for more than 15 percent of all immediate-release opioid prescriptions. Immediate-release opioids are usually conventional drugs, such as tablets and capsules, taken orally or by the mouth. By the 2000s, dentists prescribed fewer opioids in relation to other medical professionals. In 2009, dentists represented 8 percent of immediate-release opioid prescriptions, but that amount dropped to 6.4 percent.

Opioids are also prescribed in emergency departments (EDs) to manage dental pain until treatment can be started.

Dentists Make Prescription Changes

Over the years, however, dentists used alternative approaches toward treating pain, following plans initiated by the American Dental Association, and the rate of opioid prescriptions that dentists ordered dropped “considerably.”

The American Dental Association launched a new policy earlier this year to reduce the misuse of opioids and to “keep prescription opioids from harming dental patients and their families.”

Among other things, the policy establishes prescribing limits on opioid dosages, such as no longer than 7 days for treatment of chronic pain. The policy also advises mandatory continuing education on prescribing opioids and other controlled substances. Dentists are developing educational interventions to encourage what is known as “risk mitigation strategies,” such as registering with and using Prescription Drug Monitoring Programs before prescribing opioids for pain management.

Databases

Prescription Drug Monitoring Programs are electronic databases that track controlled substance prescriptions in a state. As such they can provide health authorities timely information about prescribing and patient behaviors that contribute to the epidemic and facilitate a nimble and targeted response, according to the Centers for Disease Control and Prevention.

Experts say that more must be done, however. Some of the problems involve general physicians and nurses who treat dental pain. For instance, emergency department physicians often prescribe opioid and other analgesic medications to manage acute dental pain. Indeed, “an examination of a nationally representative data set suggested no reduction in the rate of opioid analgesic prescriptions for dental pain in emergency settings,” according to the studies.

The reports noted that a separate study of Medicaid recipients found that patients having a dental condition were almost three times as likely to receive an opioid from a nurse practitioner as a dentist.

More Research Necessary

To better understand dentists’ opioid prescribing practices, the National Institutes of Dental and Craniofacial Research (NIDCR) is using the National Dental Practice-Based Research Network. The Network includes than 6,000 dental practitioners who regularly see patients and seek to conduct research on their work.

The network seeks to develop tools to improve clinical-decision making related to alternatives among other plans.

“Dentists play a key role in addressing the opioid crisis,”  researchers said. “(American Dental Association’s) new opioid policy has the potential to lead to further reductions in opioid prescribing for acute dental pain and may serve as a model for other clinical professions.”

The ADA says it is partnering with the National Institutes of Health “that underscores the importance of scientific evidence to guide clinical decision- making and helps ensure that dental practitioners are kept abreast of the latest research.” – Joe Cantlupe, HealthDataBuzz

References

Centers for Disease Control and Prevention. Opioid overdose. 2018. National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention. https://www.cdc.gov/drugoverdose/index.html.

Ibid. What States Need to Know about PDMPs. 2017. Retrieved from: https://www.cdc.gov/drugoverdose/pdmp/states.html

 

Dr. Martha Somerman, director of the National Institute of Dental and Craniofacial Research, Journal of the American Dental Association, and Nora Volkow, director of the National Institute of Drug Abuse. The Role of the Oral Health Community in Addressing the Opioid Overdose Epidemic. Retrieved from: https://jada.ada.org/article/S0002-8177(18)30419-7/fulltext and

https://www.drugabuse.gov/news-events/news-releases/2018/07/journal-commentary-addresses-role-dentists-in-opioid-crisis 

Dr. Nora Volkow. National Institutes of Health blog: NIH Partners with the Dental Community to Help Curb the Opioid Crisis.

Miriam Valverde, Donald Trump declares public health emergency over opioid crisis. Here’s what that means. 2017. Politifact. Retrieved from: https://www.politifact.com/truth-o-meter/article/2017/oct/30/opioid-epidemic-united-states-and-trump-administra/

 

 

Physicians’ Education Journey Beyond Journals

Physicians opined for years how important – and difficult — it was that they keep up with journals and academic literature in their respective fields of expertise, either in general, primary care, or specialty practice.

“Keeping one’s personal fund of knowledge current is one of the most formidable challenges that physicians face,” wrote Christine A. Laine and David S. Weinberg in the Annual Review of Medicine in 1999.

Today, “literature” or “journals” is only a mere collective speck of that knowledge landscape as the terrain has shifted seismically, reflecting the information surge through society. For doctors, there is not only the barrage of new information to sort through, but the fact is: they want information now. Staying on top of evolving clinical practice knowledge helps ensure the best patient care and improves physician work and well-being.

And there is certainly a vast array of resources vying for physicians’ attention. There is email, social media, podcasts, live meetings, Facebook and Twitter, which can be absorbed in real time, and practitioners can glean that information in different ways.

Years ago, physicians were known to read a select group of favorite journals cover-to-cover. As doctors keep up with their daily demands, they are spending in some cases mere minutes or seconds perusing abstracts of journals, written or online. In a survey of cardiologists, TCTMD asked 130 respondents how many read journals. An overwhelming majority – 90 percent – did, but only 2.3 percent said they read them from beginning to end, as they might have done a generation ago.

“”The average physician does not receive a physical copy of a journal at their office or home, but instead, receives email notifications of new issues,” wrote Milton Packer, MD in MedPage Today. “Some dutifully click on the table of contents, but they spend less than 30 seconds perusing the titles.”

“There is no guilt associated with ‘not keeping up,’’ Packer added. “Everyone has conceded that they can’t – and won’t be current in their medical reading. How bad is it? Much worse than you think.”

Anticipation may be too great, in some cases. It may take years for a journal article, for instance, to be published, and by then some physicians think they can get more updated information and have a virtual conversation on Twitter to debate the clinical issue at hand.

As information flows constantly, more physicians and researchers continually explore new channels of obtaining information, with many new innovations at their disposal. They are looking for depth, breadth, and better and speedy access to information as clinical inquiries mount.

There are a host of possibilities: There are point –of- care references at hospital computers, independent networks and journal clubs that make medical research databases available. U.S. Department of Health & Human Services offers a set of clinical practice and education tools to help them manage their care.

In 1950, doctors could expect the total amount of medical information to double every 50 years, according to the NEJM Knowledge. By 2020, it would take just 73 days. – Joe Cantlupe, Health Data Buzz.

 

 

The Science of Reducing Calories

While there are many different theories about aging and preventing aging, some scientists are looking closely at one thing: the importance of a nutrient found in milk.

One of the major impacts that can fend off the physiological signs of aging involves cutting down calories, studies show. That has been proven in research into fruit flies, roundworms, rodents and yes, even people, and possible health benefits, according to the University of Colorado researchers.

In some ways, however, people may not have to reduce their food intake to reduce calories. That may seem strange, but there’s a dietary supplement called nicotinomide riboside (NR) that essentially “mimics” how the body deals with calorie restrictions without a person actually, well, cutting those calories.  Nicotinomide riboside was originally identified as a nutrient compound found in milk.

It also “lowers blood pressure and reduces arterial stiffness, and helps with mild hypertension,” according to the University of Colorado study published in the journal Nature Communications. There are many potential healthy benefits to it, including helping people keep a healthy circadian rhythm, improving muscle tissue in the brain, liver and metabolism, the study said.  In addition, it may prevent obesity, poor diet and related metabolic disorders, although researchers say further research is needed.

“This was the first ever study to give this novel compound to humans over a period of time,” said senior author Doug Seal, a professor and researcher at the Department of Integrative Physiology in a statement. “We found that is well tolerated and appears to activate some of the same key biological pathways that calorie restriction does.”

Forms of Vitamin B3

Nicotinamide riboside (NR) is considered a precursor of a chemical agent known as nicotinamide adenine dinucleotide, NAD+. It is also a form of Vitamin B3. In chemistry, a precursor is a compound that participates in a chemical reaction that produces another compound. There are different compounds involved in Vitamin B3. One of the most well known is nicotinamide, a water soluble form of Vitamin B3, which is produced by eating niacin-rich foods, including eggs, cereal grains, nuts, legumes, poultry and fish. Nicotinamide supplements also have been used to treat skin conditions.

Health Benefits of NAD+

NAD+ is required for activation of enzymes called sirtuins, which are considered an important chemical element linked to calorie restrictions, the University of Colorado study says. Sirtuins also can help generate energy in tissues within the muscles, brain, and liver and also help circadian rhythm.

Several studies have shown that, unfortunately, NAD levels decrease with age in the body, especially in the skin and brain.  And that’s where the study and possibilities of nicotinamide riboside come in, and can be extremely helpful, scientists say. The efficacy of these and other NAD precursors in preventing age-related health problems has been borne out in several animal studies. Studies have shown that NAD element has been able to protect against metabolic problems and tissue damage.

There are other areas that show how NAD and its precursors may protect against other ailments or diseases.

Obesity

One of the things scientists explore to promote anti-aging is the ability to restrict weight gain. Studies have shown in animal studies that NAD+ has protected against obesity in mice despite a high fat diet.

Cancer 

NAD+ may play a role in the process of cancer formation, so there is evidence that “evidence that modulation of NAD+ levels could be important in cancer prevention,” and its progression, according to the Journal of Clinical and Experimental Oncology. 

“NAD+ restoration could prevent or reverse the phenotype of malignant cells at early stages by inducing cellular repair,” the scientists said.

Sepsis

Sepsis remains a major cause of mortality in intensive care units. As a precursor, Nicotinamide riboside “plays an important role in regulating oxidative stress,” according to a study.  It added: “Administration of NR elevated NAD levels and elicited reduction on oxidative stress, inflammation in the lung and heart tissues leads to less mortality in sepsis models.”

Longevity

So what about longevity? While taking these supplements appears to show health improvements, so far the idea that these molecules can increase longevity itself is uncertain. In a study of mice that was designed to replicate human trends in obesity, with related poor diet and related metabolic disorders, the results found no change in longevity.

In the report, scientists said they hope “hope future studies in this may help reveal how NAM supplementation can be explored for use in humans ultimately to counteract harmful effects of poor diet while improving physical and metabolic performance.”  – Joe Cantlupe, HealthDataBuzz

 

Based on my story at hcpnow.com

References:

Poljsak, B, NaD+in Cancer Prevention and Treatment: Pros and Cons. Journal of Clinical & Experimental Oncology. 2016. Vol. 5, Issue 6. Doi: 10.4172/2324

National Institute on Aging. Featured Research. Nicotinamide supplement in aging mice shows some health improvements, but inot increased longevity. April 13, 2018. Retrieved from: https://www.nia.nih.gov/news/nicotinamide-supplement-aging-mice-shows-some-health-improvements-not-increased-longevity

Dellinger, R, Santos, S, et al. Repeat dose NRPT (nicotinamide riboside and pterostilbene) increases NAD+ levels in humans safely and sustainably: a randomized, double-blind, placebo-controlled study. Aging and Mechanisms of Disease. 2017: 3: 17. Doi: 10.1038/s41514-017-0016-9. 

Lisa Marshall. 2018. A pill that saves off aging? It’s on the horizon. CU Boulder Today. Retrieved from: https://www.colorado.edu/today/2018/03/28/pill-staves-aging-its-horizon

https://www.ncbi.nlm.nih.gov/pubmed/29803807

Hong, G, Zheng, Administration of nicotinamide riboside prevents oxidative stress and organ injury in sepsis.Free Radical Biology & Medicine. 2018. Aug1: 123:125-137-doi.10.1016/j.freeradiomed.2018.05.073. Epub 2018. May 24.

Memorial Sloan Kettering Cancer Center. Nicotinamide. 2018. https://www.mskcc.org/cancer-care/integrative-medicine/herbs/nicotinamide

PubChem. Open Chemistry Database. Nicotinamide Riboside. 2018. Retrieved from: https://pubchem.ncbi.nlm.nih.gov/compound/nicotinamide_riboside#section=Top

Salmonella Outbreak Again – Too Often

 

After you eat, you may feel abdominal cramps, a fever, headache, and just feeling lousy over the next few days. That could be a sign you have food poisoning, also known as salmonella.

No, it is not named for the fish. Salmonella, a group of bacteria, is the most common cause of food borne illness, and was named for a doctor named Salmon who discovered it more than 100 years ago. The illness that people get from salmonella infection is called salmonellosis.

Salmonella comes from food contaminated with bacteria, which can happen during food processing or food handling. It only takes a tiny amount of bacteria to cause food-borne illness.

Salmonella can occur in raw, tainted or live poultry, eggs, beef, fish and unwashed fruits and vegetables. People can get salmonella when they are handling food and don’t wash their hands, especially after being in contact with animals, such as chicks or rodents.

It seems like it happens too often. Just yesterday, 92 people from 29 states have been sickened in a salmonella outbreak linked to raw chicken, reported the Centers for Disease Control and Prevention.

At least 21 were so sick they had to be hospitalized. While not specifying the source of the contaminated chicken, the CDC says the “ill people report eating different types and brands of chicken products purchased from many different locations.” The outbreak of what was labeled as Salmonella infantis can be present in live chickens, and many types of raw chicken products, “indicating it might be widespread in the chicken industry,” the CDC says.   Federal officials have shared the information with chicken industry representatives and they are working to reduce Salmonella contamination. The particular salmonella strain may be resistant to to general antibiotics, officials said.

Impacts Millions of People

About one of six people in the U.S. will get some type of food poisoning this year, officials say. The Centers for Disease Control and Prevention estimate 1.2 million illnesses, 23,000 hospitalizations and 450 deaths related to salmonella each year. Food is the major source for most of those illnesses.

Nausea, vomiting and diarrhea are the most common signs of salmonella, but fever and chills often accompany the illness. It can take a week for symptoms of the illness to begin.

One of the most important things you can do if you get salmonella is drink plenty of liquids to replace fluids lost through vomiting or diarrhea.

How salmonella occurs

The most common causes of salmonella usually come from animals. Touching certain birds and lizards can spread the disease. Reptiles, baby chicks and small rodents are among the animals that may carry it.

Foods contaminated with bacteria can occur during food processing or food handling. Salmonella can be lurking in cooked meats, such as chicken or beef. It is also found in seafood, dairy products and lettuce, in packaged and prepared foods. Outbreaks of contamination have ranged the gamut, including raw turkey products, shell eggs, past salads, cereal, pre-cut melon, dried coconut, chicken salad, and raw sprouts.

In some rare instances, water can be contaminated with salmonella.

Kratom, an herbal supplement that the Food and Drug Administration has said is not safe, also has had instances of containing salmonella, the agency said.

When someone is sick

People who get salmonella may develop symptoms of illness anywhere from 12 to 72 hours or nearly a week after infection. The illness usually lasts 4 to 7 days and most people recover without treatment. However, in some people, diarrhea may be so severe that the patient needs to be hospitalized.

An infection could be more serious in infants or people with chronic conditions, according to the National Institute of Allergy and Infectious Diseases. If left untreated, salmonella poisoning can appear in joints and the urinary tract in a condition known as Reiters Syndrome. In some cases that could become permanent.

Use Best Practices in Handling Food

Taking care in handling food is one of the most important preventative practices in preventing salmonella. For instance, take care when making or handling raw eggs or foods such as cookie dough or burgers. You should also make sure raw meat is cooked to the proper internal temperature, or properly refrigerated. You should always wash the food after purchasing.

What You Can Do When Eating

  • Stay hydrated. Liquid intake is important for your body to fight off food poisoning effects. You can have sports drinks that include electrolytes to prevent dehydration, clear sodas, chicken or broth, and decaffeinated tea.
  • Eat foods gentle on your stomach. Such foods would include bananas, potatoes, cereals, honey, gelatin, and oatmeal. – Joe Cantlupe, HealthDataBuzz

 

References:

Rahayu, S, Nurdiana, N, et al. The Effect of Curcumin and Cotrimoxazole in Salmonella Typhimurium Infection in Vivo. 2013. ISRN Microbiology. Article ID 601076, 4 pages.

Healthline. What to Eat After Food Poisoning. Retrieved from: https://www.healthline.com/health/food-nutrition/what-to-eat-after-food-poisoning

Teatulia. What is Ginger? Retrieved from: https://www.teatulia.com/tea-varieties/what-is-ginger-tea.htm

Michael and Lesley Tierra’s East West School of Planetary Herbology. Salmonella in Species and the Herbal Treatment of Food Poisoning. Retrieved from: https://planetherbs.com/blogs/michaels-blogs/salmonella-in-spices-and-the-herbal-treatment-of-food-poisoning/

 

WebMD. Andrographis. Retrieved from:https://www.webmd.com/vitamins/ai/ingredientmono-973/andrographis

 

National Institutes of Health. NIH Scientists describe how salmonella bacteria spread in humans. Retrieved from:

https://www.nih.gov/news-events/news-releases/nih-scientists-describe-how-salmonella-bacteria-spread-humans

 

Food and Drug Administration Administration. 2018. FDA warns companies selling illegal, unapproved kratom products marketed for opioid cessation, pain treatment and other medical use. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm608447.htm

https://www.cdc.gov/salmonella/index.html

 

Based on my article from https://www.hcpnow.com/feeling-lousy-could-be-food-poisoning/

The Joy of Athletic Repetition: Just Hitting Tennis Balls Against A Wall

Sometimes, there’s just no one to play with.

Or maybe I just don’t feel like playing with others.

It may be cold or windy. So I take my tennis racket and go inside, yes, a racquetball court nearby. I warm up slowly, and then hit ball after ball against the walls. I can imagine how high the net is when there is none. I can picture my opponent on the other side, when there is none. I can smash, slice, hit lobs, hit soft overheads.

I can hit ball after ball after ball: over and over.

It’s meditative. The mind is still, oddly enough, with the sound that echoes off the walls. It’s relaxing and yet a tough workout as I sprint back and forth inside the small court.

The court is a cinderblock rectangle. In my head, it’s Wimbledon.

I’ve done this for years. I feel lucky to do this. When the winter comes, the court feels warm inside, though no heat is on. I notice sometimes the spout outside is frozen and the water is solid ice. I don’t look forward to that.

Hitting the balls. One after another. I’ve done this before, I think. A variation of it.

A long time ago.

Yes. Decades ago, as a 10-year-old, I made believe I was Whitey Ford or Sandy Koufax and go into a windup and throw, throw tennis balls against the outside brick wall of the apartment building where I grew up.

In my head, I had a lineup of baseball players I made up. I would pitch. Sometimes they blasted a home run in my imagination. More often, they struck out.

The repetition. The tranquility and joy of it. Yes.  – Joe Cantlupe

 

 

 

Millions Paid to Ohio Medicaid Contractors On Behalf of …..(Oops!)…Deceased Beneficiaries, Feds Say

Ohio officials mistakenly  made more than $90.5 million payments to contractors for medical services under Medicaid on behalf of  beneficiaries who had died, federal officials say in an investigative report.

That was found in a random sample of 100 so-called capitation payments made to Medicaid Managed Care Service Organizations.  Ohio eventually recovered 37 payments, but did not recover the remaining 63 — which amounted to at least  $51.3 million in unapproved payments, according to the federal Health and Human Services Inspector General’s Office. That amount includes $38 million in federal funds.

“Ohio did not always identify and process Medicaid beneficiaries’ death information. Although Ohio’s eligibility systems regularly interfaced with Federal data exchanges that identify dates of death, county caseworkers did not always receive notification that beneficiaries had died,” the report said.

“We confirmed that all beneficiaries associated with the 100 capitation payments in our stratified random sample were deceased,” it added.

Not that this hasn’t happened before in the U.S.

Since 2016, Florida, Texas and Tennessee have made payments after beneficiaries’ deaths, according to HHS.- Joe Cantlupe, HealthDataBuzz