Medicine & Health articles from October 2004

Medicine & Health archives from October 2004

GAO: demo PPOs did little to expand MA's geographic reach.(Medicare PPO Demo)
October 4, 2004... Medicare demonstration projects on preferred provider organizations did little to expand private-plan access to a wider range of beneficiaries--such as in rural regions--even though PPOs serving the private sector exist in virtually every...

DOC-owned specialty hospitals have clinical pros and cons.(In Medicine & Health Perspectives this week ...)
October 4, 2004... This is the third in a Perspectives series on policy issues related to physician-owned specialty hospitals. The second was published in our Sept. 27 issue. As health-care systems around the world struggle with the intertwined problems of...

Administraton, legislators fight over $1.1 billion in SCHIP money.(Children's Health Funding)
October 4, 2004... The Bush administration wants to earmark $1.1 billion in expiring children's health coverage funding for outreach efforts under the president's "Cover the Kids" initiative, announced at the Republican convention. "We believe that this $1.1...

Grassley, CMS: USP classes won't get formulary a free pass.(Medicare Prescription Drugs)
October 4, 2004... A Medicare health or drug-only plan's prescription-drug formulary that has the same therapy categories and classes as in the "safe harbor" model now in development by the United States Pharmacopeia may still be rejected as unsuitable by the...

Will higher-than-FFS payment solidify Medicare health plans?(Medicare Private Plans)
October 4, 2004... Not too long ago, many policymakers argued that bringing private plans to Medicare would save taxpayer dollars, since plans would deliver care far more efficiently than the traditional fee-for-service program. The argument was heard often in...

CMS to arrange another practical clinical study.(In Other News)
October 4, 2004... As the Centers for Medicare and Medicaid Services proposes to expand Medicare coverage of implantable cardioverter defibrillators, the agency under new Administrator Mark McClellan continues its push to develop scientific evidence to guide...

Dewine lays out GPO options, HIGPA opposes legislation.(In Other News)(Brief Article)
October 4, 2004... Robert Betz, CEO of the Health Industry Group Purchasing Organization, says his group wants to work with Congress "to explore non-legislative approaches for assuring that the changes that have been made in the HIGPA Code of Conduct remain...

HHS launches dispute resolution test.(In Other News)(Department of Health and Human Services )(Brief Article)
October 4, 2004... On Sept. 21, the Department of Health and Human Services launched an "early offer" pilot program designed to encourage early settlement of health-care lawsuits. The pilot program applies only to claims made against HHS, by people treated...

Quote of the week.(In Other News)
October 4, 2004... "We've been moving at the right pace in the wrong direction," Shiriki Kumanyika of the University of Pennsylvania School of Medicine said Sept. 30. She was speaking of fighting childhood obesity, but the beauty of the quote is that it could...

Federation of American Hospitals.(People)(Brief Article)
October 4, 2004... Joining the Federation of American Hospitals as vice president and general counsel is Jeffrey Miklos. Previously, he was a partner in the law firm of Foley & Lardner LLP. Howard Isenstein also joins FAH, as vice president for public...

U.S. loses half its vaccine doses for coming flu season.(Immunization)
October 11, 2004... The United States Oct. 5 received yet another reminder of the weakness of its immunization infrastructure: After finding evidence of contamination, United Kingdom health authorities suspended operations at Chiron Corp's UK manufacturing plant,...

Next steps tough to discern for covering poor, uninsured.(In Medicine & Health Perspectives this week )
October 11, 2004... The evidence is in. "No economy," no matter how robust, will be enough to "grow" the United States out of its health-care coverage dilemma. That was the verdict delivered by Project HOPE Senior Fellow Gail Wilensky, a top health-care adviser...

New demo will focus on high-cost Medicare beneficiaries.(Medicare Chronic-Care Improvement)
October 11, 2004... A new Medicare demonstration project looks to discover whether providers can improve care quality and trim spending by tailoring programs that target only the highest-cost beneficiaries. A number of care-management and care-coordination...

After MMA raise, Medicare private plans expand coverage.(Medicare Managed Care)
October 11, 2004... Medicare's private plans are seeking to expand coverage to 1.6 million additional seniors and persons with disabilities in 2005, Health and Human Services Secretary Tommy Thompson announced Oct. 6. This completes a turn-around for Medicare's...

Disease management, long-term care move up on state agendas.(Medicaid Cost Cutting)
October 11, 2004... What's hot in Medicaid? Disease management, according to data released Oct. 4 from the most recent round of an ongoing survey of state Medicaid programs conducted by the Kaiser Commission on Medicaid and the Uninsured. By 2005, 28 states...

Grassley: FDA suppressed Vioxx safety concerns.(Rx Drug Evaluation)
October 11, 2004... In Washington, it's a lot safer to go in against a Sicilian when death is on line than to have Sen. Charles Grassley (R-IA) think you're engaging in a cover-up. The Food and Drag Administration now finds itself accused by the Senate Finance...

House votes to promote state Rx drug monitoring.(Rx Drug Abuse)
October 11, 2004... In an effort to fight prescription drug abuse, the federal government would give states grants to establish monitoring programs under legislation, HR 3015, approved by the House in an Oct. 5 voice vote. States would not have to establish such...

New bill would regulate GPOs.(Hospital Purchasing)
October 11, 2004... Under legislation introduced Oct. 1 by Sens. Mike DeWine (R-OH) and Herb Kohl (D-WI), the Department of Health and Human Services would have new authority to regulate group purchasing organizations that negotiate the purchase of medical...

FDA tobacco regulation dropped from tax bill.(In Other News)(Brief Article)
October 11, 2004... It was the marriage that helped produce 78 votes for the Senate version of corporate tax legislation: A buy-out of tobacco farmers' production quotas coupled with a grant to the Food and Drug Administration of power to regulate tobacco...

Congress eager to see pay-for-performance recommendations.(In Other News)(Brief Article)
October 11, 2004... "Congress is putting a lot of pressure on" a new Institute of Medicine panel to speed up production of recommendations for creating provider-payment mechanisms to reward high-value, high-quality care. So said Project HOPE Senior Fellow Gail...

Dartmouth care-variation data shows more care can produce worse outcomes.(In Other News)(Brief Article)
October 11, 2004... Hospital-specific information demonstrating that higher utilization is not connected to better clinical outcomes--and in many cases may create worse ones--is now available in a set of papers published Oct. 7 on the Health Affairs Web site. ...

American's Health Insurance Plans.(People)(Brief Article)
October 11, 2004... Much traveled health economist Jeff Lemieux later this month will take the helm of American's Health Insurance Plans' new Center for Health Policy Research. For much of the 1990s, Lemieux was a Congressional Budget Office analyst. Since 1998...

McClellan's themes: care coordination, pay for performance.(Medicare Advantage)(Brief Article)
October 25, 2004... Whether 2003's Medicare Modernization Act will be effective in summoning private insurance plans to sign up--and stick around--to serve Medicare beneficiaries all across the country is still unknown. It's clear, however, that initial interest...

Flu worries highlight more than one public-health quandary.(In Medicine & Health Perspectives this week)
October 25, 2004... An Institute of Medicine panel hit it right on the nose in its Aug. 2003 report, Vaccines in the 21st Century: Assuring Access and Availability. The number of companies that manufacture vaccines has been dropping for decades and continues to...

CMS stresses tight timelines for MMA implementation.
October 25, 2004... CMS has recently reorganized--and flattened out--to facilitate accomplishment of its many MMA-related tasks, said Patricia Smith, head of the agency's Medicare Advantage group. With fewer layers of hierarchy, stakeholders seeking assistance may...

Bills would halt 75-percent rule, but will they pass this year?(Appropriations)
October 25, 2004... Against the wishes of the Bush administration, fiscal year 2005 spending bills in both houses of Congress seek at least a temporary halt to the so-called 75-percent rule for inpatient rehabilitation facilities. After a series of revisions...

Drafting of new bioterror bill renews old drug-patent fights.(Bioterrorism)
October 25, 2004... At an Oct. 6 Senate hearing, senators and witnesses sparred over a proposal to allow drug companies to add two years to the patent life of any drug in return for developing bioterror countermeasures. The proposal is contained in S 666,...

Corporate tax bill includes retiree-health changes.(Legislation)(Brief Article)
October 25, 2004... Under corporate tax legislation signed Oct. 22 by President Bush, large companies will have more flexibility in how they reduce retiree health costs in certain situations. Under current law, employers with defined-benefit pension plans are...

New law also excludes doc loan repayments from income.(Legislation)(Brief Article)
October 25, 2004... HR 4520 also helps health care professionals who get some of their educational loans paid back, either by states or the federal National Health Services Corps loan repayment program, in exchange for serving in areas with shortages of health...

Medical-error bill stuck over use of information in criminal cases.(In Other News)(Brief Article)
October 25, 2004... The House and Senate seem unlikely to resolve their differences in 2004 over patient-safety bills that both chambers passed earlier this year. After months of struggle, Senate Republicans and Democrats managed to agree this summer on...

House, senate both would extend J-1 visa waiver program, but face a hitch.(In Other News)(Brief Article)
October 25, 2004... In last-minute action, the House on Oct. 6 and the Senate on Oct. 11 passed separate bills authorizing extension of a program through which underserved rural and urban areas get access to foreign doctors. The bills have heavy backing from both...

McClellan announces new cancer-drug administration codes.(In Other News)
October 25, 2004... Effective Jan. 1, 2005, the Centers for Medicare and Medicaid Services is implementing 14 new physician payment codes covering the cost of administering anti-cancer drugs, agency administrator Mark McClellan announced in an Oct. 12 letter to...

IDSA, hatch cite need to encourage treatments for natural diseases, too.(In Other News)(Infectious Disease Society of America)(Brief Article)
October 25, 2004... As Congress discusses providing new incentives for the development of bioterrorism countermeasures, the Infectious Disease Society of America is urging legislators to extend those same incentives to treatments for naturally occurring infectious...

Centers for Medicare and Medicaid Services.(People)
October 25, 2004... New staff members are helping the Centers for Medicare and Medicaid Services handle new duties the agency has taken on as it prepares for full implementation of the Medicare Modernization Act in 2006.

Medicare.(People)(Brief Article)
October 25, 2004... Newly opened is the agency's first office to have full-time responsibility for managing Medicare policy and operations as it relates to employers. Mark Hamelberg, formerly of the William M. Mercer consultancy's Washington Resource Group, is the...

National Association of Chain Drug Stores.(People)(Brief Article)
October 25, 2004... Larry Kocot, formerly senior vice president and general counsel at the National Association of Chain Drug Stores, joins the agency's expanded center on prescription drug-related issues.

CMS.(People)(Brief Article)
October 25, 2004... New to CMS's health-plan division is David Lewis. He's moved over from the Office of Personnel Management, where he had broad oversight responsibilities for the operation of health plans in the Federal Employees Health Benefit Program.

Also temporarily joining CMS from OPM is Deputy Associate Director Abby Block, OPM's top administrator for health plans.(Centers for Medicare and Medicaid Services)(Brief Article)
October 25, 2004... Also temporarily joining CMS from OPM is Deputy Associate Director Abby Block, OPM's top administrator for health plans. She's detailed into CMS Administrator Mark McClellans's office as a senior advisor.