WEEKLY E-BULLETIN


340B Drug Discount Supporters Rush to Its Defense

Although no formal action has yet been taken by Congress, supporters of the 340B pharmaceutical discount program are wasting no time rushing to its defense.  Following a critical report against the program by Big Pharma interests two months ago and critical comments by US Senator Chuck Grassley (R-IA), program supporters issued their written rebuttal two weeks ago.  Then last week, supporters began circulating bipartisan letters written by Sens. Thune (R-SD) and Baldwin (D-WI) and Reps. Capito (R-WV) and Castor (D-FL) asking other senators and representatives to sign on and show their support for the program.  Click here for a copy of the House letter.  Click here for the Senate letter.  Call or email your senators and representatives today and urge them to sign on.  Click here for the study supporting 340B.  Click here for the report challenging the 340B program.

Leapfrog Releases Hospital “Hidden Surcharge Calculator”

In what has already evoked negative reaction from the American Hospital Association, The Leapfrog Group last week unveiled a new tool that allows purchasers to calculate how much they spend annually on unnecessary costs due to medical errors that occur within general acute care hospitals.  The Hidden Surcharge Calculator, developed by a team of experts, has been awarded Gold Standard status by the Disease Management Purchasing Consortium. The calculator is accompanied by Leapfrog’s descriptive white paper, “The Hidden Surcharge Americans Pay for Hospital Errors.” Click here to see how your hospital fares.

Report:  Hospital Acquired Infections Spreading at “Alarming Rate”

Hospital-acquired infections are spreading at an alarming rate, with 1.7 million Americans developing them each year at a cost of up to $45 billion, according to the Alliance for Aging Research.  Infections are becoming a national crisis, medical experts said during an event last week announcing the Alliance’s release of a new fact sheet about the growing problem. An estimated 99,000 people die from these infections each year and the numbers are expected to grow as the rate of infection rises and more Americans develop resistance to antibiotics. Click here for the 2-page fact sheet.

IOM Decides Against Certain Adjustments to Geographic Variations in Medicare Spending 

The Institute of Medicine (IOM) released a report last week on geographic variations in health care spending, utilization, and quality that is certain to continue to debate on the fairness of Medicare spending.  The IOM analyzed the variation in spending between geographic regions.  Ultimately, they recommended not to adopt a geographically based “value index” to adjust Medicare provider payments. The IOM argues that because medical decisions are made at the provider level, a geographic value index would be a poorly targeted mechanism for encouraging value improvement.  They also state that, because there is little uniformity in hospital costs within hospital referral regions, the adoption of a value index would reward low-value providers in high-value regions.  Click here for more from the IOM.

CMS Imposes Rare Moratorium on Provider Enrollment in 3 Cities

CMS announced late Friday that it was imposing a temporary moratorium on the enrollment of home health agencies in the Miami and Chicago areas and on ambulance companies in Houston.  “It is important to note that all of the moratoria target areas identified in this notice — Miami, Houston, and Chicago — are [fraud and abuse] Strike Force cities, and each of these areas has experienced intense, sustained criminal prosecution activity with respect to the provider and supplier types subject to these moratoria,” according to a notice posted in the Federal Register. Click here for that notice.  The federal health care law gave CMS the authority to impose moratoria on enrollment in regions with suspected fraud. The enrollment freeze applies to Medicare, Medicaid and CHIP and remains in effect for at least six months.

SGR Reform Bill Voted This Week; Some Docs Want Changes

The House Energy & Commerce Committee is scheduled to mark up its physician Medicare payment reform bill this week.  (Click here for an excellent summary.) Several doctors groups are asking the Committee to remove a provision in the bill that would allow a 1 percent cut in Medicare payments for “misvalued” services. The letter, signed by the American Medical Association, the American Academy of Family Physicians and the American College of Physicians, and other groups, opposed additional cuts.  Click here to read their 2-page letter.

US News Hospital Rankings Criticized

US News was out ten days ago with its new rankings of American hospital (click here) and the New York Times followed up last week with a “what does it all mean” story from one of its health care reporters.  Most of it was criticism of hospital advertising.  Click here for that.

House GOP Medicare Plan Not Well Received by Democrats

House Democrats are not supporting proposed legislation from House Republicans that would codify three proposals from President Obama’s FY2014 budget proposal: a new home health copayment requirement and increases in Part B and Part D fees for consumers.  Click here for a two-page summary.  Interested parties have until August 16 to send in comments.

Exchange Subsidies Challenged in Certain States

Can the Obama Administration provide exchange subsidies in those states that don’t have their own exchanges?  Some House Republicans continue to insist that it violates the law.  Emily McMahon, Treasury deputy assistant secretary for tax policy, will testify before the House oversight committee on Wednesday on why the administration thinks it can offer tax credits through the federal health exchanges. Oklahoma Attorney General Scott Pruitt, whose state is suing the administration over that decision, is also scheduled to testify. Critics say the law only authorizes subsidies in the state exchanges. Top Republicans also sent a letter to Treasury Secretary Jack Lew last week asking for more information about the decision on the tax credits.  Click here for the letter.

The Obamacare Debate Rages On

  • You may have missed it over the weekend, but the conservative group Young Gun Network debuted an ad during “Saturday Night Live” making fun of Obama administration efforts to market the law.  Click here to see the ad. The spot is airing about a month after Organizing for Action put out its first ad promoting the law’s benefits.  Click here to see the anti-Obamacare ad.  Click here to see the pro-Obamacare ad. 
  • The President was out across the country last week selling his name-sake health care law.  Click here to see what the White House strategy is.  Two GOP governors – Jindal from Louisiana and Walker from Wisconsin – wrote an op-ed critical of Obamacare last week.  Click here to read. 
  • And pharmacies have decided to help pitch Obamacare to their customers.  Click here for that story. 
  • Long time political scientist and commentator Norm Ornstein wrote a scathing article last week against the GOP for trying to destroy Obamacare.  It has some very interesting points.  Click here.
  • The total amount to be spent nationally on publicity, marketing and advertising to promote Obamacare will be at least $684 million, according to data compiled The Associated Press from federal and state sources. Click here for details.

New Health Insurer Internet Start Up Hopes to Revolutionize the Business

A $40 million start up in New York City is seeking to transform the health insurance market and it could only be done because of Obamacare, according to news reports.  The health insurance internet company hopes to make the insurance process so simple and responsive that it will drive consumers to it in droves.  Click here for the story.  Click here to see the site – which is still under development.

CMS Releases Document on Medicaid “Super-Users”

Five percent of Medicaid beneficiaries account for 54 percent of the program’s total expenditures, according to a report out last week from CMS on how hospitals can control Medicaid “super-users.”  The report said one percent account for 25 percent of the program’s total expenditures; eighty-three percent of the top 1 percent of users has at least three chronic conditions, and more than 60 percent of the top 1 percent has five or more chronic conditions.  Click here for their very good 39-page report.

Feds Urge Florida to Expand Medicaid, No Deadline for Action

With no deadline to implement Medicaid expansion under the Affordable Care Act, federal officials last week urged Florida lawmakers to expand coverage, the Miami Herald reported.  Accepting the federal funds available for Medicaid expansion would add 120,000 private sector jobs and save Florida almost $430 million in healthcare costs. However, the longer Florida waits to expand its program, the more federal Medicaid dollars it gives up, the article said.  Click here for more.

Docs, Hospitals Ask for Stage 2 Meaningful Use Delay

The American Medical Association and the American Hospital Association last week asked HHS to delay the next step of requirements for the electronic health records incentive program an additional year.  In a joint letter to HHS, the associations asked for the transition to Stage 2 in the “meaningful use” EHR program to be voluntary in fiscal year 2014. They also ask that providers get more time to complete each stage: bumping the time period up from two years to three. Stage 2 of the meaningful use program has already been postponed from 2013 to 2014. Click here to read the letter.

Cost of Births Higher in US than England

The birth of Prince George to the royal family in England caused a stir across the world and a new look at the cost of delivering babies.  According to one report out last week, a “normal” deliver in the U.S. is about double the cost of the same in England.  Click here for the story.  A very detailed report at U.S. pregnancy and delivery costs was issued by Truven Analytics a few months ago. Click here for the 86-page report.

HPV Vaccination Rates Not Increasing: CDC

Top officials from CDC and the American Academy of Pediatrics announced last week that HPV vaccination rates in girls aged 13-17 years failed to increase between 2011 and 2012, according to data from the CDC. Three-dose coverage actually declined slightly from 2011 to 2012. Click here for details.