Medicine & Health articles from June 2003

Medicine & Health archives from June 2003

Traditional worker population lags as need mushrooms. (Long-Term Care).(Brief Article)
June 2, 2003... Demand for professional and paraprofessional long-term-care workers is expected to mushroom over the next decade, while growth in the populations that traditionally provide such workers will be significantly slower, according to an analysis...

CMS launches ESRD demo ... (ESRD).(for Medicare and Medicaid Services; end-stage renal disease )
June 2, 2003... A new four-year Medicare demonstration program offers end-stage renal disease providers two reimbursement options designed to rationalize payments and promote disease management through the uniquely close relationship ESRD providers have with...

... Pay-for-quality hospital demo in works. (Hospitals).(Brief Article)
June 2, 2003... CMS also hopes to soon announce another demonstration that would pay more to hospitals that provide better quality care. As reported last week in the Wall Street Journal and confirmed to M&H by CMS sources, hospitals with high quality marks...

Higher costs, more cost sharing in HSC forecast. (Trends).
June 2, 2003... Health care costs continue to increase rapidly, employers are shifting more costs to employees, and there's little relief in sight. That's the assessment of today's health care marketplace offered in the latest issue brief from the Center for...

Justices find no 'treating physician' rule in ERISA. (ERISA).(Brief Article)
June 2, 2003... In evaluating an employee's claims for disability benefits, health plans have no obligation under the Employee Retirement Income Security Act to give particular deference to the opinions of the treating physician, the U.S. Supreme Court ruled...

Bushies softening on Medicare reform? (Medicare).(Brief Article)
June 2, 2003... So far, House and Senate bills being drafted to add a prescription drug benefit are "clearly within the range of acceptability," Centers for Medicare and Medicaid Services Administrator Tom Scully told reporters May 29. While couched in...

State workers may sue under FMLA. (Family Caregiving).
June 2, 2003... The U.S. Supreme Court ruled May 27 that state government employees can sue and collect damages for violations of the federal Family and Medical Leave Act, which allows workers to take up to 12 weeks of unpaid leave annually to, among other...

Hospitals fight Baldacci coverage plan. (In Other News).(Brief Article)
June 2, 2003... * Hospitals Fight Baldacci Coverage Plan. Maine hospitals are waging a "ferocious" lobbying campaign against Gov. John Baldacci's (D) ambitious health-coverage plan, the Portland Press Herald reports. To make coverage affordable and keep...

Prolonged hormone therapy linked to cognitive declines. (In Other News).(Brief Article)
June 2, 2003... * Prolonged Hormone Therapy Linked To Cognitive Declines. In another blow to supporters of prescribing combination hormone-therapy to post-menopausal women as a preventive measure, researchers on the big Women's Health Initiative clinical trial...

OSHA won't proceed with TB standard. (In Other News).
June 2, 2003... * OSHA Won't Proceed With TB Standard. The Bush administration will end a rulemaking process initiated in 1993 to protect against workplace exposure to tuberculosis, says the May 27 Federal Register. Cancellation of the rule has been long...

New use of tax-cut sunsets warps budget projections, analysts say. (In Other News).(Brief Article)
June 2, 2003... * New Use Of Tax-Cut Sunsets Warps Budget Projections, Analysts Say. Numerous small-scale tax cuts had sunset provisions in the 1990s. But the sunsets that lower the apparent price tag for the 2001 and 2003 rounds of cuts represent a "dramatic"...

Lawmakers who hope to save money by addressing chronic ills, take note. (In Other News).(Brief Article)
June 2, 2003... * Lawmakers Who Hope To Save Money By Addressing Chronic Ills, Take Note. "We've changed an acute illness into chronic illness," with drug and surgical treatments that now allow heart patients to survive for years, interventional cardiologist...

Nobody's new at MedPAC. (In Other News).(Brief Article)
June 2, 2003... * Nobody's New At MedPAC. The Medicare Payment Advisory Commission will have the same roster at least through spring 2004 as it had during the past year. In General Accounting Office chief David Walker's recently issued annual announcement of...

Allen Feezor, administrator of health benefits for the California Public Employees Retiree System, leaves the organization later this month. (People).(Brief Article)
June 2, 2003... Allen Feezor, administrator of health benefits for the California Public Employees Retiree System, leaves the organization later this month. Feezor, who is also a member of the Medicare Payment Advisory Commission, reportedly will take a...

Gordian Health Solutions, Inc. (People).(Brief Article)
June 2, 2003... President Gregg Lehman has departed the employer health-benefits collective purchasing organization National Business Coalition on Health to become president of the Nashville-based risk- and disease-management company Gordian Health Solutions,...

National Committee on Quality Assurance. (People).(Brief Article)
June 2, 2003... Webber most recently served as vice president for public policy for the National Committee on Quality Assurance. Previously, he's held positions with the Consumer Coalition for Quality Health Care, the American Medical Peer Review Association,...

International Foundation of Employee Benefit Plans. (People).(Brief Article)
June 2, 2003... Chief executive officer of the Brookfield, WI-based International Foundation of Employee Benefit Plans is Michael Wilson, who replaced the retiring John Altobelli. Wilson previously headed an Arizona-based multispecialty physician organization,...

American Accreditation HealthCare Commission. (People).(Brief Article)
June 2, 2003... At URAC--the accreditation and standard-setting body formerly known as the American Accreditation HealthCare Commission--Lisa Gallagher holds the newly created post of senior vice president for information and technology accreditation. Her two...

National Chronic Care Consortium. (People).(Brief Article)
June 2, 2003... Jane Horvath, most recently deputy director of the Robert Wood Johnson Foundation-sponsored Partnership for Solutions, joined the National Chronic Care Consortium as vice president for policy April 1. Horvath has previously held posts at the...

Coverage tax credits--money isn't everything. (Perspectives).
June 2, 2003... This is the second in a Perspectives series on tax credits. The first appeared on May 26. When it comes to expanding health coverage to the uninsured, about the only mechanism that nearly everyone agrees is worth trying is a tax credit to...

PPOs won't prolong Medicare solvency, says CMS. (Medicare Private Plans).
June 9, 2003... Adding preferred provider organizations to Medicare, as the White House strongly advocates, won't significantly improve the program's long-term solvency, according to a Centers for Medicare and Medicaid Services actuarial projection released by...

Senate Finance produces bipartisan Rx plan. (Medicare Prescription Drugs).
June 9, 2003... Senate Finance Committee Chair Chuck Grassley (R-IA) and ranking Democrat Max Baucus (D-MT) unveiled a Medicare drug package June 5, and hope to gain panel approval of the legislation June 12. Under the plan, all beneficiaries who...

Confusion still reigns about Medicare outcome. (Medicare Overhaul).
June 9, 2003... It appears that the White House will see only minor pieces of its Medicare plan included in bills produced by Congress this summer. Bills may include a PPO option with slightly enhanced benefits such as more catastrophic or preventive-care...

Group: govs won't get their wish on Medicaid caps. (NGA Medicaid Proposal).
June 9, 2003... The National Governors Association task force on Medicaid is expected to ask the federal government to take over all health-care costs for people who are dually eligible for Medicare and Medicaid, an obligation the left-leaning Center on Budget...

CMS issues final outlier rule. (Medicare Outlier Payments).(Centers for Medicare and Medicaid Services)
June 9, 2003... Hospitals will have until Oct. 1, 2003, before their most up-to-date cost data is used to calculate "outlier" payments under the final rule issued June 5 by the Centers for Medicare and Medicaid Services. Outlier payments are designed to...

Senators agree on generic drug bill. (Generic Drugs).
June 9, 2003... A bipartisan compromise announced June 5 means the Senate is again likely to pass legislation designed to increase the availability of generic drugs. However, the package's prospects in the House and at the White House are still uncertain. ...

CMS: investors concerned about nursing homes. (Nursing Homes).
June 9, 2003... The view from Washington is that the view from Wall Street of the nursing home industry is pretty bleak. That's according to the latest Centers for Medicare and Medicaid Services Health Care Industry Market Update. Wall Street's assessment...

So maybe there just isn't much Medicaid fraud. (Medicaid Fraud).(Brief Article)
June 9, 2003... The federal government collected over $1.3 billion in health-care fraud recoveries in fiscal year 2001. So far, so good, says a report sponsored by the nonpartisan Taxpayers Against Fraud Education Fund. But there's a hitch. More than $1...

Cost of covering uninsured a "compared to what" question. (In Other News).(Brief Article)
June 9, 2003... Cost of Covering Uninsured A "Compared To What" Question. It would cost between $34 billion and $69 billion annually to expand coverage to all of the uninsured, depending on the mechanisms used, according to Urban Institute researchers Jack...

Thompson won't do second term. (In Other News).(Brief Article)
June 9, 2003... Thompson Won't Do Second Term. Health and Human Services Secretary Tommy Thompson told the Associated Press June 3 that he won't stay on for a second Bush presidential term. He also said that he's unlikely to challenge Sen. Russ Feingold (D-WI)...

Quixotic Oregon program meets its match in budget woes. (In Other News).(Brief Article)
June 9, 2003... Quixotic Oregon Program Meets Its Match In Budget Woes. Established with the rallying cry of "Ration dollars, not people" the Oregon Health Plan has offered coverage to many state residents who need it while conserving dollars by prioritizing...

Reporting program roster over 700 hospitals. (In Other News).(Brief Article)
June 9, 2003... Reporting Program Roster Over 700 Hospitals. As of May 30, 711 hospitals nationwide had committed to participate in the voluntary quality-reporting initiative spearheaded by the American Hospital Association and other industry groups, says AHA....

Office of Inspector General. (People).(Brief Article)
June 9, 2003... Dara Corrigan, who was director of program integrity for the Centers for Medicare and Medicaid Services, is the new Health and Human Services acting principal deputy inspector general, taking charge of the Office of Inspector General in the...

Health and Human Services. (People).(Brief Article)
June 9, 2003... Health and Human Services Secretary Tommy Thompson has appointed Scott Whitaker his chief of staff. He has been HHS assistant secretary for legislation since February 2001. Before that, the 35-year-old Whitaker was an aide to Sen. Don Nickles...

Fluor Corporation. (People).(Brief Article)
June 9, 2003... David Marventano, chief of staff for the House Energy and Commerce Committee, leaves that post to become senior vice president for government affairs at the California-based Fluor Corporation, an engineering and construction company. ...

Note to readers. (People).(Correction Notice)
June 9, 2003... Note to Readers: In our April 7 issue, M&H incorrectly stated that two Kentucky "any willing provider" laws, upheld by the U.S. Supreme Court in Kentucky Assn. of Health Plans v. Miller, did not apply to self-insured health-benefit plans....

New disease sources, workforce woes bedevil public health. (Perspectives).
June 9, 2003... This is the second part of a two-part Perspectives on public-health infrastructure issues brought into focus by the emergence of SARS. The first was published May 19. Thank goodness for SARS? To the extent that the newly emerged...

Senate Finance approves drug bill ... (Medicare Rx Drugs).
June 16, 2003... After an all-day June 12 mark-up, the Senate Finance Committee approved a bill that would add prescription drugs to Medicare and carve out a new role in the program for preferred provider organizations. The 16 to 5 favorable vote evidenced...

... And House GOP unveils proposal. (Medicare Rx Drugs).
June 16, 2003... At a June 12 briefing, House GOP staffers said their bill would also cost $400 billion. They emphasized that the House's standard drug benefit would be more front-loaded than the Senate's. After a $250 deductible, the government would pay 80...

Tobacco industry pushing products it calls lower-risk. (Tobacco).
June 16, 2003... Two House committees June 3 entertained tobacco-industry pleas for the Federal Trade Commission to allow advertising of some tobacco products, including chewing tobacco, as lower risk alternatives to smoking traditional cigarettes. Energy...

Wyden: NIH ignored patient, taxpayer costs for Taxol. (NIH).
June 16, 2003... The National Institutes of Health had the authority to get a better deal for taxpayers and patients when it negotiated rights for the cancer drug Taxol, whose development relied heavily on NIH research. But the agency didn't use its clout to...

Baldacci introduces revised Maine Rx. (Prescription Drugs).
June 16, 2003... Maine Governor John Baldacci has proposed a revised version of the state's Maine Rx initiative, designed to provide access to affordable prescription drugs to Mainers without pharmaceutical coverage. The Governor said the new initiative, dubbed...

Weiss: caps don't bring quick premium relief. (Medical Liability).
June 16, 2003... Caps on non-economic damages in medical liability cases won't give physicians the quick relief from high malpractice insurance premiums they are looking for, according to a June 3 analysis by Weiss Ratings, Inc. Weiss looked at the...

House Panel approves AHP legislation. (In Other News).(Brief Article)
June 16, 2003... * House Panel Approves AHP Legislation. Legislation allowing small-business and other associations to offer health-insurance coverage free of state regulation (H.R. 660) was approved by the House Education and the Workforce Committee June 11....

Generics advance by rule and legislation. (In Other News).(Brief Article)
June 16, 2003... * Generics Advance By Rule and Legislation. On June 12, the Food and Drug Administration issued a final rule limiting brand-name drugmakers to one thirty-month "stay" of a generic competitor's entry into the market during patent litigation. The...

House approves partial birth abortion ban. (In Other News).(Brief Article)
June 16, 2003... * House Approves Partial Birth Abortion Ban. As expected, the House voted 282-139 on June 4 to ban "partial birth abortions." Like the prohibition passed earlier by the Senate, the bill defines the procedure as delivering a living fetus either...

CMS proposes SNF payment fix. (In Other News).(Brief Article)
June 16, 2003... * CMS Proposes SNF Payment Fix. On June 10, the Centers for Medicare and Medicaid Services proposed using actual rather than forecast data to calculate the skilled nursing facility market basket. SNFs would see an upward PPS adjustment of 3.26...

Doctors think cost-efficient treatment benefits insurance companies, not patients. (In Other News).(Brief Article)
June 16, 2003... * Doctors Think Cost-Efficient Treatment Benefits Insurance Companies, Not Patients. Asked in a variety of scenarios whether they'd choose a marginally more effective but more expensive screening, physicians chose the more expensive option...

Fraud hunters will follow drug money, seek non-reporters. (In Other News).(Brief Article)
June 16, 2003... * Fraud Hunters Will Follow Drug Money, Seer Non-Reporters. Perhaps the top activity for state and federal fraud busters these days is following pharmaceutical money through the complex health-care system, two federal enforcement officials said...

PhRMA fights price controls as elections near. (In Other News).(Brief Article)
June 16, 2003... * PhRMA Fights Price Controls As Elections Near. The brand-name pharmaceutical industry's main trade group, the Pharmaceutical Research and Manufacturers of America, will spend at least $150 million on lobbying activities this year, up 23...

American Association for Homecare. (People).(Brief Article)
June 16, 2003... Kay Cox is American Association for Homecare's president and chief executive officer, beginning June 1. Most recently, she's been vice president of skilled-nursing-facility giant Beverly Enterprises' Washington office and political action...

National Alliance for Health Information Technology. (People).(Brief Article)
June 16, 2003... Scott Wallace is the first president and chief executive officer of the National Alliance for Health Information Technology, an industry coalition devoted to promoting development of voluntary IT standards for health care. He was principal...

National Health Council. (People).(Brief Article)
June 16, 2003... Marc Boutin is the new vice president for policy development and advocacy at the health-care umbrella group National Health Council. Previously, he was vice president for government relations at the American Cancer Society's New England...

2002 cost trend slows; but angst for future grows. (Perspectives).
June 16, 2003... This is the first in a Perspectives series on healthcare cost trends, their causes and potential effects. Health care spending per privately insured person increased 9.6 percent in 2002, slightly less than 2001's 10 percent spending rise....

Medicare overhaul advances in house ... (Medicare Rx).
June 23, 2003... Medicare beneficiaries would receive 100 percent coverage of drug expenses after spending $3,500 out-of-pocket under bills approved by two House committees last week. That's down from $3,700 in the proposal unveiled June 12 by Ways and Means...

... Senate bill still on path to passage ... (Medicare Rx).
June 23, 2003... In the Senate, there is still a ways to go before a final product. However, it's looking more and more like the bill authored by Finance chair Charles Grassley (R-IA) and senior panel Democrat Max Baucus (MT), S. 1, will be approved with...

... Endgame up to White House. (Medicare Rx).
June 23, 2003... Most Democrats supporting Grassley-Baucus would not support the direct competition between FFS Medicare and private plans envisioned in the House approach. Therefore, whether a Medicare bill is finally enacted is likely to depend on whether the...

Costs soaring, CalPERS edges toward regional premiums. (CalPERS).
June 23, 2003... Premiums for health coverage in the California Public Employee Retirement System will rise between 16.7 and 18.4 percent, on average, for 2004, the 1.2-million-member system announced June 18. The substantial hike nevertheless represents...

Financial analysts: drug-only plans a no-go. (Medicare Drug Plans).(Brief Article)
June 23, 2003... The Medicare prescription-drug legislation being debated in Washington proposes private drug-only insurance plans--presumably operated by pharmacy benefit management companies--that would take on some insurance risk to participate in the...

CMS can't, congress might can whole-hospital exemption. (Specialty Hospitals).
June 23, 2003... The rise of specialty hospitals funded mainly by physician investors is a recent phenomenon that many believe increases questionable service utilization and threatens the viability of full-service hospitals. Both Congress and the Centers for...

MedPAC pushes pay for quality, competitive pricing. (MedPAC).
June 23, 2003... To provide high-quality, cost-effective treatment, Medicare must launch demonstration projects exploring financial-reward systems for top-quality providers and expand its use of competitive pricing, the Medicare Payment Advisory Commission...

Still mysterious SARS requires global cooperation. (SARS).(Brief Article)
June 23, 2003... SARS, "the first severe and readily transmissible new disease to strike a globalized society," demonstrates the importance of global public-health cooperation, the World Health Organization said last week. SARS remains a serious threat in...

Finance Acts to preserve SCHIP funds. (In Other News).(State Children's Health Insurance Program)(Brief Article)
June 23, 2003... * Finance Acts To Preserve SCHIP Funds. The Senate Finance Committee June 12 unanimously approved legislation to prevent states from losing $2.7 billion in unspent State Children's Health Insurance Program funds. States have three fiscal...

As Maine goes? (In Other News).(Brief Article)
June 23, 2003... * As Maine Goes? The Democrat-controlled Maine state legislature June 13 approved an ambitious plan to insure all state residents and curb health spending through voluntary price caps and restraints on new-facility construction. Under Dirigo...

House approves AHP bill. (In Other News).(Brief Article)
June 23, 2003... * House Approves AHP Bill. The House voted 262-162 to allow small businesses to pool together to purchase insurance through "association health plans," which could operate free of most state coverage mandates and insurance regulations. Previous...

Hospital outcomes demo to go forward. (In Other News).(Brief Article)
June 23, 2003... * Hospital Outcomes Demo To Go Forward. Agreement has been reached on terms of a Medicare demonstration project that would give hospitals a one or two percent bonus for achieving good patient outcomes in conditions like heart attack, hip...

CMS settles appeals suit. (In Other News).(Brief Article)
June 23, 2003... * CMS Settles Appeals Suit. Under a May 27 legal settlement, a dozen experts from the Medicare Coverage Advisory Commission will review whether Medicare should cover verteprofin for certain types of macular degeneration. CMS will have 60 days...

National Institutes of Health. (People).(Brief Article)
June 23, 2003... At the National Institutes of Health, John Burklow is associate director of communications. Previously, he's been deputy associate director and acting associate director. From 1986 to 1999, he was a communications officer for the National...

Supply, prices--not quality--push spending skyward. (Perspectives).
June 23, 2003... This is the second in a series of Perspectives on the new wave of cost concerns in health care. The first was published June 16. High prices paid to providers and revenue-boosting utilization increases that may do little or nothing to...

House and Senate vote to overhaul medicare. (Medicare Rx).
June 30, 2003... In the early morning hours of June 27, both the House and the Senate passed bills that would add a prescription drug benefit for seniors and increase the role of private preferred provider organizations in the program. The Senate passed...

House expands tax-favored health accounts. (Consumer-Directed Care).
June 30, 2003... The House voted 237-191 June 27, mostly along party lines, to dramatically expand opportunities to save money for health-related expenses and retirement. The House tacked HR 2596 onto HR 1, the Medicare prescription-drug bill, and it will...

Employers expect HMO rate increase in high teens. (2004 HMO Premiums).(Brief Article)
June 30, 2003... Premium increases for health maintenance organizations in 2004 will average 17.7 percent, according to preliminary estimates offered by around 140 large employers surveyed by the benefits consultancy Hewitt Associates. That means...

House would allow waiver of credit protections. (Health-Care Tax Credits).
June 30, 2003... The House June 19 voted 252-170 to give trade-displaced workers in some states the right to waive congressionally mandated consumer protections when they use the health-care tax credits provided in last year's trade bill. Republicans said...

Court: QIOs must tell complaining seniors more. (QIOs).
June 30, 2003... A Medicare quality improvement organization must tell a complaining beneficiary, at a minimum, whether or the QIO believes the beneficiary's treatment met "professionally recognized standards of health care." So said a unanimous...

RAND: Americans often don't get recommended care. (Health Care Quality).(Brief Article)
June 30, 2003... Americans receive recommended medical care only about half the time, according to a study by researchers from RAND Health that appeared in the June 26 New England Journal of Medicine. To conduct what RAND calls "the largest and most...

Expanding coverage is worth it for all, IOM panel insists. (Uninsured).
June 30, 2003... Many Americans fail to reach their developmental potential, and public programs like Medicare, the employment disability system, and the justice system incur substantial costs, as a result of high levels of uninsurance. So says the...

Med schools relieved, some wary of high court's call. (Affirmative Action).
June 30, 2003... The U.S. Supreme Court's June 23 decision upholding inclusion of racial criteria in university admissions processes "will not only affect higher education" but "will help ensure better health care for all Americans," according to Association of...

Bipartisan bill seeks cost-effectiveness data on drugs. (In Other News).(Brief Article)
June 30, 2003... * Bipartisan Bill Seeks Cost-Effectiveness Data On Drugs. Big payers who belong to the RxHealthValue coalition support bipartisan legislation developed by Rep. Tom Allen (D-ME) to produce evidence-based cost-effectiveness information on...

Labor-HHS appropriations clear House and Senate Committees. (In Other News).(Brief Article)
June 30, 2003... * Labor-HHS Appropriations Clear House And Senate Committees. The $27 budget of the National Institutes of Health would increase by $1 billion under the fiscal year 2004 spending bill for the departments of Health and Human Services, Labor, and...

Nobody knows what to do about flood of imported counterfeit drugs. (In Other News).(Brief Article)
June 30, 2003... * Nobody Knows What To Do About Flood Of Imported Counterfeit Drugs. Years of investigations keep turning up the same old thing, said Republican and Democratic members of the House Energy and Commerce Oversight and Investigations Subcommittee...

Who does the CMS actuary work for, anyway? (In Other News).
June 30, 2003... * Who Does The CMS Actuary Work For, Anyway? That was a question hotly contested last week between House Democrats and Centers for Medicare and Medicaid Services Administrator Tom Scully. In February 2000, CMS's chief actuary Rick Foster...

Food and Drug Administration. (People).(Brief Article)
June 30, 2003... Michael Friedman, MD, who in the 1990s served in a variety of positions at the Food and Drug Administration, including as acting commissioner, is the president of Los Angeles' City of Hope medical and researchcenter. Most recently, he worked on...

Medicare RX: even when it's over, it won't be over. (Perspectives).
June 30, 2003... Medicare legislation to add a prescription-drug benefit and inject more private health-plan competition into the program has passed both houses of Congress. But uncertainties still abound, starting with whether a conference committee can bridge...