Medicine & Health articles from November 2003

Medicine & Health archives from November 2003

Negotiators get a visit, but end not yet in sight.(Medicare Conference)
November 3, 2003... It was House Democrats that crashed the Oct. 30 meeting of Medicare negotiators, but House Republicans may prove the more serious obstacle for final passage of a Medicare bill. Reps. Charles Rangel (D-NY) and Marion Berry (D-AK),...

ED use: up for most, but for different reasons.(In Medicine & Health Perspectives this week ...)
November 3, 2003... Both the insured and the uninsured have been visiting hospital emergency departments more often, but for significantly different reasons. This is the picture offered by the Center for Studying Health System Change in a recent issue brief,...

Is revenue drain the cost of coverage portability?(Health Savings Accounts)
November 3, 2003... One--of several--remaining high hurdles to enacting Medicare prescription-drug legislation is a House provision that would greatly expand the use of tax-favored savings accounts to pay for medical expenses. The accounts--christened health...

Senate adds almost $300 million.(Global Infectious-Disease Funds)
November 3, 2003... The Senate passed its version of the foreign operations appropriations measure Oct. 30, after adding $289 million in additional money to fight international AIDS, tuberculosis, and malaria. The new dollars, contained in an amendment by Mike...

Hospitals see widening wealth gap.(Hospital Capital Access)
November 3, 2003... It's not only individuals who are increasingly concentrated at the far ends of the U.S. economic spectrum. Hospitals too are experiencing a widening have/have-not gap, especially when it comes to the ability to access capital. That's the...

CMS announces cut, but congress may reverse.(Physician Reimbursement)
November 3, 2003... Physicians are slated to receive a 4.5 percent cut in Medicare reimbursement under a final rule scheduled for publication in the Nov. 7 Federal Register Sen. Charles Grassely (R-IA) told reporters Oct. 30 that congressional Medicare...

Fracas over sex studies heats up, AAAS weighs in.(Health Research)
November 3, 2003... The American Association for the Advancement of Science--the world's largest general federation of scientists--fought back Oct. 30 against an initiative by conservatives to curtail National Institutes of Health funding for over 150 research...

Commissioned Corps transformation transformed.(In Other News)
November 3, 2003... Commissioned Corps Transformation Transformed. World-class scientists won't be drummed out of the Public Health Service Commissioned Corps because they can't do enough push-ups, U.S. Surgeon General Richard Carmona, MD, told the House...

Group starts campaign to repeal California Insurance Mandate.(In Other News)
November 3, 2003... Group Starts Campaign To Repeal California Insurance Mandate. Now that California voters have recalled Gov. Gray Davis (D), who recently signed "play or pay" legislation into law, a business coalition wants to recall the new law as well. ...

Help approves bar on recreational injury exclusions.(In Other News)
November 3, 2003... HELP Approves Bar On Recreational Injury Exclusions. Under S 423, approved by the Senate Health, Education, Labor and Pensions Committee Oct. 30, insurers and health plans could not "deny benefits otherwise provided for the treatment of an...

Jerome Hauer is leaving the position of acting assistant director for public-health-emergency preparedness for the U.S. Department of Health and Human Services.(People)
November 3, 2003... Jerome Hauer is leaving the position of acting assistant director for public-health-emergency preparedness for the U.S. Department of Health and Human Services. As of November, he joins George Washington University's Response to Emergencies and...

Former Office of Management and Budget lead Medicaid analyst Chiquita White joins the Health Strategies Consultancy.(People)
November 3, 2003... Former Office of Management and Budget lead Medicaid analyst Chiquita White joins the Health Strategies Consultancy.

Joining Health Strategies from the Congressional Budget Office is Alexis Ahlstrom.(People)
November 3, 2003... Joining Health Strategies from the Congressional Budget Office is Alexis Ahlstrom. She's worked in CBO's cost-estimating division, analyzing costs of legislation on such issues as Medicare provider payments and health insurance.

New on the health information-technology staff at the consultancy Health Strategies is Sheera Rosenfeld.(People)
November 3, 2003... New on the health information-technology staff at the consultancy Health Strategies is Sheera Rosenfeld. Previously, she was managing director of a nonprofit research group, HealthTech; a senior associate at The Lewin Group; and an analyst for...

Premium support, health savings accounts, more, still unresolved with time running out.(Medicare Conference)
November 10, 2003... Congressional Medicare negotiators are not giving up, but it's fair to say the odds seem relatively long against a conference report emerging, and even longer against any report passing in both the House and Senate. For the first time last...

How far is it from e-record vision to reality?(In Medicine & Health Perspectives this week ...)
November 10, 2003... This is the second in an occasional Perspectives series on electronic health records. The first appeared in our Oct. 20 issue. Electronic-health-record initiatives and products are emerging at health plans and hospitals around the country....

Minority med-school applicants rise, matriculants fall.(Physician Pipeline)
November 10, 2003... After declining for six years, the number of applicants to U.S. medical schools finally rose for the 2003-2004 academic year, posting a 3.4 percent increase in the overall applicant pool to nearly 35,000 applicants. Applications rose for...

Fewer EDs, fewer poor at specialty facilities.(Specialty Hospitals)
November 10, 2003... Compared to general hospitals, specialty hospitals treat smaller numbers of poor patients, and they are much less likely to have emergency departments, according to a General Accounting Office report released Oct. 22. Specialty hospitals,...

Danzon: nations' Rx R&D contributions about right.(Rx Pricing)
November 10, 2003... In arguing against allowing Americans to buy less expensive prescription drugs from abroad, Food and Drug Administration head Mark McClellan, MD, has argued that the real answer to high U.S. drug prices is for other developed nations to step up...

Federal panel supports switch to new system.(Coding)
November 10, 2003... The standards and security subcommittee of the National Committee on Vital and Health Statistics has unanimously approved a draft recommendation for national adoption of a new medical coding system, ICD-10--the International Classification of...

On the money front, we ain't seen nothin' yet.(Health Spending)
November 10, 2003... Technology seems to be diffusing from the most seriously ill, highest-utilizer patients down to the next highest utilizers, said Wellmark Blue Cross Blue Shield Chief Medical Officer Dale Andringa, MD. An analysis of recent cost trends by...

If Medicare bill were enacted, PPOs would be happy covering between 10 and 20 large regions nationwide.(In Other News)
November 10, 2003... * If Medicare Bill Were Enacted, PPOs Would Be Happy Covering Between 10 And 20 Large Regions Nationwide.... The Medicare+Choice program works only in urban areas because lawmakers structured it to allow health plans to pick counties they'd...

... And DM would be in, e-prescribing out.(In Other News)
November 10, 2003... *... And DM Would Be In, E-Prescribing Out. A Medicare prescription-drug bill also most likely would include a mandate to integrate disease management into the program across the board, including in the government-run program, DM advocate Rep....

If Medicare bill falls, AWP rule will emerge quickly.(In Other News)
November 10, 2003... * If Medicare Bill Falls, AWP Rule Will Emerge Quickly. If a Medicare prescription-drug bill doesn't emerge from Congress this year, the Centers for Medicare and Medicaid Services will be "pretty quick" to issue a new rule dumping the so-called...

Justices to tackle health-plan negligence question.(In Other News)
November 10, 2003... * Justices To Tackle Health-Plan Negligence Question. The Supreme Court will decide whether participants in employer-based health plans may sue in state court for negligence when they are injured by a plan's refusal to pay for...

Bush signs abortion restriction, which judges immediately block.(In Other News)
November 10, 2003... * Bush Signs Abortion Restriction, Which Judges Immediately Block. On Nov. 5, President Bush signed Congress' newly passed ban on "partial birth" abortions, a term coined by the bill's authors that does not exist in medical literature....

The CMS quality bandwagon rolls on.(In Other News)
November 10, 2003... * The CMS Quality Bandwagon Rolls On. The Centers for Medicare and Medicaid Services went national Nov. 3 with home health quality reporting. Expanding on an eight-state pilot program, CMS posted 11 quality indicators for home health agencies...

Sneaking fondness for single-payer grows.(In Other News)
November 10, 2003... * Sneaking Fondness For Single-Payer Grows. Fifty-five percent of people with employer-based health coverage still say that system is best for the country. But uncertainty was evident in the annual Health Confidence Survey from the Employee...

Med students will be able to look before they leap.(In Other News)
November 10, 2003... * Med Students Will Be Able To Look Before They Leap. Before having to rank their residency program preferences for the computerized selection process run by the National Resident Matching Program, students will get a chance to see the...

The Senate Finance.(People)
November 10, 2003... The Senate Finance Committee is expected this week to confirm Michael O'Grady as Health and Human Services assistant secretary for planning and evaluation and Jennifer Baxendell Young as assistant secretary for legislation. O'Grady most...

Frist, Hastert propose premium support compromise.(Medicare Conference)(US health insurance concerns)
November 17, 2003... Senate Majority Leader Bill Frist (R-TN) and House Speaker Dennis Hastert (R-IL) shook up the stalled Medicare talks Nov. 12 with a compromise proposal on premium support, the direct competition between traditional Medicare and private plans...

Disease management evolves, as its Medicare fate hangs in balance.(In Medicine & Health Perspectives this week ...)
November 17, 2003... This is the first in a Perspectives series on disease management that M&H will publish periodically over the next several weeks. If the Medicare prescription drug bill finally sinks in ideologically troubled waters, down with the ship will...

Tough going likely in both house and senate.(issues in US health policy )
November 17, 2003... The task of coming up with a viable compromise will be extremely difficult. On the one hand, many conservatives, nervous about the unfunded entitlement expansion represented by a broad new benefit, believe that premium support is necessary to...

Business trends in large firms drive coverage loss.(Employer-Sponsored Coverage)
November 17, 2003... The changing nature of business in America is making large private firms--long the bedrock of employer-sponsored coverage--the newest venue of coverage erosion. That's according to an analysis for the Commonwealth Fund by George Washington...

Targeted solutions difficult.(worker health insurance coverage)
November 17, 2003... * One Company, Many Small "Establishments." A hitherto overlooked factor--the increase in number of smaller, geographically separate establishments per firm--also appears to have played a role, say the analysts. The number of...

House dems seek FTC scrutiny of WellPoint/Anthem deal.(Insurers)(merger could affect future of Blue Cross Blue Shield status)(Brief Article)
November 17, 2003... If it takes place as planned, the merger of for-profit WellPoint, Inc., and Anthem, Inc., the country's two largest Blue Cross Blue Shield plans, could "radically" increase chances that more Blues plans will soon convert to for-profit status....

Deal's effect on competition would be complex.(mergers in the US health care insurance markets)
November 17, 2003... Competitive-marketplace changes spawned by the WellPoint/Anthem merger would be different from those created by the union of national insurer UnitedHealth Group Inc. with regional Mid Atlantic Medical Services Inc., announced the same day as...

Can a national plan iron out local price variation?(Insurers)(national health care insurance in the US)
November 17, 2003... But could even more be at stake? Schaeffer, who is no stranger to running a giant health plan--he headed the Health Care Financing Administration from 1978 through 1980--has suggested that he envisions his new private-sector giant as...

Acting IG seeks to distance office from Rehnquist era.(Office of Inspector General)(acting Inspector General Dara Corrigan)
November 17, 2003... When reporters arrived at the Health and Human Services Office of Inspector General Nov. 10 for a "meet and greet" with Acting Principal Deputy IG Dara Corrigan, the lone non-press-office staff member to say hello was Deputy IG George Grob. ...

CMS rule creates new appeal tool.(Medicare Appeals)
November 17, 2003... A final rule published in the Nov. 7 Federal Register rounds out the arsenal available to Medicare beneficiaries and others to request or appeal local and national coverage determinations. The rule implements portions of Section 522 of the...

Hospitals get 4.5 percent outpatient hike.(In Other News)(Brief Article)
November 17, 2003... Hospitals will get an average 4.5 percent reimbursement increase for outpatient services under the Centers for Medicare and Medicaid Services' 2004 Outpatient Prospective Payment System final rule, published in the Nov. 7 Federal Register. ...

Joint Economic Committee.(People)(appointment of senior health economist)(Brief Article)
November 17, 2003... Tom Miller--formerly director of health-policy issues for the Cato Institute--is now a senior health economist for the Joint Economic Committee. He'll focus on analyzing alternative private-sector means of providing insurance coverage outside...

Health-care consultant and futurist Russ Coile died Nov. 10 at the age of 60, of complications related to brain cancer.(People)(Brief Article)
November 17, 2003... Health-care consultant and futurist Russ Coile died Nov. 10 at the age of 60, of complications related to brain cancer. The Texas-based Coile was the editor of Russ Coile's Health Trends and wrote ten books on the future of health care.

Medicare agreement: premium support demo ... maybe.(Medicare Conference)
November 24, 2003... The most extensive revamping of Medicare since its 1965 inception moved close to enactment Nov. 20, when House and Senate negotiators filed a 681-page bill that would add a prescription drug benefit and increase the role of private health plans...

What the drug benefit looks like now.(In Medicine & Health Perspectives this week ...)(Medicare prescription drug benefits)
November 24, 2003... After months in flux, Medicare prescription-drug legislation--which Congress may pass this weekend--is complete. Herewith, some details of the conference agreement, focusing on the main event--the prescription-drug benefit itself. *...

Medicare bill retains reimportation restrictions.(Medicare Legislation)(reimportation of prescription drugs)(Brief Article)
November 24, 2003... The movement to import less-expensive, Food and Drug Administration-approved medications from Canada has gone way beyond the old-style bus trip across the border. Mayors and governors--including the Republican governor of Minnesota--have moved...

McCain panel mulls novel drug-buying options.(Prescription Drug Prices)(Senate Commerce hearings)
November 24, 2003... "Show me the dead Canadians." That was the demand of Minnesota Gov. Tim Pawlenty (R) at a Nov. 20 Senate Commerce panel hearing. Convened even as some lawmakers demanded greater leeway for Americans to buy prescription drugs from Canada and...

Reimportation: European style.(parallel trade in pharmaceuticals )(Brief Article)
November 24, 2003... One option, said Donald MacArthur, secretary general of the European Association of Euro-Pharmaceutical Companies, would be a 20-year-old buying program widely used in Europe: parallel trade. Parallel trade "occurs when products are...

Lobbies behind medicare bill have big stakes.(Medicare Legislation)
November 24, 2003... One of the stories in the Medicare endgame has been the massive lobbying campaign behind the bill. The Capitol Hill newspaper The Hill said the House Republicans' thrust, involving some 400 groups as far removed from Medicare as the Securities...

CMS pleased with error-rate program, Grassley not so much.(Medicare Improper Payments)(Centers for Medicare and Medicaid Services)
November 24, 2003... The rate of improper payments made by the Medicare program in fiscal year 2003 dropped to 5.8 percent--$11.6 billion--an improvement over the 6.3 percent rate in 2002 and 2001. That's according to the Centers for Medicare and Medicaid Services,...

Flexibility to manage, dump contractors key, says cully.(Medicare error rates in dispute)
November 24, 2003... In an irate Nov. 14 letter to Principal Deputy IG Dara Corrigan, Grassley--who opposed switching the audit to CMS from the OIG--wrote that he's suspicious of the whole enterprise: "Today, CMS and AMC provided Congress with two Medicare error...

Uninsured problem bigger through longer-term lens.(Uninsured)
November 24, 2003... Nearly two out of every five people, or about 85 million Americans, were uninsured at some point during the four years from 1996 to 1999, according to an analysis by Pennsylvania State University's Pamela Short in the November/ December Health...

FTC gives green light to MGMA doc pay survey.(In Other News)(Medical Group Management Association)(Brief Article)
November 24, 2003... The Medical Group Management Association may publish survey data on health-plan payments and physicians' views of insurer contracts without running afoul of antitrust considerations, the Federal Trade Commission advised in a Nov. 3 letter. ...

Urban Institute.(People)(Brief Article)
November 24, 2003... Robert Berenson, MD, has joined the Urban Institute's health policy group as a senior fellow. Berenson, who oversaw Medicare health plans during the Clinton administration, has most recently been a consultant to AcademyHealth.

Pharmaceutical Care Management Association.(People)(Brief Article)
November 24, 2003... Assistant vice president for state affairs at the Pharmaceutical Care Management Association is Barbara Levy. Most recently, she was legislative director and counsel for state affairs at the Health Insurance Association of America.

PCMA.(People)(Pharmaceutical Care Management Association)(Brief Article)
November 24, 2003... Brian McCarthy is executive director for corporate development at PCMA Previously, he worked in corporate relations for the American Council of Life Insurers.

National Center for Complementary and Alternative Medicine.(People)(Brief Article)
November 24, 2003... John Killen, MD, is director of the office of international health research at the National Center for Complementary and Alternative Medicine. A 21-year employee of the National Institutes of Health, Killen has specialized on research ethics...