Health Care Reform

Healthcare Reform News

Households hold back on healthcare spending
More evidence of the economy's effect on healthcare spending emerged in recent weeks to paint a grim picture for access to medical care during a downturn. Now federal health officials have released an analysis that underscores the close link between employment and the wherewithal to get needed treatment or prescriptions. A Centers for Disease Control and Prevention survey found half the unemployed were uninsured compared with one-fifth of those in the workforce in 2009—the year the recession officially ended—and the following year.

Kaiser Hospital Still Open Despite Strike
Kaiser Permanente workers across the state began picketing began at 7 a.m. today in a one-day strike over a new contract for mental health and optical employees. Thousands of workers took to picket lines today in Northern and Southern California over a contract dispute involving 4,000 employees who are members of the National Union of Healthcare Workers, a NUHW representative said.

Malpractice lawyer recommendations come from unlikely source: hospitals
Several medical systems — including MedStar Health, LifeBridge Health and the University of Maryland Medical System, which collectively run about two dozen hospitals — keep lists of vetted lawyers who will accept patient cases for lower fees, often with the expectation that claims will be settled quickly.

Mass. health insurance law: More coverage, more expensive
The state’s landmark health insurance law, passed in 2006, significantly increased the number of residents ages 19 to 64 with coverage -- now at 94.2 percent. A survey released today found that it also is starting to produce results by keeping patient’s healthier and out of emergency rooms and hospitals.Unfortunately, as many probably suspect, it has done little to control costs. “There was a significant increase in premium costs paid by workers, reflecting Massachusetts decision to put off efforts to address lowering health care costs in the 2006 legislation,’’ according Health Affairs, the journal that published an article based on the survey on its website today.

AHRQ finds gains in teamwork, leadership
Hospitals are making progress in a number of areas related to safety culture, including teamwork and leadership, according to a report from HHS' Agency for Healthcare Research and Quality.Released in 2004, AHRQ's 42-item Hospital Survey on Patient Safety Culture allows employees at participating hospitals to report on their organization's approach to open communication, patient handoffs and other safety topics. The agency released the first comparative report of survey data in 2007, covering 382 hospitals.

Florida bill would make doctors, health centers post prices
Restaurants have menus, retailers have pricetags and soon, Florida doctors could have price boards.Legislation in Tallahassee would force doctors and some medical care centers to post signs of about 3-feet-by-5-feet in their waiting rooms showing the prices to be charged a person paying out of pocket. Charges for the insured vary by policy and wouldn't be posted. "The cost of health care is a big mystery. Nobody knows how much health care costs. We need some clarity," said Rep. Richard Corcoran, R-Trinity, the sponsor of one of the bills. "When consumers are price-conscious, they shop around, and there's competition. That lowers costs and gives better quality."

Baltimore Deemed U.S. City With Most Top-Ranked Hospitals
Baltimore is the top U.S. city for hospital care, according to a new report that examined patient death and complication rates at nearly 5,000 hospitals across the nation. The report identified hospitals performing in the top 5 percent for 26 different medical procedures and diagnoses, and then ranked cities according to those with the highest percentage of top-ranked hospitals. Baltimore had nine top-performing hospitals out of 19 eligible hospitals in the city. The other cities in the top 10 were: Phoenix-Prescott, Ariz.; Cedar Rapids, Iowa; Richmond, Va.; Cincinnati; West Palm Beach, Fla.; Chattanooga, Tenn.; St. Louis; Hartford-New Haven, Conn.; and Grand Rapids-Kalamazoo, Mich.

Health insurers hold back on rate increases in Mass
State regulators have approved premium increases averaging 2.3 percent for health insurance covering hundreds of thousands of residents, the most modest hikes in at least a decade and a sign that years of efforts to control costs may be working. The new rates are in Massachusetts’ “small group’’ market, which includes tens of thousands of small businesses as well as self-employed and formerly uninsured individuals. They apply to policies taking effect April 1, the biggest renewal date for insurance coverage. Last year, small group premium increases averaged 9 percent.

Medical lobby keeps up ‘doc fix’ push
Medical groups are keeping up the pressure on Congress to find a long-term solution to Medicare’s payment formula for doctors. The American Medical Group Association said in a letter Friday that Congress’s near-constant cycle of short-term “doc fix” bills is a strain on doctors as well as the Medicare program, and the group pressed Congress to find a longer-term solution. The latest temporary patch is set to expire March 1, at which point doctors would see a nearly 30 percent cut in the Medicare payments.

Arkansas court weighs in on medical malpractice law
The Arkansas Supreme Court has thrown out part of a law that specifies what kind of doctors can testify as experts in medical malpractice cases. The state’s highest court ruled Thursday that a requirement that says expert testimony has to come from “medical care providers of the same specialty as the defendant” violates the separation of powers doctrine. Their decision comes in the case of Teresa Broussard, who says she was injured during a procedure at a Fort Smith hospital.

Health Insurance Exchanges — Which States Are Progressing?
Although health-care reform has become a political hot potato, 28 states and the District of Columbia currently are “on their way toward establishing their own Affordable Insurance Exchange,” according to a report released by the White House on Wednesday, Jan. 18. The exchanges, also called marketplaces, are a key component of the Patient Protection and Affordable Care Act, often derisively referred to as Obamacare. The websites are intended to become an online destination where Americans who need coverage can comparison shop for regulated insurance plans.

Amid cost concerns, lawmakers delay vote on universal healthcare
A proposal to have the state provide healthcare coverage to all Californians hit another snag Tuesday in a legislative committee amid concerns about its cost. The measure to create a single-payer California Healthcare System could cost the state general fund $200 billion annually, according to a legislative analysis, so the Senate Appropriations Committee put the proposal on hold for at least a few days so it can be given further consideration

Alert: Health spending growth stayed slow in 2010: CMS
U.S. healthcare spending grew 3.9% in 2010, reaching a total level of $2.6 trillion and following the slower-growth trend seen in 2009, according to the annual report on national health expenditures published in the journal Health Affairs.The rate of spending in 2010 increased only 0.1 percentage point faster than in 2009 (3.8%), a year that had the lowest rate of increase in the 51-year history of the annual report, according to economics analysts from the CMS.

ACR Appropriateness Criteria Released
The ACR Appropriateness Criteria® are evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for a specific clinical condition. By employing these guidelines, providers enhance quality of care and contribute to the most efficacious use of radiology. The guidelines are developed by expert panels in diagnostic imaging, interventional radiology, and radiation oncology. Each panel includes leaders in radiology and other specialties. There are 175 topics with over 850 variants in the December 2011 version.

Report Finds Most Errors at Hospitals Go Unreported
Hospital employees recognize and report only one out of seven errors, accidents and other events that harm Medicare patients while they are hospitalized, federal investigators say in a new report. Yet even after hospitals investigate preventable injuries and infections that have been reported, they rarely change their practices to prevent repetition of the “adverse events,” according to the study, from Daniel R. Levinson, inspector general of the Department of Health and Human Services.

Patients Not Taking Prescribed Medicines Cost US Healthcare System $290B Yearly
Not taking your medicines as prescribed can hurt your wallet as well as your health and far outweigh any savings on your pharmacy bill. Not filling prescriptions and even skipping doses can result in serious complications and lead to ER visits and hospital stays, even premature death. Patients not taking medicine as prescribed cost the U.S. healthcare system roughly $290 billion a year in extra treatment and related costs, research shows. One study estimated those patients pay about $2,000 a year in extra out-of-pocket medical costs.

University: New medication shortages hit 267 drugs in 2011, for 5th straight yearly increase
The number of new prescription drug shortages in 2011 shot up to 267, well above the prior record and about four times the number of medication shortages in the middle of the last decade. Figures just released by the University of Utah Drug Information Service, which tracks national drug shortages, show there were 56 more newly reported drug shortages in the U.S. last year than in 2010, when there were 211. By contrast, there were only 58 drug shortages reported in 2004.

Should Doctors Be 'Parsimonious' About Health Care?
A major medical group issued ethical guidelines on Monday that take the provocative position of urging doctors to consider cost-effectiveness when deciding how to treat their patients. The American College of Physicians, the second-largest U.S. doctors' group after the American Medical Association, included the recommendation in the latest version of its ethics manual, which provides guidance for some 132,000 internists nationwide.

More consumers choosing high-deductible plans
Millions of patients are enrolled in health insurance plans that don't kick in until they've spent $1,000 or more out of pocket, and many don't have tax-free accounts to help them meet their deductibles. Enrollment in high-deductible plans rose from 14% of insured adults in 2010 to 16% in 2011, according to the Employee Benefits Research Institute, which surveyed 4,703 adults from age 21 to 64 who had employer-based insurance.

One in Five Struggles to Pay Medical Bills
One American in five reported having trouble paying medical bills in 2010, according to a study by the Center for Studying Health System Change. That proportion didn't change much from 2007 to 2010 -- a somewhat surprising finding, according to the study authors, given that the period was the peak of the economic recession. "Given the recession, the sluggish recovery, and healthcare costs continuing to increase faster than incomes, it's a bit surprising that the rate of medical bill problems didn't increase," Anna Sommers, PhD, co-author of the study, said in a press release.

FDA releases draft guidance on medical device applications
The Food and Drug Administration unveiled draft guidance Wednesday on how it reviews applications for low-risk medical devices. The FDA has been working with industry and patient advocacy groups to overhaul its so-called 510(k) program, which medical device makers complain has grown too complicated and uncertain. The draft guidance is not final and is not currently in effect, but gives stakeholders a chance to comment before the agency begins to develop its final guidance.

Blue Shield to pay $2 million over dropping of policyholders
More than a year after the healthcare reform law sought to prevent sick patients from losing medical coverage, insurers are still paying for their alleged abuses. Blue Shield has agreed to pay $2 million to resolve accusations that the company improperly dropped policyholders after they got sick and needed expensive treatment.

NIH, health centers avoid cuts in fiscal 2012
For the third time in 2011, Congress adopted appropriations legislation that narrowly prevented a partial shutdown of the federal government -- this time for the remainder of fiscal year 2012. President Obama signed the measure on Dec. 17, which includes a mixed bag of small spending cuts, increases and freezes for nonmandatory federal health programs.

House rejects Senate tax measure; doc pay cut looms
The threat of a 27.4% cut to Medicare physician payments Jan. 1 became more real Tuesday after the House of Representatives voted 229-193 on a motion to disagree with a Senate-amended version of a House payroll tax cut bill that would have placed a two-month freeze on payments to the nation's doctors. In that same vote, the lower chamber requested a conference, which would allow the House and Senate to resolve their differences in the two bills. On Saturday, the Senate approved an amended version of a House payroll tax cut bill that the House passed Dec. 13.

HHS names Pioneer ACOs
HHS on Monday announced the 32 organizations the agency selected from among 80 applicants to participate in the Pioneer accountable care organization model. Overseen by the CMS Innovation Center, the Pioneer ACO model will test the effects of several payment arrangements to support these groups in providing better care and outcomes at a lower cost, according to HHS, , which estimated the project could save up to $1.1 billion over 5 years.

Boehner Rejects Deal; Fate Of 'Doc Fix' In Doubt
Boehner Says House G.O.P. Opposes Deal on Payroll Tax A day after the Senate overwhelmingly approved legislation to extend a payroll tax cut for two months, House Republicans made clear Sunday that they would not support the measure. Speaker John A. Boehner, who was among the Republican and Democratic leaders who on Friday had worked out a deal on the $33 billion package, did an about-face on Sunday and said he and other House Republicans were opposed to the temporary extension

Price Tag Hindering Congress in Struggle to Pass Year-End Legislation
The costs of last-minute items pending before Congress are formidable, and lawmakers say that is a major reason they have had so much difficulty reaching a year-end agreement on payroll taxes and other issues. Politics and ideology play a big role in the debate, but the sheer cost of the items — which could easily top $350 billion, according to the Congressional Budget Office — is also a factor.

Interest building for drug shortage solution
More congressional committees are investigating the causes of national drug shortages, increasing the possibility that more lawmakers will offer legislation to address this issue.Two House committees and a Senate panel have each held hearings since September to explore the causes of drug shortages. Many of the more than 200 drugs in shortage are older generic sterile injectables, the Food and Drug Administration said

Republicans put together 'doc fix' offer
House Republicans seem to be coalescing around a two-year “doc fix” paid for with Medicare cuts — including cuts that could directly affect seniors. As expected, a two-year fix was included in the larger tax proposal GOP leaders pitched to their caucus on Thursday. Doctors will face a nearly 30 percent cut in their Medicare payments if Congress doesn’t act by the end of the year. Republican lawmakers told The Hill after Thursday’s caucus meeting that leadership discussed a plan to avert that cut and give doctors a 1 percent pay increase in 2012 and 2013.

Supreme Court has hard time finding an easy test for patents on medical processes
Prometheus Laboratories holds patents for how to determine the proper dosage of drugs that treat gastrointestinal and other autoimmune diseases. The problem for the company, defending itself Wednesday at the Supreme Court against a patent challenge from the Mayo Clinic, was that its procedures don’t sound like much of a discovery. You administer the drug. You take a blood sample. If the level of the drug or its components is too low, you increase the dosage. If too high, you decrease.

Plan to Widen Availability of Morning-After Pill Is Rejected
For the first time ever, the Health and Human Services secretary publicly overruled the Food and Drug Administration, refusing Wednesday to allow emergency contraceptives to be sold over the counter, including to young teenagers. The decision avoided what could have been a bruising political battle over parental control and contraception during a presidential election season. The contraceptive pill, called Plan B One-Step, has been available without a prescription to women 17 and older

Health care law changing behavior
More than 2.65 million Medicare recipients have saved more than $1.5 billion on their prescriptions this year, a $569-per-person average, while premiums have remained stable, the government plans to announce today.That's because of the provision of the health care law that put a 50% discount on prescription drugs in the "doughnut hole," the gap between traditional and catastrophic coverage in the drug benefit, also known as Part D.

Vermont, New Hampshire top list of healthiest states
Progress in the fight against obesity, heart disease, and several other public-health scourges all but ground to a halt in the past year, although as usual a person's chances of being in good health varied widely by location, according to the latest state-by-state rankings of the nation's health. As they have in the past, northeastern states dominated the top of the rankings, while states in the southeastern United States were clustered at the bottom.

Secretary Sebelius Announces Delay of Meaningful Use Stage 2
Secretary of Health and Human Services (HHS) Kathleen Sebelius Nov. 30 announced that HHS intends to delay the implementation of Meaningful Use Stage 2 requirements for both hospitals and eligible professionals until 2014 (i.e., until fiscal year (FY) 2014, beginning Oct. 1, 2013, for hospitals, and until calendar year (CY) 2014, beginning Jan. 1, 2014, for eligible professionals). The delay was announced in an effort to “encourage faster adoption” of electronic health records under the Medicare and Medicaid incentive payment program funded by the American Recovery and Reinvestment Act

Foes of health-care law are among states receiving federal money to implement it
Thirteen states were awarded nearly $220 million in federal grants Tuesday to help them erect the private health-insurance marketplaces that are at the heart of the 2010 health-care law — including eight led by Republican governors who opposed the legislation. The announcement by the Obama administration brings the number of states that have received such grants to 29. It also highlights the dual path that many Republican state leaders have been following when it comes to the law — petitioning the Supreme Court to strike it, even as they ready their states for implementation in the event that the justices uphold the statute.

AMA delegates detail steps to confront national drug shortage emergency
The AMA House of Delegates said the rising number of critical drug shortages constitutes a "national public health emergency" that requires a swift and sophisticated response to address the complex roots of the crisis. The tally of drugs classified as being in shortage by the Food and Drug Administration tripled from 61 in 2005 to 178 in 2010. Nearly three-quarters of the shortages involved sterile injectables, and 80% of the shortage drugs are generics

Global health fund halts new programs
The world's biggest financier in the fight against three killer diseases says it has run out of money to pay for new grant programs for the next two years — a situation likely to hit poor AIDS patients around the world. An official with the Global Fund to Fight AIDS, Tuberculosis and Malaria said Thursday that they have been forced to cease giving new grants until 2014 because of global economic woes brought on by debt crises in the United States and Europe. An independent panel recommended in September that the fund must adopt tougher financial safeguards after it weathered a storm of criticism and doubts among some of its biggest donors.

Cain signs anti-abortion pledge, leaving Romney as sole GOP presidential outlier Republican presidential candidate Herman Cain has signed the Susan B. Anthony List's anti-abortion pledge, leaving Mitt Romney as the only major candidate who hasn't done so. The "Pro-Life Presidential Leadership" pledge commits candidates to abide by four pro-life goals if elected to the presidency.

AMA opposes ‘active purchaser’ model for exchanges
The American Medical Association said Tuesday that state insurance exchanges should not try to actively negotiate with health plans. Some consumer advocates have endorsed an “active purchaser” model, in which states empower their exchanges to negotiate with insurers and allow only certain plans into the exchange. But insurers — and now doctors — say any plan that meets the federal standards laid out in the healthcare reform law should have access to the exchanges.

Uninsured hospital patients discharged sooner
Uninsured Americans tend to be discharged from the hospital somewhat sooner than those with health coverage, regardless of the medical condition itself, a new study finds. Researchers are not sure what the reasons for the findings are. And it's not clear that a shorter hospital stay is a bad thing. Still, the findings suggest that financial factors are playing a role in hospital length of stay, the authors say.

Physicians want revisions to health insurance exchange rules
Federal health officials should ensure that families can afford health coverage, that physicians have access to patients' coverage status and type, and that physicians can lead health insurance exchanges, according to physician organization responses to several proposed rules implementing the health system reform law. Generally, physician organizations agreed in comment letters with several proposed rules released over the summer by the Dept. of Health and Human Services, the Centers for Medicare & Medicaid Services and other agencies.

Obama administration launches $1 billion healthcare drive
The Obama administration on Monday said $1 billion of federal funds allocated in last year's health reform law will go toward innovation programs designed to boost jobs and improve patient care. The announcement is the administration's latest attempt to show that it is working outside of a deeply divided Congress to create jobs. The administration will award grants in March to people who come up with the best ideas to lift care and save money for those enrolled in the federal healthcare programs Medicare, Medicaid and the Children's Health Insurance Program.

Fewer Americans than ever insured through their employers
The number of Americans who get health insurance through their employer hit a new low in the third quarter of this year, according to a new poll from Gallup and Healthways. The poll of 90,070 adults in all 50 states found that 44.5 percent of Americans had employer-sponsored coverage, a drop of more than three percentage points since 2008.

Report: Mass. must control health care spending
A special commission charged with studying rising health care costs in Massachusetts is recommending the creation of an independent oversight panel to identify acceptable and unacceptable reasons for price variations in care based on which hospital or doctor is used.The Special Commission on Provider Price Reform was created by lawmaker last year. It also recommends that state regulators be given the authority to settle price disputes between insurers and health care providers if the cost of a medical procedure exceeds the market-based median.

28 states, DC cut $1.7B in mental health funding
Modest increases in some states' mental health budgets have done little to erase massive cuts nationwide over the past three years and a reduction in Medicaid funds, according to a report to be released Thursday by the nation's largest mental health advocacy group. All told, the Washington-based National Alliance on Mental Illness found, 28 states and the District of Columbia have cut nearly $1.7 billion from their mental health budgets since the 2009 fiscal year.

Study Raises Questions About ‘Bundling’ To Pay Doctors
There’s a lot of concern today that paying fees to medical providers for each service may lead to unnecessary care. But there’s no easy way to replace the massively complicated fee-for-service system. One of the fashionable suggestions for new-style payment is “bundling”, in which providers typically get a set amount that is supposed to cover an episode of care – a surgery, say – or a disease state such as diabetes. The idea is that the set payment will push providers to avoid unneeded procedures, as well as to do high-quality work that avoids the extra costs that accompany complications. The Centers for Medicare and Medicaid Services recently announced a bundling effort.

Test for Hospital Budgets: Are the Patients Pleased?
“I’m a great kvetcher,” said Pearl Schwartz, sitting in her hospital bed at NYU Langone Medical Center. Indeed, during her brief stay to receive a pacemaker, Ms. Schwartz, an 88-year-old retired state worker, had a litany of complaints. Sure, the nurses were “splendid, warm and kind” and sang in her room — and her operation went off without a hitch. But her sink was too small, she had to wait eight hours in the radiology unit for an X-ray, and no one brought her anything to read as she had requested.

Glaxo Agrees to Pay $3 Billion in Avandia Case
Drug maker GlaxoSmithKline said on Thursday that it would pay $3 billion to the U.S. government to settle charges it improperly marketed the diabetes drug Avandia and other products. The case is not completely settled, but the agreement brings the British drug company and the U.S. government closer to resolving the issue. “In recent years, we have fundamentally changed our procedures for compliance, marketing, and selling in the U.S. to ensure that we operate with high standards of integrity and that we conduct our business openly and transparently,”GlaxoSmithKline CEO Andrew Wittysaid in a statement.

The Bush-Obama Rx Shortages
This week President Obama finally confronted a major U.S. health-care disgrace—the growing shortages of lifesaving drugs, especially anticancer therapies. For some reason the White House lumped its executive order with its "we can't wait" campaign against House Republicans, but the pity is that we will have to wait, because the only genuine fix is a liberal anathema: market prices.

Doc pay cut revised down to 27.4%
Physicians will face a slightly smaller but still massive cut in their Medicare payment rates under a revised schedule the administration issued Tuesday for the fees it plans to pay starting in 2012. An across-the-board Medicare payment reduction of 27.4% is expected, according to the new fee schedule, which is slightly less than the 29.5% cut the administration had previously anticipated. The cuts are mandated under the program's cost-control funding formula established by the Balanced Budget Act of 1997.

Obama Tries to Speed Response to Shortages in Vital Medicines
President Obama will issue an executive order on Monday that the administration hopes will help resolve a growing number of critical shortages of vital medicines used to treat life-threatening illnesses, among them several forms of cancer and bacterial infections. The order offers drug manufacturers and wholesalers both a helping hand and a gloved fist in efforts to prevent or resolve shortages that have worsened greatly in recent years, endangering thousands of lives.

AMA Statement on House Vote to Eliminate 3 Percent Withholding
The U.S. House of Representatives today passed H.R. 674, legislation which removed the three percent withholding provision that was created under the Tax Increase Prevention and Reconciliation Act of 2005 (TIPRA). “The AMA applauds the House for passing legislation that removes the three percent withholding provision. This flawed provision would have required the government to withhold three percent of Medicare physician payments. This additional burden is simply untenable in our current Medicare system. There is already a 20 percent gap between Medicare’s payments to physicians and the cost of providing care to seniors, and physicians now face a nearly 30 percent cut on January 1 due to the broken Medicare physician payment formula.

Medical Marijuana Dispensary in Oakland Is Focus of Federal Government
Richard Lee, the leader of the marijuana legalization movement in California, does not appear to be intimidated by the federal government’s crackdown on medical marijuana dispensaries. Mr. Lee closed his Oakland dispensary, Coffeeshop Blue Sky, this week after the Department of Justice threatened his landlord with criminal prosecution. He then reopened it three doors down, with enormous posters of marijuana buds in the windows. On Thursday morning, an employee was handing out fliers to customers at the new locale that read: “Thank you for your support. Together we will survive the attack. Long Live Oaksterdam.”

Panel endorses anthrax vaccine test on children
A key panel of government advisers Friday recommended that the federal government sponsor a controversial study to test the anthrax vaccine in children to see whether the inoculation would protect young Americans against a bioterrorist's attack. The National Biodefense Science Board, which advises the federal government on issues related to bioterrorism, voted 12-1 to recommend that the Health and Human Services Department move forward with a study aimed at determining whether the vaccine is safe and effective in children and identifying the best dose. Patricia Quinlisk of the Iowa Department of Public Health, who chairs the panel, was the only dissenter.

Mitt Romney may be haunted by Massachusetts health care costs
Mitt Romney’s health care albatross isn’t just the similarity between his Massachusetts health care overhaul and President Barack Obama’s health reform law. It’s also the fact that Massachusetts still has the highest health costs in the country — even after the reforms Romney signed into law as governor. It’s a problem his Republican challengers are beginning to use against him, and it’s yet another health care issue that could keep him on the defensive in the primaries.

Boys should get routine HPV vaccination, CDC panel says
All 11- to 12-year-olds — both boys and girls — should be routinely vaccinated against HPV, a family of viruses that causes more than 25,000 cases of cancer a year in the USA, a federal advisory panel recommended Tuesday.Vaccinating boys will protect both boys and their sexual partners from HPV-related cancer, say doctors with the Centers for Disease Control and Prevention. Although HPV, the human papillomavirus, is best known for causing cervical cancer, it also causes cancers of the vagina, vulva, anus, penis and back of the throat, as well as genital warts. And just this week, a study suggested that HPV also is linked to heart disease in women.

Demanding action, Deval Patrick presses for January vote on health care cost bill
Gov. Deval Patrick dialed up his pressure on lawmakers Friday to act on health care cost legislation, requesting a commitment from House and Senate leadership to vote on a bill in January and saying he’s discussed scaling up cost control strategies nationally with Obama administration officials. “The building is full of good intentions. We need action,” Patrick said during an interview with News Service reporters, making a rare and impromptu visit to the press Friday morning before a meeting with his Cabinet.

Inventor hopes for malaria shot by 2015
Molecular biologist Dr Joe Cohen is holding out hope for an effective malaria vaccine by as early as 2015. The 68-year-old bearded soft-spoken Cohen is one of the inventors and original patent-holder of the RTS,S/AS02A malaria vaccine (RTS,S is a scientific name given to this malaria vaccine candidate that represents its composition).

Senate votes to keep Canadian prescription drugs out of US
The Senate on Thursday defeated an amendment that would have made it easier for individuals to get prescription drugs from Canada for personal use. "This amendment would allow the importation of small personal-use quantities of safe FDA-approved prescription drugs from Canada alone," argued Sen. David Vitter (R-La.), the amendment's author. "It is a very modest amendment." The measure would have prohibited the Food and Drug administration from blocking such imports.

U.S. Moves to Cut Back Regulations on Hospitals
The Obama administration moved Tuesday to roll back numerous rules that apply to hospitals and other health care providers after concluding that the standards were obsolete or overly burdensome to the industry. Kathleen Sebelius, the secretary of health and human services, said the proposed changes, which would apply to more than 6,000 hospitals, would save providers nearly $1.1 billion a year without creating any “consequential risks for patients.”

Oklahoma judge halts law barring drug-induced abortions
A judge blocked a new Oklahoma law on Wednesday that would have prohibited women in the state from having medication-induced abortions to end unwanted early-term pregnancies. The law had been scheduled to go into effect on November 1, but state District Judge Dan Owens issued a temporary restraining order in a victory for abortion rights advocates.

Heart failure hospital stays fall, saving billions
Hospital stays for heart failure fell a remarkable 30 percent in Medicare patients over a decade, the first such decline in the United States and forceful evidence that the nation is making headway in reducing the billion-dollar burden of a common condition. But the study of 55 million patients, the largest ever on heart failure trends, found only a slight decline in deaths within a year of leaving the hospital, and progress lagged for black men.

Outside Panel Backs Prostate Test Advisory
In the wake of a government panel’s advice last week that healthy men should no longer be routinely screened for prostate cancer, an independent team of experts sought to explain, in an assessment of the scientific evidence in a prominent medical journal, why a simple blood test generally results in more harm than good. The review, published online Friday in the Annals of Internal Medicine, provides the scientific justification for the United States Preventive Services Task Force’s recommendation that men should no longer have an annual P.S.A. — prostate-specific antigen — test. The task force’s recommendation, which was supposed to come out after the review’s publication, leaked out on Thursday.

FDA Medical Device Process Is Best
In "How the FDA Could Cost You Your Life" (op-ed, Oct. 3), Scott Gottlieb asserts that the Food and Drug Administration approves medical devices in the U.S. years after they're approved in Europe due to burdensome data requirements. For higher-risk devices, there are big differences between the two systems. While the FDA requires that high-risk devices actually benefit patients, the European Union doesn't. A lung sealant to close air leaks and a drug-eluting stent are two examples of products approved in the EU only to be recalled or withdrawn after U.S. studies found them to be unsafe or ineffective.

FDA earns plaudits for flexible approach to approval of drugs for rare diseases
Drugmakers should not fear investing in new medicines for rare diseases because federal regulators have shown considerable flexibility when approving them, says a new report from the National Organization for Rare Disorders. The report was released Tuesday in conjunction with the start of a three-day U.S. conference on rare diseases and orphan drugs. Federal law offers financial incentives for drug companies to develop so-called "orphan" drugs for diseases that affect 200,000 or fewer U.S. patients, but the standard for federal approval is the same as for more mainstream medicines — even though the pool of test patients is much smaller.

Physicians sue Washington state for limiting emergency room visits
The American College of Emergency Physicians is suing the state of Washington over its new policy of paying for only three non-emergency trips to the emergency room per year for low-income Medicaid patients, ABC News reports. The state has defined 700 symptoms as non-emergencies, including difficulty breathing, dizziness, early-pregnancy hemorrhage, gall stones, abdominal pains and chest pains not related to a heart attack, ABC News reports. Patients with these symptoms should visit a regular doctor's office instead, the state suggests.

Feds Seek to Curb Calif. Medical Marijuana Industry
Federal authorities in California are cracking down on the state's medical marijuana industry, four U.S. attorneys in the state announced. Prosecutors have stepped up campaigns to break up businesses that take shelter under a state law allowing patients to possess marijuana for medical use, sending warning letters, filing civil forfeiture lawsuits, and prosecuting criminal cases, the attorneys said. "It's the new California gold rush," Andre Birotte Jr., the U.S. attorney for the state's central district, said during a press briefing. "There's an epidemic of these marijuana stores."

In health insurance, what counts as ‘essential’?
This Friday, the Institute of Medicine will take a first stab at answering one of health reform’s most important unknowns: What counts as an “essential health benefit”? It’s a key question that just about everyone with a stake in health reform is waiting for an answer on.Under the health reform law, every insurance plan will be required to cover a set of “essential health benefits.” The Affordable Care Act defines 10 broad categories that must be included, such as “professional services of physicians and other health professionals” and “hospitalizations.”

Senators say home care companies overbooked care
Senate investigators are accusing three of the nation's biggest home care providers of deliberately increasing their visits to patients to get higher payments from the government's Medicare program. A report released Monday by the Senate Finance committee lays out more than a half-dozen strategies used by executives at Amedisys, LHC Group and Gentiva to increase home care, even when patients may not have required extra attention. Staffers for Senators Max Baucus, D-Mont., and Charles Grassley, R-Iowa, reviewed internal documents by the companies.

Employers' Health-Care Premiums Jump 9%
The health-insurance premiums employers pay rose sharply this year, with the average annual cost of family coverage passing the $15,000 mark for the first time, according to a major survey. The 9% average increase, reported in an annual poll of employers performed by the Kaiser Family Foundation and the Health Research and Educational Trust, comes despite a continued trend toward more limited use of medical services in the U.S. Last year, family premiums rose just 3%, the survey found.

Health insurance, poverty: Numbers of poor, uninsured increase, census figures show
More than 46.2 million Americans live in poverty — the highest number in the 52 years for which such estimates have been published, according to census figures released Tuesday. From 2009 to 2010, the nation's poor increased by 2.6 million, and the number of those without health insurance grew by nearly 1 million people. In Florida, 3.8 million people — more than one in five — were without health insurance last year. Nationwide, the number of uninsured was closer to one in six.

Democrats See Perils on Path to Health Cuts
As Congress opens a politically charged exploration of ways to pare the deficit, President Obama is expected to seek hundreds of billions of dollars in savings in Medicare and Medicaid, delighting Republicans and dismaying many Democrats who fear that his proposals will become a starting point for bigger cuts in the popular health programs. The president made clear his intentions in his speech to a joint session of Congress last week when, setting forth a plan to create jobs and revive the economy, he said he disagreed with members of his party “who don’t think we should make any changes at all to Medicare and Medicaid.”

Romney's Health Care Success?
If Monday night's GOP presidential debate is any indication, Romneycare may not be the liability it once was for Mitt Romney. The former Bay State governor took fewer punches on the issue than before and seemed to have absorbed most of the blows.During the debate, Romney once again defended the health care law he signed into Massachusetts law and insisted that Barack Obama’s signature legislation, Obamacare, ought to be repealed. Romney said he would also “direct the secretary of Health and Human Services to grant a waiver from Obamacare to all 50 states” on his first day in office. Then his chief rival went on the attack.

Doctors find ways to treat uninsured patients
Practicing family medicine in one of the most economically depressed cities in the country, Eric Ramos has watched his patients make wrenching choices about health care.One couple, longtime patients, had to decide whether to maintain coverage for the wife, who had chronic kidney failure, or instead for her diabetic husband. "He decided to cover her," Ramos, 55, says of the husband, "and he's scraping by." How? With medications Ramos obtains from pharmaceutical representatives or elsewhere.

A Bipartisan Move to Tackle Benefits Programs
In a significant shift driven by bipartisan concern about the looming long-term debt, Republicans and Democrats are no longer fighting over whether to tackle the popular entitlement programs — Medicare, Medicaid and Social Security — but over how to do it. In the presidential race, Gov. Rick Perry of Texas, the Republican front-runner of the moment, took the debate over entitlements to a level never before seen from a major candidate, calling for the end of all three programs as currently structured.

Multistate insurance plans in development; AMA submits comments
In order to provide competition with the qualified health insurance plans that will offer coverage through the state-based health insurance exchanges by January 2014, the Affordable Care Act (ACA) directs the Office of Personnel Management (OPM) to offer multistate health plans (MSHP) to the same individual and small group markets. This ACA provision represents a compromise between members of Congress. One group of legislators wanted to allow insurers to sell health insurance across state lines and permit them to choose which state's insurance laws would apply. The other group was concerned that this approach would undermine state consumer protection laws.

Texas, Massachusetts Book-End Health Insurance Stats
Texas residents are the least likely to have health-insurance coverage, while those in Massachusetts are by far the best-covered, according to a Gallup poll published on Tuesday. There are few surprises in the latest Gallup-Healthways Well-Being Index, which finds on average 16.8 percent of U.S. adults went without any kind of health insurance in the first half of 2011, virtually the same as the year before but up from 14.8 percent in 2008.Not surprisingly, the numbers also reflect the strongly differing approaches to health care taken by the two governors responsible, who both happen to be seeking the Republican nomination for president—former Massachusetts Gov. Mitt Romney and current Texas Gov. Rick Perry.

S.F. experiment in improving patient health care
Researchers long ago established that certain medical procedures are performed at dramatically different rates from place to place, and that these disparities affect the quality and cost of health care. Now, health insurers, hospitals and government agencies from the Bay Area to Washington, D.C., are getting more aggressive about tackling variation in medical care. The issue will surface in San Francisco with a collaboration that started this summer among Blue Shield of California and some local hospitals and physicians, aimed at better coordination of patient care for about 26,000 public employees.

CDC: 2 children sickened by novel swine flu strain
A new strain of swine flu has shown up in two children in Pennsylvania and Indiana who had direct or indirect contact with pigs. The virus includes a gene from the 2009 pandemic strain that might let it spread more easily than pig viruses normally do. So far, there's no sign that the virus has spread beyond the two children, the Centers for Disease Control and Prevention reported Friday. "We wanted to provide some information without being alarmist," because people have contact with pigs at fairs this time of year and doctors should watch for possible flu cases, said Lyn Finelli, the CDC's flu surveillance chief. "We're always concerned when we see transmission of animal viruses to humans."

ERs may see rise in uninsured as subsidy expires
Hospital emergency departments may see a continued increase in the number of uninsured people they treat, now that a federal stimulus-funded benefit that helped underwrite health care coverage for the unemployed ended Wednesday. Deficit-conscious members of Congress last year decided to let the subsidy expire, leaving unemployed people who had been getting COBRA coverage the option of paying for it in full, finding a short-term policy or going without health insurance. Enrollment in the program ended in May 2010, and subsidies expired Wednesday for most eligible individuals.

FDA Accord With Drugmakers Raises User Fees 6% to Renew Law
Drugmakers such as Pfizer Inc. (PFE) and Eli Lilly & Co. (LLY) agreed with regulators on a 6 percent increase in review fees as part of reauthorizing the drug-approval process through fiscal 2017. The deal, disclosed in part today, would renew for five years a federal law funding Food and Drug Administration evaluations of brand-name drugs. Congress must approve the accord before the law expires on Sept. 30, 2012. The increase is expected to add $40.4 million to user-fee revenue in fiscal 2012, bringing the fiscal 2013 total to $712.8 million, Karen Riley, a spokeswoman for the FDA, said in an e- mail. The agency in turn will have to meet with companies in the midst of reviews to raise concerns and ensure that evaluations are carried out in a timely way.

Why President Obama's Health Care Plan Missed The Mark
A paradigm shift in health care has begun and traditional health insurance will become obsolete. Major health companies have recognized this but the Administration hasn’t. This is the fundamental reason why President Obama’s health care plan missed the mark.The true risk in health care that is insurable is major medical. There is not so much “risk” in primary care as there is more the administration of expenses. If you talk with most any primary care physician, the complaint you will hear is about insurance billing.

Kaiser Health Tracking Poll -- August 2011
The August tracking poll examines the views of Americans without health insurance, with a particular focus on how they think the health reform law will affect them. Findings from the poll include: Although estimates are that 32 million uninsured Americans will gain coverage under the ACA, only about half of non-elderly Americans currently without coverage say they are familiar with the chief components in the law designed to achieve this goal. Perhaps because awareness of these coverage expansions is low, nearly half (47%) of the uninsured do not expect to be affected at all by the health reform law, either positively or negatively.

Health Law Puts Governors in Pickle
Texas Gov. Rick Perry, along with a slew of other Republican governors, faces a dilemma: Do they apply for millions of dollars in federal grants by September to begin establishing state-run health insurance exchanges, or let the deadline slide, lose the federal money and risk falling into a federally run exchange? Republican governors are unanimous in their condemnation of President Barack Obama's health care law. But one by one, many of them are moving forward to build state exchanges, which are intended to help people not covered by large-company plans buy private health insurance at subsidized rates.

Survey: Some employers may end health coverage after overhaul expands in 2014
Nearly one of every 10 midsized or big employers expects to stop offering health coverage to workers after insurance exchanges begin operating in 2014 as part of President Barack Obama’s health care overhaul, according to a survey by a major benefits consultant. Towers Watson also found in its July survey that another one in five companies are unsure about what they will do after 2014. Another big benefits consultant, Mercer, found in a June survey of large and smaller employers that 8 percent are either “likely” or “very likely” to end health benefits after the exchanges start.

Cancer Drug Shortages Getting Worse, FDA Says
Since 2010, the number of drugs either in short supply or not available at all has risen dramatically, according to the U.S. Food and Drug Administration.Most of these are generic drugs given by injection and used in hospitals to treat serious conditions such as breast and testicular cancer. These shortages are putting patients at risk and compromising their care, experts say."FDA has been monitoring shortages for the last six years, and in 2010 we saw a large spike in shortages, which was a large jump from the year before," said Valerie Jensen,

NIH finalizes financial conflict of interest rules
The National Institutes of Health has finalized rules to reduce financial conflicts of interests among federally funded researchers who also receive payments or stock from drug and medical device companies.
The rules, which will affect more than 40,000 researchers, come after a string of high profile cases in which federally funded researchers failed to disclose millions of dollars from companies with a financial interest in the outcome of their work.Researchers who receive more than $5,000 in income from drug or device companies must disclose the payments. Universities or other institutions employing the researchers must collect the data and provide for public access to it.

Get Informed on Prices
Insured consumers are paying a growing share of their health-care costs out of pocket. But it has been hard for them to shop for deals and compare prices on medical services. Now a growing number of employers, insurers and states are trying to lift the veil on health prices. Most of these resources still have limits, however, and it often remains difficult to project the real bill for any complicated health need. Ideally, "you should know exactly what you're going to be spending," says Giovanni Colella

Survey analysis: CMS needs to revise HIPAA rule
Healthcare IT News recently asked its readers if they think CMS should revise its proposed changes to the HIPAA privacy rule. An overwhelming majority think so. Seventy-three percent of respondents think CMS should revise its proposed rule changes. Only 27 percent think the proposed changes don’t need any alteration. Many believe that the accounting of disclosures rule included in the proposed changes fails to reconcile individuals’ privacy concerns with the requirements providers must meet to ensure compliance.

Grant to sign up children for health coverage
A Tulsa organization was one of 39 across the nation to receive a federal grant to help enroll children for health coverage, a federal agency announced Thursday.Morton Comprehensive Health Center with locations in Tulsa and Nowata County will receive a $388,190 grant. Morton could not be reached for comment. According to the announcement by the U.S. Department of Health and Human Services, grants totaling $40 million were awarded to state agencies, health centers, school-based organizations and nonprofit groups in 23 states.

Study: Only 1 in 5 medical malpractice cases pay
Only 1 in 5 malpractice claims against doctors leads to a settlement or other payout, according to the most comprehensive study of these claims in two decades. But while doctors and their insurers may be winning most of these challenges, that's still a lot of fighting. Each year about 1 in 14 doctors is the target of a claim, and most physicians and virtually every surgeon will face at least one in their careers, the study found. Malpractice cases carry a significant emotional cost for doctors, said study co-author Amitabh Chandra, an economist and professor of public policy at the Harvard Kennedy School of Government.

Florida gets more doctors
Sen. Bill Nelson, D-Fla. announced Wednesday that Florida will gain 325 new medical residents this year. The Centers for Medicare & Medicaid Services, under legislation by Nelson, redistributed the Medicare funding to residency slots in areas that most needed physicians. Each teaching hospital around the country has a cap on the number of resident slots they can claim for Medicare funding. But some hospitals don’t come close to hitting the limit, while others, like Florida, are at capacity and experiencing physician shortages.

Dems hit private firms' nursing homes
Congressional Democrats used a Government Accountability Office report Monday to call for changes in the way Medicare pays some nursing homes.
Rep. Pete Stark (D-Calif.) and Sen. Max Baucus (D-Mont.) raised questions about nursing homes that are owned by private investment firms. They said those facilities target the best care to patients who will generate higher Medicare reimbursements.

Drug shortages set to reach record levels
Monika McBride has acute myeloid leukemia, a life-threatening blood cancer that requires six months of intensive chemotherapy.Three days before her third treatment, however, a nurse called to cancel her appointment: Her doctor had run out of the drug. Doctors, hospitals and patients across the USA are grappling with a record number of drug shortages, causing them to delay treatment, postpone surgery or make do with costlier and less effective substitutes. "I thought, 'Maybe this is it. I'm done. I won't have any more chemo,'" says McBride, 55, of Victor, Idaho. "I didn't want to stress about it, because I believe stress could make the cancer worse. I thought, 'I'm just going to give it up to God.'"

From Standard & Poors, a bit of good news
Standard & Poor's has some good news for once. It's not going to knock down credit ratings of nonprofit health care systems just because the source of most of their revenue — the U.S. government — got downgraded. Their reasoning, explained in a statement issued Wednesday afternoon, is similar to what we wrote in last Friday's print edition. In that article, hospital and other medical outfits say the recent debt-reduction deal is troublesome, but really just another in a long-line of cutbacks to Medicare and Medicaid that threaten their bottom lines, the Wasington Business Journal reported.

CMS Must Ensure Data Is Reliable for Patients, Physicians
Ensuring public reports on Medicare and private payer data are valid, reliable and actionable is critical, the American Medical Association (AMA) and 81 physician organizations told the Centers for Medicare and Medicaid Services (CMS) today in comments submitted on the proposed rule on Medicare data for performance measurement. The organizations applauded the inclusion of safeguards that protect patients and physicians in the rule, but noted several critical issues must be resolved for physician measurement and public reporting to be effective. “The release of accurate data provides an opportunity to inform patients and physicians and to advance the quality of care in the Medicare program,” said AMA President Peter W. Carmel, M.D.

Insurance companies boost investments in inner cities, rural areas
Major insurance companies are pumping $11 million in new investments into inner-city and rural areas that normally aren't served by large financial institutions. The money is part of a 14-year-old program called the California Organized Investment Network that's designed to encourage insurers to plow some of their profits back into low-income communities. The program, known as COIN, has invested more than $100 million since its inception. The money has financed low-cost housing, mobile home mortgages, small businesses, day care centers and other community improvements

Demonstration project seen as model for ACOs
The Medicare agency heralded a test program Monday that it says will serve as a model for healthcare reform's accountable care organizations (ACOs). The agency said it has seen strong results from a five-year demonstration project with goals that are similar to ACOs' — lowering costs by improving quality and shifting away from paying doctors to perform more procedures. The demonstration program involved 10 large, integrated healthcare systems. Seven of the 10 met all 32 of the program's quality benchmarks, the Medicare agency said in a release. And all 10 agreed to participate in a two-year

Gun Query Off Limits for Doctors in Florida
As a primary care physician, I regularly ask patients questions that many people would consider rude, inappropriately nosy or just irrelevant in polite conversation. Do you wear your seat belt? How much alcohol do you usually drink? Do you use recreational drugs? Have you ever injected yourself with anything? Do you have sexual relations, and if so, with men, women or both? Questions like these have long been a standard part of medical interviewing, and for good reason. The answers may reveal clues about a person’s symptoms or physical findings on exam.

CMS adds new quality metrics on care
The Medicare agency announced new programs Friday to help consumers compare hospitals based on quality. The Centers for Medicare and Medicaid Services launched a new website that allows users to compare not just hospitals, but also doctors and nursing homes. The site compares facilities based on several criteria, including the satisfaction of previous patients. CMS also added new metrics to its comparison tool for hospitals. Users can now compare hospitals based on how well they protect against surgical infections and how well they treat possible heart attacks.

Electronic records no panacea for health care industry
It has become health care industry dogma that electronic records can help improve efficiency. Reduce errors. Save lives. And -- just maybe -- put the brakes on runaway health costs, by allowing better sharing of patient information and eliminating duplicative services. It's why hospitals and physicians' practices across the country want a piece of the $27 billion in federal stimulus incentive money to help doctors move their systems away from papers and manila file folders and toward computerization.

Rising cost of health benefits unlikely to slow soon
The inexorable rise in the cost of health benefits shows no signs of abating. Health insurance premiums increased 8% to 10% on average for employers and employees in the Milwaukee area this year, with much steeper increases for some small employers, according to the annual survey done by HCTrends. That's down from average increases of 11% to 13% last year. The overall cost of living, in contrast, increased 1.6% last year. The HCTrends survey and others show that little headway has been made in slowing the rise in health care costs - and little suggests the long-established trend is likely to change in the short term.

Deal could endanger health care law
The debt ceiling agreement could jeopardize millions of dollars, and perhaps billions, in initiatives from President Barack Obama’s health care reform law if the super committee can’t come up with required spending cuts. Many of the pots of money in the law — one of the Democrats’ most prized pieces of legislation — could get trimmed by the debt deal’s sequestration, or triggered cuts. The funds for prevention programs and community health centers, grants to help states set up insurance exchanges and co-ops, and money to help states review insurance rates could be slashed across the board if the panel can’t find enough cuts this fall.

More Families Turning to Public Plans for Children's Health Care
A growing number of American families are using public health insurance to provide coverage for their children, a new study finds. The trend, which is being driven by job losses, changes in coverage within private plans and expanded access to public plans is particularly strong in rural and inner-city areas, according to the University of New Hampshire researchers. "When people become unemployed, not only do they lose their employment-based private insurance but, with the loss of income, families may become newly eligible for public plans," the researchers noted.

HHS announces free birth control for women in the U.S.
The U.S. Department of Health and Human Services announced new guidelines in Washington Monday requiring health insurance plans beginning on or after August 1, 2012 to cover several women's preventive services, including birth control and voluntary sterilization. According to HHS Secretary Kathleen Sebelius the decision is a part of the Affordable Care Act's move to stop problems before they start. "These historic guidelines are based on science and existing literature and will help ensure women get the preventive health benefits they need," she said in a news release.

Study Faults Approval Process for Medical Devices
The government’s system for regulating many medical devices like artificial hips should be abandoned and replaced because it fails to examine their safety and effectiveness before sale, according to a report released Friday by one of the nation’s top scientific groups. The report’s unequivocal recommendation to scrap the current system was unexpected, and it unleashed reactions ranging from outright rejection by industry officials, an embrace by patient groups and seeming disbelief from federal regulators, who had commissioned the review

Bipartisan hospital training bill soars through House panel
Legislation to allow for five more years of funding for resident training at children's hospitals soared through a House panel Tuesday despite the White House's call to terminate the program. The Energy and Commerce Health subcommittee cleared the bipartisan bill by voice vote. The legislation isn't paid for and would have to be appropriated. "The [Children's Hospital Graduate Medical Education] program has been tremendously successful since first being authorized in 1999," panel Chairman Joe Pitts (R-Pa.) said in his opening remarks. "It trains 40 percent of our nation’s pediatricians and 43 percent of pediatric sub-specialists."

States may get substantial power over health insurance exchanges
States will have leeway in determining who operates their health insurance exchanges and which health plans qualify for sale in the exchanges, among other state powers outlined in proposed guidelines unveiled July 11 by the Dept. of Health and Human Services. "This isn't a one-size-fits-all solution," said HHS Secretary Kathleen Sebelius. Health insurance exchange officials will carry out key functions as the health reform law expands coverage by about 30 million Americans beginning in 2014. These tasks include certifying the health plans that will be sold in