FEDERAL HEALTH UPDATE
November 21, 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 2009 National Defense Authorization Act (NDAA), section 704, required TRICARE to analyze Reserve Select costs from 2006 and 2007, and set new rates for 2009. Established in 2005, TRS is a premium-based health plan for National Guard and Reserve personnel available for purchase by members of the Selected Reserve who are not eligible for or enrolled in Federal Employee Health Benefit plans. TRS provides a health plan option to members of the Selected Reserve and their families when they are not on active duty status. The TRS plan delivers coverage similar to TRICARE Standard and Extra to eligible members who purchase the coverage and pay monthly premiums. TRS also features continuously open enrollment.? http://www.tricare.mil/Pressroom/News.aspx?fid=480
The National Resource Directory is a Web-based network of care coordinators, providers and support partners with resources for wounded, ill and injured service members, veterans, their families, families of the fallen and those who support them. It offers more than 10,000 medical and non-medical services and resources to help service members and veterans achieve personal and professional goals along their journey from recovery through rehabilitation to community reintegration. The directory will be a valuable tool for wounded, ill and injured service members and their families as they navigate through the maze of benefits and services available to them in their transition to civilian life. The National Resource Directory is organized into six major categories: Benefits and Compensation; Education, Training and Employment; Family and Caregiver Support; Health; Housing and Transportation; and Services and Resources. It also provides helpful checklists, Frequently Asked Questions, and connections to peer support groups. All information on the Web site can be found through a general or state and local search tool.? http://www.health.mil/Press/Release.aspx?ID=429
A new, $4 million, 12,000-square-foot facility, which was privately funded, is slated to open Dec. 1, 2008.? The facility will have its own dining room plus a great room, a classroom, a video game room and, overall, a lot more room. The project was spearheaded as a charitable project by the owners of Huffman Developments, a Texas-based building company. Estimates for the project were just over $3 million when it started, but the contractor solicited service members¡¦ and families¡¦ ideas on its construction and subsequent design changes increased its cost to about $4 million.? Future plans of adding a therapeutic garden and other landscaping will take the project to nearly $5 million. A classroom with computers will offer educational opportunities for service members and families. A donor is willing to pay tuition and books for those wishing to advance their education. The overall design is built with a Hill Country theme, with rock and stucco throughout and a large star as a centerpiece on the front of the building. As of September, nearly 250,000 visitors had used the center.? http://www.health.mil/Press/Release.aspx?ID=424
Legislative amendments provide new entitlements that pertain to military families and enable them to take caregiver leave. The Labor Department administers FMLA for private-sector workers. The changes, authorized by the National Defense Authorization Act of 2008, give military families special job-protected leave rights to care for servicemen and women who are wounded or injured and also help families of members of the National Guard and reserves manage their affairs when their service member is called up for active duty. One change stipulates that eligible employees who are family members of covered service members can take up to 26 work weeks of leave in a 12-month period to care for a covered service member with a serious illness or injury incurred in the line of duty while on active duty. This change extends the period of available unpaid leave beyond the original 12-week leave period. The new provision was a recommendation of the President¡¦s Commission on Wounded Warriors. A second family-leave-related amendment to the act makes the normal 12 work weeks of FMLA job-protected leave available to certain family members of National Guardsmen or reservists for qualifying exigencies when service members are on active duty or called to active-duty status. Qualifying exigencies for which employees can use FMLA leave include:
Another change requires employees to follow their employers' call-in procedures when taking FMLA leave. Previous rules were interpreted that employees could inform employers of taking FMLA leave for up to two full business days after initiating it. An additional rule change allows employers¡¦ human-resource officials, leave administrators or management officials to contact employees¡¦ health care providers to verify information on medical certification forms, so long as Health Insurance Portability and Accountability Act of 1996 requirements and medical privacy regulations are met.
Military OneSource provides support and assistance to service members and their families on a wide range of subjects, including education, finances, child care and relocations.
VA Secretary Dr. James B. Peake?announced that he will use his?authority to raise the mileage reimbursement from the 28.5 cents per mile to 41.5 cents per mile for all eligible veterans. Congress, which mandates such increases, recently provided funding to VA to increase the reimbursement rate.? These changes go into effect on Nov. 17, 2008.? Service-connected disabled veterans, veterans receiving VA pensions, and veterans with low incomes are eligible for the reimbursement. While increasing the payment, the current deductible amounts applied to certain mileage reimbursements will remain frozen at $7.77 for a one way trip, $15.54 for a round trip, and capped at a maximum of $46.62 per calendar month.??On Jan. 9, 2009, these deductibles will decrease to $3 for a one way trip, $6 for a round trip, with a maximum of $18 per calendar month.??Deductibles can be waived if they cause a financial hardship to the veteran.? http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1617?
An estimated 19.8 percent of U.S. adults (43.4 million people), were current smokers in 2007, down from 20.8 percent in 2006, according to a study in CDC¡¬s Morbidity and Mortality Weekly Report (MMWR). However, based on the current rate of decline, it is unlikely that the national health objective of reducing the prevalence of adult cigarette smoking to 12 percent or lower will be met by 2010. Smoking causes at least 30 percent of all cancer deaths, including more than 80 percent of lung cancer deaths, and 80 percent of deaths from chronic obstructive pulmonary disease. Smoking is responsible for early cardiovascular disease and death. As a result, about half of all long-term smokers, particularly those who began smoking as teens, die prematurely, many in middle age. Another MMWR study released by CDC assessed the U.S. health consequences and productivity losses attributable to smoking. National estimates of annual smoking deaths indicate that, during 2000¡V2004, cigarette smoking and exposure to secondhand smoke resulted in approximately 443,000 annual premature deaths, consistent with previous estimates. In addition, during 2001¡V2004, average annual smoking-attributable health care expenditures were approximately $96 billion, compared to $75 billion in 1998. Accounting for direct health care expenditures and productivity losses ($97 billion), the total economic burden of smoking is approximately $193 billion per year. Tobacco users who want help in quitting can call 1-800-QUIT-NOW (1-800-784-8669) (TTY 1-800-332-8615) for free telephone-based counseling anywhere in the United States or visit http://1800quitnow.cancer.gov for quitting assistance. Information about the Great American Smokeout is available at http://www.cancer.org/docroot/ped/ped_10_4.asp.
The report, ¡§Personalized Health Care: Pioneers, Partnerships, Progress,¡¨ includes reports from 10 institutions where personalized health care techniques are beginning to be used. It also includes seven commissioned papers examining the opportunities and challenges for personalized health care from the perspectives of different stakeholders in the health care sector. Personalized health care envisions medical care that is increasingly differentiated between patients based on variations in their individual biology. For example, differences in metabolism or other factors cause a given prescription medication to work well with some individuals, but not others. By measuring such individual variations in patients before prescribing, drugs could be used more safely, effectively and at lower cost. Genetic and molecular medicine should also help spot diseases before symptoms appear, enabling treatments to delay or preempt the disease and avoid costly late-stage treatments. Personal genomic profiles may also enable patients to learn their particular predisposition to disease and take more effective disease prevention steps. http://www.hhs.gov/news/press/2008pres/11/20081114a.html
HHS Secretary Mike Leavitt and FDA Commissioner Andrew von Eschenbach, M.D. will travel to the three cities to meet with manufacturers and Chinese government officials to discuss policy and governance reforms aimed at improving the safety of food and other consumer products. They will also mark the opening of the three offices, and introduce some of the HHS/FDA officials who will work there. HHS is working to have an FDA presence in five geographic regions: China, India, Europe, Latin America and the Middle East. During a visit to the Middle East in October, Secretary Mike Leavitt announced that the FDA¡¦s Middle East office will be headquartered in Amman, Jordan. In June, the Secretary and other HHS and FDA officials met with government and industry leaders from Central America and Mexico at a summit on product safety in El Salvador to outline possible ways of working together more closely, including through a proposed memorandum of understanding.? In December 2007, the United States signed two Memoranda of Agreement on the safety of food, feed, drugs and medical devices with agencies of the Chinese government. The agreements contain a framework for closer collaboration between HHS/FDA and its Chinese counterpart agencies to help assure Chinese products under HHS/FDA jurisdiction that come to the United States will be safer. As a result, the transmission of information between the agencies of the two countries has especially improved, and they have worked more closely to address safety concerns. Establishing a permanent HHS/FDA presence in China will greatly enhance the speed and effectiveness of regulatory cooperation and efforts to protect consumers in both countries. HHS/FDA officials will also assist the Chinese Government, as requested, in its ongoing efforts to improve its regulatory systems for exports to help assure product safety. FDA has selected eight senior experienced FDA officials to work in its offices in China. The employees are inspectors and senior technical experts in foods, medicines and medical devices. The HHS/FDA office in Beijing will be located in the US Embassy.? In Guangzhou, it will be located in the U.S. Consulate General, and in Shanghai it will be part of the U.S. consular mission, but will be situated in the Shanghai Centre, a well-established business complex in the city where several other U.S. government agencies have staff. For more information about HHS import safety initiatives, visit http://www.importsafety.gov/. For more information about HHS global health efforts, visit www.globalhealth.gov.
In the six-year, $16 million study, funded by the National Institute on Aging (NIA), scientists hope to identify the sequence of brain changes in early-onset Alzheimer's, even before symptoms appear.? By understanding this process, they also hope to gain insight into the more common late-onset form of the disease. The vast majority of people with Alzheimer's have the late-onset form of the disease, in which symptoms of memory loss become evident at age 60 or older. Less than five percent are diagnosed with the inherited form of the disease, sometimes as early as their 30s or 40s. Until now, research into inherited early-onset Alzheimer's was hindered by the rarity of the condition and geographic distances between patients and research centers. DIAN is designed to overcome those challenges. Each study participant will undergo the same assessments, from genetic analysis to cognitive testing. Researchers will build a shared database of blood and cerebral spinal fluid samples and neuroimages, including MRI and PET amyloid images. These assessments, samples and images should enable researchers to determine the type and sequence of changes in the brain in early-onset inherited Alzheimer's. People interested in participating in the DIAN study should contact DIAN Global Coordinator Angie Berry at Washington University at 314-286-2442, or go to www.dian-info.org. Study participants must be aged 18 or older. http://www.nih.gov/news/health/nov2008/nia-19.htm
In addition to improved Medicare FFS payments for FY 2008, CMS reports its first Medicare Advantage improper payment rate of 10.6 percent, or $6.8 billion, in payments made in Calendar Year (CY) 2006. Also being reported for the first time are the FY 2007 national composite error rates for Medicaid and for SCHIP. The Medicaid composite error rate is 10.5 percent, or $32.7 billion of which the federal share is $18.6 billion, and, for SCHIP, the rate is 14.7 percent, or $1.2 billion, with a federal share of $0.8 billion.? Improper payment rates include those payments that may have been paid incorrectly and do not necessarily reflect fraud. For Medicare FFS, most improper payments are due to claims for services that were medically unnecessary or incorrectly coded.? The vast majority of Medicaid and SCHIP errors are due to inadequate documentation; providers either did not submit information to support their FFS or managed care claims or did not submit additional data when requested.? Other errors are due to services provided under Medicaid or SCHIP to beneficiaries who were not eligible for either program or who were not eligible for the services received.? The CY 2006 rate for Medicare Advantage primarily reflects health plan errors in documenting members' diagnoses.? Improper payments due to incorrect calculations in the Medicare Advantage payment system are routinely resolved and payment adjustments are made and documentation errors improve over time.?? Due to CMS' aggressive efforts to reduce payment errors, the Medicare FFS rate has declined from about 14 percent in 1996 to the 2008 rate of 3.6 percent. CMS expects the error rates for Medicare Advantage, Medicaid and SCHIP to decline similarly through program maturation and the agency's use of tools that include statistical sampling, medical reviews and error rate reduction plans. CMS continues to work with Medicare FFS contractors, health and drug plans and states to further ensure that payments for treating Medicare, Medicaid and SCHIP beneficiaries are accurate; reflect updated coverage policies; and educate providers on how to avoid errors in areas with high improper payment rates. To strengthen confidence in the accuracy of reported error rates, CMS also announced it is conducting an in-depth evaluation effort to review this year's Medicare FFS error rate. CMS also is developing methodologies to report the Medicare Part D error rate in the future. CMS NR 11-17-2008
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