Medicine & Health articles from November 2005

Medicine & Health archives from November 2005

Report predicts part D disaster if 2006 enrollment is low: to succeed, PDPs must include all types of benes.(PDPs)
November 7, 2005... Premiums for Medicare prescription drug plans could skyrocket in 2007--if many low-utilizing beneficiaries decide against 2006 PDP enrollment, analysts reported at the recent National Medicare Prescription Drug Congress. If large numbers...

Medicare launches physician voluntary reporting program: CMS phases in quality measurements to facilitate performance improvement.(Pay-For-Performance)
November 7, 2005... With lackluster Medicare reimbursement plaguing physicians nationwide and lawmakers straining federal health care programs' already meager funding, one new federal program may provide a win-win solution to both health care providers and...

New CMS drug Web site draws ire: the agency acknowledges incomplete, potentially misleading data.(Prescription Drugs)(Centers for Medicare & Medicaid Services)
November 7, 2005... Medicare's new Internet-based tool for beneficiaries, the "Prescription Drug Plan Finder," is already garnering some negative reviews from public advocates and members of Congress. Most arguments from both sides claim that the plan finder...

Draft legislation would override states' privacy standards for EHRs: bill may ease IT restrictions on physicians.(EHRs)
November 7, 2005... Influential lawmakers have proposed a bill to override the patchwork of state privacy laws that they claim threaten to make an electronic national health information exchange a practical impossibility. House Ways and Means Health...

The future of health care: how many will be left behind? Number of uninsured grew by 6 million over the last four years.(Health Care)
November 7, 2005... The country's health system is undergoing a dramatic shift--the burden of supplying coverage is falling to federal and state governments, as private corporations continue to scale back benefits. But because most safety nets cover only children,...

Health care fraud unit nets $1.51 billion for Medicare in 2004: Feds have most success prosecuting big pharma, physicians.(Fraud)
November 7, 2005... Federal and state governments' intense focus on combating health care fraud has paid off in a big way. A report for 2004 has revealed blockbuster Medicare and Medicaid fraud proceeds, encouraging fraud fighters to continue to investigate and...

In other news ...(United States. Department of Health and Human Services. Centers for Medicare and Medicaid Services)(Brief Article)
November 7, 2005... When the competitive acquisition program for Medicare Part B drugs begins on July 1, 2006, physicians may have a clearer picture of their arrangements with vendors for collecting coinsurance and related information. The Centers for...

President threatens veto if Medicare stabilization fund is cut; administration pressures Congress on cost-saving measures.(Medicare)
November 14, 2005... President Bush has vowed to veto the Senate version of a deficit-reducing budget package that includes elimination of the Medicare Advantage Regional Plan Stabilization Fund, intended as an inducement for Preferred Provider Organizations to...

Federal health care safety net close to breaking: South has highest, fastest-growing rate of uninsured adults, study shows.(Uninsured)
November 14, 2005... Barring drastic changes in this country's health-care system, the hard truth for millions of middle-class Americans is that eventually the only way they'll be able to obtain coverage is to buy their own private plans. Increasingly, corporations...

Bush, Levitt unveil bird flu strategies--but not without criticism; plans have significant problems, some Democrats complained.(Policy)
November 14, 2005... On the heels of President Bush's $7 billion plan he announced Nov. 2 to combat a potential national bird flu epidemic, Health and Human Services Secretary Mike Leavitt has released the medical and public health component of the president's...

United States ranks poorly for health care errors, six-nation study found; despite problems, no single country emerges as systematically the best or worst.(International Health)
November 14, 2005... One-third of patients with health problems in the United States report experiencing medical, medication or test errors--the highest rate of any nation in a new international study by the Commonwealth Fund. In comparison with many other...

Medicaid may be failing children with developmental disabilities: but Medicaid may also have the key to better developmental screenings.(Medicaid Managed Care)
November 14, 2005... One organization has not only raised doubts about whether Medicaid is doing enough for poverty-stricken children, but also offered strategies to improve the program's efforts to catch and react to children's developmental delays. The...

Physicians' medicare payment rate will take a 4.4-percent hit next year; CMS removes care management activities from inhalation-drug dispensing fees.(Physicians)
November 14, 2005... While the Centers for Medicare & Medicaid Services has socked physicians with a pay cut for 2006, the Medicare Physician Fee Schedule final rule does have a silver lining for doctors. CMS will reduce physicians' payment rates per service by...

Red tape hampers FDA as illegal prescription-drug importation booms: limited data makes the safety of illegally imported prescription drugs difficult to gauge.(Prescription Drugs)
November 21, 2005... The volume of prescription drugs illegally imported into the United States is huge--and increasing. Despite the Food and Drug Administration's efforts to encourage mail facilities' practices of detecting and destroying packages that contain...

Privacy, security worries could thwart health IT efforts: many Americans are unaware of their medical information privacy rights.(Privacy)
November 21, 2005... The federal government's sweeping efforts in recent years to tighten up privacy laws relating to patients' health information have been lost on most health care consumers, a new survey reveals. Further, patients' skepticism of health...

Support for P4P gains steam, but application concerns remain: why P4P might not work for Medicare and PPO providers.(Pay-For-Performance)
November 21, 2005... Pay-for-performance advocates got a big shot in the arm this week: the most comprehensive study of its kind shows that these programs can improve patients' quality of care. Essentially, P4P gives providers a financial incentive to seek...

Could 'Managed Consumerism' strengthen health care? This is one way to provide universal coverage without hurting competition, study says.(Coverage)
November 21, 2005... Combing a market-oriented and managed-care approach to health care could be the answer to securing universal coverage without sacrificing the competition that fuels major improvements to the longevity and quality of life. So says a new...

Successful reductions in improper payments mean more scrutiny for providers: targeted oversight and provider education results in $9.5 billion in savings.(Physicians)(Brief Article)
November 21, 2005... Saving a lucrative $9.5 billion from 2004, the Centers for Medicare & Medicaid Services slashed improper Medicare fee-for-service payments nearly in half during 2005. On Nov. 10, CMS revealed its analysis of FFS improper-payment error...

CMS gets more heat for Part D, plan finder tool: private plans' involvement in administering the benefit could be the problem.(Medicare Part D)
November 21, 2005... Yet another patient-advocacy group has slammed the Centers for Medicare & Medicaid Services' new online "Plan Finder," charging that the tool--and the new Medicare prescription drug program itself--is too complicated for seniors. Medicare...

Medicare's inpatient hospital care bill for 2003 was a whopping $327 billion, according to statistics that the Agency for Healthcare Research and Quality released Nov. 16.(In Other News ...)
November 21, 2005... Medicare's inpatient hospital care bill for 2003 was a whopping $327 billion, according to statistics that the Agency for Healthcare Research and Quality released Nov. 16. Just 10 major conditions accounted for 41 percent of the hospital...

Spending caps for nonhospital outpatient therapy services have been in place since 1997.(In Other News ...)(Brief Article)
November 21, 2005... Spending caps for nonhospital outpatient therapy services have been in place since 1997, but their frequent moratoriums could soon end. The end-of-year expiration of the current therapy cap moratorium has prompted a Nov. 10 Government...

In a move noteworthy in its attempt to expand and target coverage for psychological illnesses, Aetna has announced a new effort to improve point-of-care assessment and treatment practices for patients with depression.(In Other News ...)
November 21, 2005... In a move noteworthy in its attempt to expand and target coverage for psychological illnesses, Aetna has announced a new effort to improve point-of-care assessment and treatment practices for patients with depression. The insurer cited as the...

The Centers for Medicare & Medicaid Services may have won an important battle this year.(In Other News ...)(Brief Article)
November 21, 2005... The Centers for Medicare & Medicaid Services may have won an important battle this year by cutting improper Medicare fee-for-service payments in half--but the war on fraud is far from over. CMS is continuing to beef up data trend analyses...

Senate passes landmark health IT bill to promote EMRs, physician incentives: legislation could kick-start HIT adoption through government funding, technology standards.(HIT)
November 28, 2005... The Senate approved the Wired for Health Care Quality Act by voice vote on Nov. 18. The bipartisan legislation--the first health information technology bill Congress has ever passed--promotes utilizing HIT to expand the use of electronic...

Under pressure: EDs struggle to meet demand: why hospital EDs are treating more patients, but have fewer specialists.(Emergency Care)
November 28, 2005... Access to local emergency departments could be in trouble if the health care system doesn't fix several disturbing trends, such as patients' difficulty finding specialists to provide on-call coverage and the increased use of EDs for primary...

CMS, MedPAC, AMA have their say on Medicare: testimony flies from 3 sides as Congress strives to improve the program.
November 28, 2005... In Washington, DC last week, federal officials and physicians testified on how to get more value out of the Medicare program while preventing excess spending. During the session, Congress heard federal pleas for more performance-based physician...

Key PBM cases advance in 2 state courts: suits could cause big changes in PBM practices, experts say.(Litigation)
November 28, 2005... Two new court cases are putting pharmacy benefit managers" practices under the microscope again. And this time the state governments are the ones who want answers. The U. S. Court of Appeals for the First Circuit in Boston has found...

Proof is in the P4P demo, CMS says: participating hospitals cash in on bonuses for improving quality of care.(Pay-For-Performance)
November 28, 2005... The Centers for Medicare & Medicaid Services" landmark pay-for-performance demonstration, which it kicked off in 2003, is showing significant quality-of-care improvements in participating hospitals. And for the first time, the agency is...

Quantity and quality of care are not related, a recent study found.(In Other News ...)
November 28, 2005... Although California hospitals varied widely in the amount of care they provided--and the amount Medicare reimbursed them--for patients with similar chronic illnesses, the volume of care had no effect on medical outcomes or patient satisfaction....

PacifiCare shareholders assent to UnitedHealth merger--but CalPERS gave a thumbs down.(In Other News ...)(Brief Article)
November 28, 2005... An overwhelming majority of PacifiCare Health Systems Inc. shareholders approved UnitedHealth Group's proposed $8.1-billion purchase of the carrier, as more than 99 percent of shareholder votes favored the agreement, with 80 percent of...

The market share of the largest health plans in individual states has increased significantly since 2002, according to a recently released Government Accountability Office report.(In Other News ...)
November 28, 2005... The median market share of the largest small-group carrier has reached 43 percent, compared to 33 percent reported three years ago, the report noted. This median figure represents a range from 19 percent in Texas to 93 percent in North Dakota....

Highmark, Inc. has created health information technology fund for provider adoption.(Highmark eHealth Collaborative)(Brief Article)
November 28, 2005... The company has contributed $26.5 million to The Pittsburgh Foundation to establish the Highmark eHealth Collaborative. The first step of the project is to provide funding to physicians to help reduce the initial cost of acquiring e-prescribing...