FEDERAL HEALTH UPDATE
June 27, 2008Produced by Kate Connelly Theroux in collaboration with the Institute of Federal Health Care (IFHC) To subscribe, please visit http://fedhealthinst.org/subscriber.cfm. Sponsored by
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Congressional Schedule
The omnibus health care bill, S. 2969, the Veterans Health Care Authorization Act of 2008, includes the following:
The omnibus benefits bill, S. 3023, the Veterans' Benefits Improvements Act of 2008, includes the following:
In addition to the omnibus veterans' benefits and health care bills, the Committee also approved legislation to provide a cost-of-living increase for disability compensation for veterans and dependency and indemnity compensation for survivors, as well as a bill to make technical corrections to veterans' educational benefits. http://veterans.senate.gov/public/index.cfm?pageid=12&release_id=11747
Mr. Donley currently serves as director of administration and management at the Department of Defense. Prior to this, he served as senior vice president at Hicks & Associates (a subsidiary of Science Applications International Corporation). Earlier in his career, he served as assistant secretary of the Air Force (Financial Management and Comptroller) and as acting secretary of the Air Force. Mr. Donley received his bachelor's degree and master's degree from the University of Southern California
Letters explaining TMOP and its convenience and cost-saving features are being sent to beneficiaries who receive regular maintenance prescriptions at network retail pharmacies. The letters tell beneficiaries how they can switch from retail pharmacies to TMOP and save up to 66 percent on their prescription drug costs. TMOP offers up to a 90-day supply of medication for the same co-payment as a 30-day supply from a retail pharmacy, and with gas prices rising daily, a trip to the pharmacy can be pricey. Beneficiaries can also register for TMOP at http://www.express-scripts.com/TRICARE -- without downloading or mailing forms. Once the registration process is complete, beneficiaries may use the Member Choice Center (MCC) service online and request that TMOP obtain prescriptions from their provider. Since launch of the MCC in August 2007, more than 90,000 retail prescriptions have been switched to TMOP. For more information, please visit the prescriptions tab at http://www.tricare.mil
The Air Force is providing manning and contracting assistance to the 88th Medical Group to help resolve temporary family practice clinic staffing problems caused by vacancies and deployments. This will fill the gap until long-term solutions can be identified to ensure adequate access to care for all enrolled beneficiaries. Provider authorizations at the medical center are stable, but filling these positions has been delayed by shortages in primary care physicians nationally. The 88th Medical Group is working with the Air Force Personnel Center to recruit active-duty, civil service and contract providers to alleviate the temporary shortage. The interim solution includes the ability for TRICARE Prime beneficiaries to consider voluntarily changing their primary care manager from a base provider to an affiliated network provider. While available to any beneficiary, this option may be an attractive alternative for any non-active duty beneficiaries who live more than 30 minutes from the base. Earlier this month, the medical group sent letters to about 3,400 TRICARE Prime beneficiaries who live more than 30 minutes drive time to the base describing the challenge of the situation and inviting them to one of three town meetings to learn more about options that are available. The intent was to focus on beneficiaries who faced the longest drive times to Wright-Patterson Medical Center to receive their primary care. Wright-Patterson Medical Center is a large regional military medical treatment facility which provides active duty members, retirees and eligible family members with a full range of services ranging from surgery to comprehensive cancer care. Col. James Cockerill, 88th Medical Operations Squadron Commander, said the base shortage affects primary care and internal medicine clinics only. Pediatrics, flight medicine, OB-GYN, laboratory, radiology, pharmacy and specialty clinics remain fully staffed for service. http://www.afmc.af.mil/news/story.asp?id=123103714
The institute’s animal care program was recently selected by the AAALAC to be assessed by a council member emeritus. This category of site visits is limited to those institutions that have demonstrated a long-term commitment to achieving and maintaining high standards of animal care and use. AAALAC International is a private, nonprofit organization that promotes the humane treatment of animals in science through voluntary accreditation and assessment programs. More than 750 companies, universities, hospitals, government agencies and other research institutions in 29 countries have earned AAALAC accreditation, demonstrating their commitment to responsible animal care and use. These institutions volunteer to participate in AAALAC's program, in addition to complying with the local, state and federal laws that regulate animal research. http://www.afip.org/cgi-bin/showstory.cgi?id=11
The majority of the 150 comments posted were negative. Ophthalmologists, dermatologists, pediatricians and other specialty physicians said the system, called the Armed Forces Health Longitudinal Technology Application (AHLTA), lacks features that are useful for their specialties. "AHLTA was designed for administrators — not clinicians," Col. Brad Waddell said in a comment, adding, "It is slow, inefficient, unreliable and in every respect an inferior product compared to other commercially available [EHR systems]." MHS staff replied, "We strive to make AHLTA a world class [EHR] and continue to upgrade and enhance the system." In another comment, Richard Lippin asked why DoD does not adopt the Department of Veterans Affairs' EHR system, called the Veterans Health Information Systems and Technology Architecture (VistA). In response, MHS staff said, "VistA is tailored more for local or regional health care with a generally static population. ... DoD's system was developed to support a global transient population. DoD recognizes the strengths of VistA and we are diligently working toward adding those strengths into AHLTA." The latest version of AHLTA, called AHLTA 3.3, is slated for release later this year. To read to the full online discussion, please visit http://www.health.mil/AHLTAWebHall.aspx
In his ruling, Judge Samuel Conti wrote “The court can find no systemic violations system-wide that would compel district court intervention.” Conti found that individual members would have standing to sue: “Given the dire consequences many of these veterans face without timely receipt of benefits or prompt treatment for medical conditions, especially depression and PTSD, these injuries are anything but conjectural or hypothetical.” http://latimesblogs.latimes.com/lanow/2008/06/veterans-get-mi.html
The new clinics, scheduled to be opened over the next 15 months, will increase VA's network of independent and community-based clinics to 782, an increase of more than 100 in five years. This growth in community clinics has helped VA meet veterans' expectations for prompt, quality service, with 98 percent of veterans seen within 30 days in all types of VA primary care facilities throughout the country. In addition to on-site primary care staff, outpatient clinics frequently feature state-of-the-art telehealth systems permitting veterans to maintain regular contact with doctors in specialties from cardiac care to mental health at regional VA hospitals linked for video consultations, coupled with telemetry of health data or images. VA's 21 regional networks develop applications for new clinics in consideration of reducing the distance veterans travel to their nearest VA hospital or clinic, as well as local demand, existing hospital, clinic workload and other factors. The planned sites for VA’s new outpatient clinics are:
The plan is the product of discussions between U.S. Secretary of Health and Human Services Mike Leavitt and senior Vietnamese officials in Hanoi and exemplifies the import-safety strategy adopted by the U.S. government in November 2007. Historically, U.S. authorities have primarily relied on intervention at the border to intercept unsafe goods. The new strategy, crafted by a Cabinet-level Interagency Working Group on Import Safety, chaired by Secretary Leavitt, calls for actively working with trading partners to help ensure quality in every step of a product’s life cycle. The MOU calls for cooperation in the following areas:
The MOU takes effect immediately, has an initial life of three years, and is subject to revision and renewal, contingent upon the approval of both nations. The United States and Vietnam have a strong and growing trade relationship that has greatly accelerated in recent years. Since signing of the United States-Vietnam Bilateral Trade Agreement in 2001, commerce between the two nations has increased eight-fold, fueled, in part, by the agriculture and aquaculture sectors. Two-way trade exceeded $12.5 billion in 2007, according to the Foreign-Trade Division of the Census Bureau within the U.S. Department of Commerce. More information on Import Safety at www.importsafety.gov
In addition to the 24 million with diabetes, another 57 million people are estimated to have pre-diabetes, a condition that puts people at increased risk for diabetes. Among people with diabetes, those who do not know they have the disease decreased from 30 percent to 25 percent over a two-year period. Diabetes is a disease associated with high levels of blood glucose resulting from defects in insulin production that causes sugar to build up in the body. It is the seventh leading cause of death in the country and can cause serious health complications including heart disease, blindness, kidney failure and lower-extremity amputations. Among adults, diabetes increased in both men and women and in all age groups, but still disproportionately affects the elderly. Almost 25 percent of the population 60 years and older had diabetes in 2007. And, as in previous years, disparities exist among ethnic groups and minority populations including Native Americans, blacks and Hispanics. After adjusting for population age differences between the groups, the rate of diagnosed diabetes was highest among Native Americans and Alaska Natives (16.5 percent). This was followed by blacks (11.8 percent) and Hispanics (10.4 percent), which includes rates for Puerto Ricans (12.6 percent), Mexican Americans (11.9 percent), and Cubans (8.2 percent). By comparison, the rate for Asian Americans was 7.5 percent with whites at 6.6 percent. The data are an update of diabetes prevalence estimates last reported two years ago and now published in the 2007 National Diabetes Fact Sheet developed by CDC in collaboration with multiple agencies under the U.S. Department of Health and Human Services and other federal agencies. For more information on diabetes, please visit www.cdc.gov/diabetes. To access the National Diabetes Fact Sheet and county-level estimates of diagnosed diabetes, click on the "data and trends" link at the left.
AHRQ data show that nearly one in eight Hispanics take a prescription drug for diabetes. The guide organizes comparative research results according to diabetes patients' concerns and questions and assists them in using research results when talking with health care professionals about their diabetes medicines. The guide compares 10 generic and 13 brand-name diabetes medications and explains how each works to lower blood sugar, which of them may increase body weight, which may cause side effects such as stomach problems or swelling and each pill's potential effect on "bad" and "good" cholesterol. The guide also warns patients to be alert for problems such as hypoglycemia—too-low blood sugar—which can be caused by certain diabetes pills, as well as other potential side effects. In addition, the guide provides an easy-to-understand comparison of the dose and average cost of each generic and brand-name diabetes medication and the appropriate dose when taken in combination. Information in the guide is based on the recent AHRQ-funded report, Comparative Effectiveness and Safety of Oral Diabetes Medications for Adults with Type 2 Diabetes. That report, based on scientific evidence found in 216 published studies, summarizes the effectiveness, risks and estimated costs for 10 diabetes medications. It was produced by AHRQ's Effective Health Care Program, an ongoing federal initiative that compares alternative treatments for health conditions. The program is intended to help patients, doctors, nurses and others choose the most effective treatments. Pastillas para la diabetes tipo 2, the English-language version, Pills for Type 2 Diabetes, and other publications from AHRQ's Effective Health Care Program for consumers and clinicians can be found online at http://www.effectivehealthcare.ahrq.gov.
The recipient institution or organization will serve as a gateway to information on health workforce issues for health providers, employers and policymakers and may receive approximately $750,000 annually for fiscal years 2008-2012 (funding beyond the first year is dependent upon federal appropriations). Eligible applicants include state or local governments, health professions and nursing schools, academic health centers and community-based facilities. Applications are due July 21. For more information, please visit HRSA-08-157
An 18-month effort by health insurers, Web portals, doctors, hospitals and nonprofit groups produced a framework that will spur growth in the use of personal health records, improving the U.S. health system, they said in a statement. The negotiations were orchestrated by the Markle Foundation, a New York-based nonprofit group that focuses on uses for information technology. The framework ends a “privacy logjam” that has inhibited use of electronic records, which many believe will cut duplication, costs and errors. The push for consumer-controlled data parallels U.S. government efforts to promote adoption of electronic medical records by health care providers, an initiative yet to win over most doctors because of costs. According to Markle President Zoe Baird, the new policies will enable the information market to grow while giving consumers control of personal information and protecting their privacy. Access to a patient's personal health record can help doctors and pharmacists know what drugs have been prescribed by other physicians, for example, helping avoid new prescriptions that could cause dangerous interactions. A new doctor could know what tests have already been given. The framework includes audit trails so consumers can see who is looking at their records and prevents insurers, employers and others from demanding to see the information. The policies are distinct from federal privacy requirements that already cover the exchange of that data among medical providers and insurers. The framework would be enforced by existing federal and state consumer protection laws based on regular oversight by private, independent groups. The plan was endorsed by health insurers, organizations representing physicians and consumers, electronic prescription benefit managers, government agencies, Google, Microsoft, Cisco Systems Inc., WebMD Health Corp., Intuit Inc. and Dossia, a group of large employers that advocates creating personal health records. http://www.bloomberg.com/apps/news?pid=20601087&sid=a38Kg3O.d86k&refer=home
The proposed regulation would require RHCs to establish quality assessment and performance improvement (QAPI) programs. It would establish location requirements necessary for a clinic to continue to participate as an RHC, which would ensure that the RHC program kept pace with demographic changes in the service areas and best met the needs of underserved beneficiaries. The regulation would also provide opportunities for existing RHCs to apply for exceptions from location requirements, and would provide RHCs with greater flexibility in staffing requirements and sharing resources with fee-for-service providers in the facility. In line with statutory requirements, the rule also would limit payments for RHCs to 80 percent of reasonable costs, minus beneficiary coinsurance and deductible amounts. Many changes in the proposed rule, such as revisions to the payment methodology, would also apply to federally qualified health centers (FQHCs). FQHCs are similar in many respects to RHCs but may operate in urban or rural underserved areas. The proposed regulation may be viewed at http://federalregister.gov/OFRUpload/OFRData/2008-13280_PI.pdf
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If you need further information on any of the items in the Federal Health Update, please contact Kate Connelly Theroux at (703) 447-3257 or by e-mail at katetheroux@fedhealthinst.org. To subscribe, please visit http://fedhealthinst.org/subscriber.cfm. To unsubscribe, please send an email to newsletter@fedhealthinst.org with UNSUBSCRIBE as the subject. Back issues availiable at Federal Health Update Archives. |
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