Medicine & Health articles from August 2005

Medicine & Health archives from August 2005

Medicare gives away free electronic health records software: cost savings could spur physicians into using EHRs.(Health I.T.)
August 1, 2005... A new government initiative could transform medical practices at huge cost savings to physicians. Beginning in August, Medicare will make available free of charge to any medical practice its time-tested electronic health record (EHR)...

Drug-plan sponsors prepare for medicare 'marketing blitz': upcoming fall and winter advertising seasons will be thick with competing messages.(Medicare Part D)
August 1, 2005... With the new Medicare drug benefit barely five months away, health plans and other prescription drug plan sponsors are ramping up massive education and advertising campaigns. On January 1, thousands of seniors will enroll in the first-ever...

Overall U.S. hospital care better, but inconsistent: studies report significant improvements, high variability by hospital type, region.(Quality)
August 1, 2005... The level of care in hospitals has improved over the past few years, concludes a study published in the July 21 edition of the New England Journal of Medicine. But a second study in the same issue reports not only large regional differences in...

Federal, state cuts hurting hospitals, private payers: low Medicare, Medicaid payments force hospitals to overcharge commercial plans.(Costs)
August 1, 2005... Health plans having a hard time controlling rising costs are getting no help from the government. A new report commissioned by Blue Shield of California and conducted by actuaries at Milliman Inc. shows that hospitals are increasing the rates...

Is another flu vaccine shortage on the horizon? Contamination of non-U.S. vaccine could mean another domestic shortage.(Influenza)
August 1, 2005... It looks like Chiron--and the U.S. flu vaccine supply--is in trouble again. The company, maker of the widely used Fluvirin vaccine, suffered contamination problems at a plant that makes its non-U.S, flu vaccine, according to the Wall...

Elderly Medicaid patients receive substandard care: physician training and experience determine better delivery of preventive services.(Quality)
August 1, 2005... Few elderly Medicaid patients receive routine preventive health care, and the likelihood of receiving poor preventive care is linked to the level of a physician's training and the size of the medical practice. These are just some of the key...

Medical liability bill passes House for third year in a row: inaction by Senate stalls pain and suffering award caps.(HEALTH Act)
August 8, 2005... The House put its stamp of approval on the HEALTH Act--setting the stage for the Senate's consideration of a $250,000 limit on pain and suffering damages for injured patients in medical liability cases. The Help Efficient, Accessible,...

Democrats claim dubious patient makeup in physician-owned facilities: government likely to extend moratorium on federal payments for new facilities.(Specialty Hospitals)
August 8, 2005... Do some physician-owned specialty hospitals have racist patient-acceptance policies? While they made no outright accusations, a trio of representatives in the House thinks the issue deserves some more government investigation. The...

A long-term crisis: who can afford nursing home care? 2 solutions might help fix tight budgets and poor planning.(Long-Term Care)
August 8, 2005... Medicaid and the majority of the country's elderly have something in common: Neither has the money to pay for nursing-home stays or home-health services. Although a significant portion of Baby Boomers will need long-term care, few have the...

Long-sought patient safety legislation becomes law: confidential reporting structure encourages healthcare workers to report medical errors.(Legislation)
August 8, 2005... President Bush swiftly signed into law the Patient Safety and Quality Improvement Act after the legislation passed both chambers with wide bipartisan support. The new law establishes a confidential reporting structure in which physicians,...

New DTC guidelines please drug companies, anger critics: Frist disappointed PhRMA didn't propose a moratorium on ads.(Pharamceuticals)
August 8, 2005... Pharmaceutical companies are supporting the new voluntary "guiding principles" their lobbying group developed to quell Congressional and public demands for tough government restrictions on direct-to-consumer advertising. But the drugmakers...

Frist's stem cell research views draw praise, incite anger: Senate Majority leader's support may sway fellow legislators--but Bush vows veto.(Stem Cell)
August 8, 2005... Senate Majority Leader Bill Frist (R-Tenn.) endorsed government-funded research on human embryonic stem cells, breaking with President Bush and key members of his own political constituency. In a statement made from the floor of the Senate...

Medicare's dream of regional PPOs might not come true anytime soon: complexities force many plans to wait until '07.(Medicare Advantage)
August 15, 2005... Health plans see great possibilities in the new Medicare Advantage regional PPO initiative, but they also see significant hurdles to overcome. The hurdles will force many plans to wait awhile to realize their goals. The regional PPOs are,...

Physicians face steep cut, but Johnson proposes increase: legislators may rally to physicians' cause and block 4.3-percent cut.(Physicians)
August 15, 2005... The Centers for Medicare & Medicaid Services issued a grim reminder of what will happen it Congress doesn't rescue physicians soon. CMS confirmed that physicians face a 4.3-percent cut in 2006, and similar cuts from 2007 to 2012. The...

More kids have coverage, even as more adults lose it: despite coverage gains, many uninsured kids don't receive needed care.(Children's Health)
August 15, 2005... One-third of uninsured children in America went without medical care for an entire year, a report released Aug. 2 found. This figure compares to nearly 88 percent of their insured counterparts receiving care during the same period. These...

Studies propose strategies to reduce disparities: introducing concept of civil rights, gathering relevant data will assist policymakers.(Disparities)
August 15, 2005... Two reports, both released Aug. 3 and supported by the Commonwealth Fund, provide templates for policymakers to follow to reduce racial and ethnic disparities in health care. The first study, entitled "Eliminating Disparities in Treatment...

Cost of proposed health IT network: more than $200B: private health care sector unlikely to move rapidly to adopt IT without public sector improvement.(Health IT)
August 15, 2005... An estimated 5156 billion in capital investment and $48 billion in annual operating costs would be required to achieve a model national health information network (NHIN) in five years. So says a report entitled, "The Costs of a National Health...

CMS ends contingency for non-HIPAA-compliant claims: non-compliant electronic claims will not be processed after September 2005.(Health Insurance Portability and Accountability Act of 1996)
August 15, 2005... The Centers for Medicare & Medicaid Services announced Aug. 4 that as of Oct. 1, 2005 it will no longer process incoming electronic Medicare claims that do not comply with standards required by the Health Insurance Portability and...

Physicians not ready for P4P, senate panel told: take it slow, say surgeons, while CMS introduces roadmap.(Quality)
August 15, 2005... The steamroller of pay-for-performance keeps pushing forward, no matter what physicians do. "Change to Medicare's payment systems is urgently needed," because the current payment system is "neutral or negative to quality," Mark Miller,...

ALJ transfer to HHS could limit access, GAO warns.(In Other News ...)(United States. Department of Health and Human Services)(Brief Article)
August 15, 2005... * ALJ Transfer To HHS Could Limit Access, GAO Warns. The Department of Health and Human Services' plan to take the administrative law judges over from the Social Security Administration by Oct. 1 is still riddled with problems, the General...

Senator intensifies scrutiny of medicare's QIOs: legislator demands that CMS account for finances and relationships with hospitals.(QIOs)(investigation of quality improvement organizations)
August 22, 2005... Quality improvement organizations have "misplaced their priorities," Sen. Chuck Grassley (R-IA) charged in an Aug. 11 letter to Centers for Medicare and Medicaid Services Administrator Mark McClellan He formally requested a number of documents...

Hispanics hurting on health coverage front: uninsurance rates outpace those for whites, blacks.(Uninsured)
August 22, 2005... The findings of a recent study by Agency for Healthcare Research and Quality contained some sobering statistics on the rates of uninsured Americans under the age of 65 in the United States, particularly in the Hispanic demographic. ...

'Dual eligibles' may have trouble getting psychiatric meds under part D: Medicaid bones' move to Medicare drug coverageinvites confusion, disruptions.(Medicare Part D)
August 22, 2005... Provisions of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) that will take effect on January 1, 2006, could jeopardize access to needed medications for the 6.4 million "dual eligibles" who are enrolled in both...

Underinsured and over burdened: millions live in healthcare debt: to save money many adults skip seeking care altogether.(Health Care Coverage)
August 22, 2005... Cutting up credit cards and living in a modest house may not be enough to escape mounting debt if you need medical treatment any time soon. A new Commowealth Fund report shows that nearly two out of five adults can't afford to pay their medical...

CMS issues marketing guidelines for PDPs: rules also monitor how physicians promote the plans.(PDPs)
August 22, 2005... On the heels of the Center for Medicare & Medicaid Services' announcement that Medicare prescription drug plans (PDPs) will offer coverage at a lower cost than first expected, the agency has now released new guidelines for how companies can...

Nursing homes face fluvaccine mandate: CMS: if you want to participate, you must vaccinate.(Rules & Regulations)
August 22, 2005... With the hope of greatly reducing the number of elderly who die each year from flue complications, the Centers for Medicare & Medicaid Services proposed Aug. 11 a rule that would require nursing facilities to vaccinate all residents with the...

Seniors Association files tobacco lawsuit for Medicare: advocacy group seeks $60 billion to reimburse Medicare under obscure law.(Tobacco)
August 22, 2005... United Seniors Association, Inc. (USA) filed a lawsuit Aug. 4 against the major American tobacco companies in United States District Court in Boston, MA, seeking recovery of damages on behalf of the Medicare program and the Treasury of the...

Bene hardship could result in Medicare waivers: CMS/ends providers a hand, but O/G makes final decisions on exclusion waivers.(Medicare)(Brief Article)
August 22, 2005... The Centers for Medicare and Medicaid Services has announced a proposed rule that would allow providers excluded from Medicare to get a waiver and gain payment, if the provider can prove the exclusion is negatively affecting beneficiary care....

Medicare eyes artificial disc coverage: CMS lends providers a hand, but OIG makes final decisions on exclusion waivers.(Medicare)(Centers for Medicare & Medicaid Services)(Brief Article)
August 22, 2005... A national coverage analysis (NCA) has opened up an opportunity for the public to state your case on Medicare coverage for artificial discs. The Centers for Medicare & Medicaid Services (CMS) announced on Aug. 16 that it will accept public...

Gingrich touts Medicaid changes to achieve universal healthcare coverage' former speaker emphasizes private-sector solutions to transform healthcare.(Medicaid Reforms)
August 29, 2005... Lawmakers can modernize Medicaid to achieve better outcomes, save money and dramatically reduce health disparities for America's minorities, says former U.S. Speaker of the House, Newt Gingrich. The political heavyweight--and possible...

PPOs will compete to bring coverage to areas without managed care plans; federal incentives will cost Medicare billions.(Managed Care)
August 29, 2005... Medicare will spend as much as $60 billion over a decade to entice preferred provider organizations to offer coverage to four million new beneficiaries in areas that managed care plans don't currently serve, concludes an analysis published in...

States negligent in addressing long-term financing needs of Medicaid, SCHIP; quick budgetary fixes only push problem into the future.(LTC Financing)
August 29, 2005... A study of eight states shows that state governments relied upon short-term solutions to address the budgetary squeeze arising from increasing Medicaid and State Children's Health Insurance Program expenses and lagging tax revenues during the...

GAO: Medicare should reevaluate its contracting reform plans; why the $1.4 billion in savings may not be as realistic as CMS thought.(Medicare)
August 29, 2005... The Centers for Medicare and Medicaid Services will implement its Medicare contracting reform in October 2009 as scheduled, despite a Government Accountability Office report that recommends the agency should delay the change by two years...

Public hospitals face extinction in urban--and suburban--areas; study finds wealthiest communities have the best access to healthcare.(Hospitals)
August 29, 2005... Public hospitals have long been a healthcare safety net for poor urban and suburban communities, whose residents don't have health insurance or the money to pay steep medical bills. But this safety net may be a thing of the past if public...

Copay issue causes Medicaid Commission commotion; increasing co-payments could put vulnerable benes at risk.(Medicaid)
August 29, 2005... A recent federal proposal that would allow Medicaid to raise co-payment rates for its beneficiaries is causing unrest in the house of the Medicaid Commission. During an August 17 meeting, the commission discussed a plan that would allow...

CDHPs lead to new payment strategies; high-deductible plans cause AR problems for providers, plans.(CDHPs)
August 29, 2005... As consumer-driven health plans take a share of the market, they're poised to have a powerful effect on the relationship between plans and providers. The days of the $5 copay for an office visit may have already left us, but...

Medicare benes don't need to formally assign claims to suppliers: suppliers can't collect more than the Medicare-allowed payment.(Suppliers)
August 29, 2005... Physicians and suppliers must avoid "fragmenting" their supplies billings to stay out of the feds' cross-hairs. Effective Nov. 14, 2005, beneficiaries no longer need to formally assign claims to physicians and suppliers when the Centers for...

The HHS Office for Civil Rights answered a frequently asked question about health plans' compliance with the Health Insurance Portability and Accountability Act on its Web site on Aug. 22.(In Other News ...)
August 29, 2005... The HHS Office for Civil Rights answered a frequently asked question about health plans' compliance with the Health Insurance Portability and Accountability Act on its Web site on Aug. 22. The question dealt with confusion over whether a group...

When the new Medicare prescription drug coverage begins on Jan. 1, 2006, Medicare fee-for-service providers will still need to bill many of their prescription.(In Other News ...)
August 29, 2005... When the new Medicare prescription drug coverage begins on Jan. 1, 2006, Medicare fee-for-service providers will still need to bill many of their prescription drugs and biologicals under Part B. Medicare fee-for-service providers cannot...