FEDERAL HEALTH UPDATE
Dec 18, 2009Produced 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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Executive and Congressional News
Military Health Care News
While qualified members of the Selected Reserve may purchase premium-based coverage under TRICARE Reserve Select (TRS), retired National Guard and Reserve personnel did not have TRICARE health coverage options until they reached age 60. A provision of the National Defense Authorization Act for 2010 will allow certain members of the Retired Reserve who are not yet age 60 (“gray-area” retirees), to purchase TRICARE Standard (and Extra) coverage. TRICARE Extra simply means beneficiaries have lower out of pocket costs if they use a network provider. While the health care benefit provided for gray-area retirees will be TRICARE Standard and Extra – similar to TRS – the new program will differ from TRS in its qualifications, premiums, copayment rates and catastrophic cap requirements. The program is tentatively called TRICARE Retired Reserve. The new statute requires premium rates to equal the full cost of the coverage. That is the major difference contrasted with TRS, where the statute provides that Selected Reserve members pay only 28 percent of the cost of the coverage. Premiums for the new gray area retiree program will be announced after program rules are published in the Federal Register. For more information about TRICARE
benefits go to http://www.tricare.mil.
The original demonstration notice
was published on June 15, 2007, and described a demonstration project
to evaluate the costs/benefits and beneficiary satisfaction of providing
OTC drugs under the pharmacy benefits program when the selected OTC
drugs are determined to be clinically effective. The demonstration was
to be conducted until the implementation of the combined TRICARE mail
and retail contract (TPharm) on Nov. 4, 2009. This demonstration project
will now be modified and extended for three additional years (November
4, 2012).
The three immunizations are H1N1
vaccine, seasonal influenza vaccine and pneumococcal vaccine. In addition,
this interim final rule solicits public comment on also including other
TRICARE-covered immunizations in the future for which retail network
pharmacies will be authorized providers. As part of DoD preparations
for a possible public health emergency involving H1N1 influenza this
fall and winter, this is being issued as an interim final rule. It became
effective Dec. 10, 2009.
This annual event provides an overview of DoD disability policy and initiatives, recognizes DoD organizations with outstanding affirmative action programs for people with disabilities, and highlights the accomplishments of DoD employees with disabilities. The keynote speaker at the ceremony was Matthew A. Staton, direct advisor and staff assistant to the secretary of the Army on wounded soldier matters. Staton was medically retired from the Army in 2007, following two deployments to Iraq with the 8th Infantry Regiment. For a list of names of DoD employees
with disabilities who received Secretary of Defense awards for their
outstanding contributions to national security, please visit http://www.defense.gov/
The new contract, awarded to International SOS, will consolidate the current overseas contracts, including those for TRICARE Puerto Rico and TRICARE Global Remote Overseas, into a standardized health care program available to all service members and their families living in other countries. International SOS will support the TRICARE Overseas Program Office, TRICARE Area Offices and military treatment facility (MTF) commanders, a step which will essentially combine the resources of the military’s direct medical care system overseas with the contractor’s services in host nations. The transition will take about ten months to complete. Under previous overseas contracts, claims payments have either been paid in full to the provider at the time services are rendered or billed to the patient weeks, or even months, following their visit. TOP will ensure that all claims are taken care of in a timely matter. An adjustment to the contract secures a “guarantee of payment” agreement with providers that ensures TOP Prime-enrolled beneficiaries have access to routine, urgent and emergency services without having to pay for services immediately or file claims. Officials also expect support services to improve substantially after TRICARE Service Center operations are consolidated worldwide, strengthening communication and service stability. Call centers will be available 24-hours-a-day and will offer extensive translation capabilities. A ten-month transition
period will ensure that customer service remains in place. Health care
delivery under TOP is scheduled to begin Aug. 31, 2010.
Co-located with other optometry and ophthalmology offices, the VCE will be a part of a veritable eye center at the new Walter Reed. The VCE, which currently operates from offices near the Pentagon in Rosslyn, Va., was established in 2008 to improve care for service members with visual disorders or visual disturbances, including traumatic brain injury. The VCE plans to establish a routine process to gather information from joint DoD/VA records and use it to learn more about the relationship between blasts, traumatic brain injury and vision interruption or loss. In turn, the data can be used to further develop preventive techniques and treatment options available to service members and veterans. While the VCE conducts its own research
and analysis based on the data gathered from DoD/VA records, it also
maintains awareness of eye health research being conducted outside the
DoD, including VA research efforts, and aims to collaborate with these
organizations to further advancements the field.
The report, “Newly Reported Hypertension After Military Combat Deployment in a Large Population-Based Study,” was published in the September issue of Hypertension, a journal of the American Heart Association. The findings have helped to shed more light on the correlation between high-stress situations and high blood pressure. The study showed that 6.9 percent of service members surveyed were reporting hypertension within a three-year period. Out of that number, service members who deployed and reported multiple combat exposures were at significantly increased risk for reporting new cases of hypertension. This is just the first study to show
an association between multiple combat exposures and hypertension.
For the first time since the series of surveys began in 1980, active duty Coast Guard personnel were included in the survey's cohort, providing the first comprehensive look at all active military services. The study shows notable decreases over the past 28 years in the use of cigarettes and illegal drugs and encouraging indicators of mental wellbeing. In addition, there are improvements in certain self-reported preventive health measures since 2005 including increases in moderate or vigorous exercise and a decline in overweight personnel under age 20. When compared to civilian data adjusted to mirror military demographic characteristics, the 2008 survey showed that military rates of heavy drinking were lower than the civilian average among persons aged 46 to 64. For cigarette use, military rates were slightly higher than civilian rates among persons aged 18 to 35 but military rates were significantly lower for persons aged 36 and older. The 2008 rate for illicit drug use, including prescription drugs, was 12 percent, an increase from 5 percent in 2005. The percentage increase is primarily attributed to the addition of questions that ask for usage of prescription medication for non-medical reasons. Rates of use of nonprescription illicit drugs (e.g. cocaine, marijuana, amphetamines) have remained low and stable at about two percent. This survey is the 10th in a series of confidential, anonymous standardized surveys that ask active duty service members about various health related behaviors. In addition to substance use, the survey also assesses mental well-being, deployment issues, fitness, nutrition and weight management, and selected national health status goals from the Department of Health and Human Services' Healthy People 2010 objectives. More than 28,500 service members from the Army, Navy, Marine Corps, Air Force and Coast Guard, randomly selected to represent men and women in all pay grades of the active force throughout the world, completed the survey. The full survey, along with a survey
summary and Q&A, are posted at http://www.tricare.mil/tma/
TriWest’s new Prime Enrollment Eligibility tool determines whether the beneficiary is eligible for TRICARE Prime, provides information about the nearest providers, reminds beneficiaries about the necessary enrollment forms and offers information on other TRICARE plan options and directs individuals how to complete enrollment. For more information, please visit www.triwest.com/eligibility. Veterans Health Care News
In addition, data from both the 2008 and 2009 reports will be available to the public in machine-readable format on Data.gov. To empower veterans and the public at large to track quality, safety and access to Veterans Health Administration (VHA) facilities, VA’s hospital report cards include raw data on care provided in outpatient and hospital settings, quality of care within given patient populations, and patient satisfaction and outcomes. VA issued its first facility-level report on quality and safety in May 2008. As part of the Obama Administration’s commitment to open government and accountability, VA highlights its rigorous quality programs and actions taken to address the issues VA identified from the last report. The current report gives the health care system high marks, with VA facilities often outscoring private-sector health plans in standards commonly accepted by the health care industry. In addition to allowing VA to demonstrate the quality and safety of its care, the report card provides opportunities to enhance health services. This year’s report recommends that
the VA improve services for women veterans and minority veterans. To
address these issues, VA has implemented several initiatives, such as
placement of women advocates in every outpatient clinic and medical
center, and creating a “mini-residency” program on women’s health
for primary care physicians and assigning a minority veteran program
coordinator in every medical center.
The Baldrige award is America’s highest honor for innovation and performance excellence, presented annually by the President to U.S. organizations judged outstanding in seven areas: leadership; strategic planning; customer focus; measurement, analysis, knowledge management; workforce focus; process management; and results. As part of the VA Research and Development Program, the center manages the devices and pharmaceuticals that are used in research trials conducted within the VA health care system. In the last three years, the coordinating center supported studies involving 90,000 patients per year across the country, ultimately benefitting millions of veterans and other Americans. The center manufactures drugs, placebos and devices, distributing them throughout the VA system to various clinical trial sites. Recent VA research trials supported by the coordinating center include the use of robotic arms to help stroke patients regain limb function, treatments for post-traumatic stress disorder, a comparative effectiveness research study of optimal medical therapy and angioplasty for coronary artery diseases, and effective approaches for diabetes management. Congress established the Malcolm
Baldrige award program in 1987 to recognize U.S. organizations for their
achievements in quality and performance, and to raise awareness about
the importance of quality and performance excellence as a competitive
edge. The presentation of the Baldrige award will occur at a ceremony
in Washington, D.C., in 2010.
Encoder is inpatient and outpatient coding, claims editing and compliance software for the government sector. Subcontractors to QuadraMed include DSS Inc., MEGAS and UnicorMed. The contract for 2010 is valued at $24 million. San Francisco-based equity firm Francisco Partners recently announced it would acquire Reston, Va.-based QuadraMed for $126 million. More information is available at quadramed.com. Health Care News
Under the recently passed Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), CMS now has the flexibility of adding to Medicare’s list of covered preventive services, if certain requirements are met. Prior to this law, Medicare could cover additional preventive screening tests only when Congress authorized it to do so. Under MIPPA, CMS can consider whether
Medicare should cover preventive services that Congress has not already
deemed as covered or non-covered by law. Among other requirements, the
new services must have been “strongly recommended” or “recommended”
by the U.S. Preventive Services Task Force. More information about the
Task Force is available online at http://www.ahrq.gov/clinic/ CMS uses the national coverage determination (NCD) process to make decisions on these types of preventive services. This process provides transparency about the evidence that CMS considers when making its decisions and allows opportunity for the public to comment on CMS’ proposals. AIDS is diagnosed when an HIV-infected person’s immune system becomes severely compromised or a person becomes ill with an HIV-related infection. Of the more than one million estimated to have the HIV infection, the Centers for Disease Control and Prevention has estimated that about a quarter of them do not realize they are infected. Without treatment, AIDS develops within 8 to 10 years. While there is no cure for HIV, screening can help identify infected patients so that they can receive medical treatment that could help delay the onset of AIDS for years. More information about Medicare’s
new HIV screening benefit is available in CMS’ final decision memorandum.
Read the final decision online at http://www.cms.hhs.gov/mcd/
The widget, a portable application embedded in a Web page that can be copied onto any other Web site or blog, will include topics such as how to report a problem with pet food, purchasing pet drugs online, and caring for a pet in a disaster. The widget allows users to access content on the FDA’s Web site without having to leave another site or Web page. The widget has two tabs, one titled “tips” and, the other, “updates. The Tips tab highlights pet health and safety articles. The Updates tab will provide up-to-the-minute recall notices and veterinary drug news for consumers. The pet health and safety widget
is available at www.fda.gov/PetHealthWidget requires no technical maintenance on the part
of the user. The FDA will provide updates to content displayed on the
widget.
The program, Translating Basic Behavioral and Social Science Discoveries into Interventions to Reduce Obesity, will fund interdisciplinary teams of researchers at seven research sites. Investigators will conduct experimental research, formative research to increase understanding of populations being studied, small studies known as proof of concept trials, and pilot and feasibility studies to identify promising new avenues for encouraging behaviors that prevent or treat obesity. The program is led by the National Heart, Lung, and Blood Institute (NHLBI), in partnership with the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the National Cancer Institute (NCI), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), and the Office of Behavioral and Social Sciences Research (OBSSR). The program's studies focus on diverse populations at high risk of being overweight or obese, including Latino and African-American adults, African-American adolescents, low-income populations, pregnant women, and women in the menopausal transition. The interventions being developed include creative new approaches to promote awareness of specific eating behaviors, decrease the desire for high-calorie foods, reduce stress-related eating, increase motivation to adhere to weight loss strategies, engage an individual's social networks and communities to encourage physical activity, and improve sleep patterns. Brain scans will also be used to understand brain mechanisms in obesity that might guide the development of new interventions. For more information about the specific
research projects, principal investigators, study sites, and the NIH
sponsors include, please visit http://www.nih.gov/news/
The drops are driven largely by declines in rates of new cases and rates of death for the three most common cancers in men (lung, prostate, and colorectal cancers) and for two of the three leading cancers in women (breast and colorectal cancer). New diagnoses for all types of cancer combined in the United States decreased, on average, almost 1 percent per year from 1999 to 2006. Cancer deaths decreased 1.6 percent per year from 2001 to 2006. These findings are from a report authored by researchers from the National Cancer Institute (NCI), part of the National Institutes of Health, the Centers for Disease Control and Prevention (CDC), the American Cancer Society (ACS), and the North American Association of Central Cancer Registries (NAACCR). Overall cancer rates continue to be higher for men than for women, but men experienced the greatest declines in incidence (new cases) and mortality (death) rates. For colorectal cancer, the third most frequently diagnosed cancer in both men and women, and the second leading cause of cancer deaths in the United States, overall rates are declining, but increasing incidence in men and women under 50 years of age is of concern, the report said. Other highlights from the report show that in men, incidence rates have declined for cancers of the prostate, lung, oral cavity, stomach, brain, colon and rectum, but continue to rise for kidney/renal, liver, and esophageal cancer, as well as for leukemia, myeloma and melanoma. In women, incidence rates decreased for breast, colorectal, uterine, ovarian, cervical and oral cavity cancers, but increased for lung, thyroid, pancreatic, bladder, and kidney cancers, as well as for non-Hodgkin lymphoma, melanoma and leukemia. The researchers created projections to look at how colorectal cancer mortality trends could change with varying levels of cancer control interventions. If there were no changes in risk factors, screening or treatment (stable since 2000), Americans could expect a 17 percent decline in colorectal cancer mortality from 2000 to 2020. However, if current trends persist, Americans could see a 36 percent decline in colorectal cancer mortality. With accelerated cancer control efforts, there could be an overall colorectal cancer mortality reduction of 50 percent by 2020. To view the full report, go to: www.interscience.wiley.com/
The partnership was established in 1997 by CDC and is known as the Tuberculosis Trials Consortium. The Consortium is a collaboration of clinical investigators who conduct research about the diagnosis, treatment and prevention of TB infection and disease. The partnership is an example of the focus CDC places on research that is programmatically relevant and that involves domestic and international partners addressing TB-related obstacles in countries hardest hit by the disease. The Consortium has grown from a small group of grantees in North America and a select few other countries to a worldwide organization. The 2010-2020 research group will include clinical research sites in Brazil, China, Kenya, the Philippines, South Africa, Spain, Uganda and Vietnam. Sites in the United States include research centers in Colorado, New Jersey, New York, North Carolina, Tennessee, Texas and Washington, D.C. The 20 selected sites will receive awards totaling $9.2 million per year over the next ten years. To date, the Consortium has conducted
nine major trials and 15 sub-studies.
This is the agency’s third post in Latin America and its tenth international post in the past 13 months. Staff assigned to the FDA’s Mexico City post will work with their counterparts in the Mexican government to harmonize regulations and guidance standards and to work on other collaborative initiatives. These collaborations will include, for example, information-sharing on the respective regulatory systems and joint workshops on the safety of food and medical products. Agencies in both governments also will make efforts to find opportunities for joint training on food-borne illnesses and the oversight of food traded internationally. FDA staff also will offer collaboration on the use of the latest laboratory techniques, foster other collaborative initiatives to ensure the safety of food and medical products marketed in the two countries, and be a “portal” to the FDA for counterpart Mexican agencies and the US-export industry in Mexico. To date, the FDA has opened 10 international
posts, including posts in China, India, Europe and Latin America, along
with its USA-based staff. The other posts in the Latin America Office
are located in Santiago, Chile, and at the FDA’s Latin America Office
headquarters in San José, Costa Rica.
Donepezil hydrochloride is indicated for the treatment of dementia related to Alzheimer’s disease. Orally disintegrating tablets dissolve on the tongue, without having to be swallowed whole. This may make it easier to take the medication for older or disabled patients who have difficulty swallowing. Alzheimer’s disease is an irreversible, progressive brain disease that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks of daily living. In most people with Alzheimer’s disease, symptoms first appear after age 60. Alzheimer’s disease is the most common cause of dementia among older people, but it is not a normal part of aging. Dementia refers to a decline in cognitive function that interferes with daily life and activities. Alzheimer’s disease starts in a region of the brain that affects recent memory and then gradually spreads to other parts of the brain. The generic donepezil hydrochloride orally disintegrating tablets, manufactured by Mutual Pharmaceutical of Philadelphia, have been approved in 5 milligram and 10 mg strengths. For
more information, please visit http://www.fda.gov/Drugs/
Inserm, a government-supported biomedical research organization, is the French equivalent of the National Institutes of Health. Each year, it honors researchers for their contributions to basic and clinical research that enhance public health. Dr. Volkow's selection acknowledges her innovative imaging research showing drug addiction to be a disease of the brain that usurps the reward circuitry and leads to compulsive behaviors. A research psychiatrist and scientist, Dr. Volkow is considered one of the world's leading specialists in the mechanisms underlying drug abuse and addiction. As NIDA's director since 2003, she leads an organization supporting most of the world's research on drug abuse and its associated health consequences. Dr. Volkow will receive
the award at a Dec. 17 ceremony at the College of France learning center
in Paris. Along with Dr. Volkow, there were six other 2009 Inserm award
winners all of France.
These funds are made possible through the American Recovery and Reinvestment Act, which has provided up to $650 million to HHS for the Communities Putting Prevention to Work initiative launched earlier this fall to promote evidence-based prevention strategies in communities and states across the country. This competitive initiative gives every state Aging and Health Department and U.S. territory the opportunity to implement rigorously tested Chronic Disease Self-Management Programs (CDSMP), one of the most prominent being the Stanford University model. The CDSMP is a six-week peer-led training program that covers topics such as healthy eating, exercise, managing fatigue and depression, and communicating effectively with health care professionals. CDSMP are specifically designed to be delivered by non-health professionals in community settings, such as senior centers, congregate meal programs, faith-based organizations and senior housing projects. Research has shown that prevention programs can improve the quality of life for older individuals, including frail seniors with multiple chronic conditions, and also reduce health care costs. The Recovery Act funds will put the results of HHS’ research investments into practice at more than 1,200 community-based sites across the country -- reaching tens of thousands of older Americans and their families. Eligible entities include all 50 states and U.S. territories. States will identify the communities and the organizations that will be involved locally in the delivery of this program. The deadline for applications is Feb.12, 2010. For more information on this funding availability, please visit: http://www.grants.gov. Reserve/Guard
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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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