Washington Highlights: December
12, 2008
Study Finds Significant Financial Impact Due to
Cost Shift from Inadequate Medicare and Medicaid Reimbursements
Contents
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Milliman Inc. Dec. 9 released
a study demonstrating low Medicare and Medicaid reimbursements to
hospitals and physicians lead to significantly higher health insurance
costs for consumers and employers. Milliman is an independent consulting
firm that was engaged by the American Hospital Association (AHA),
America's Health Insurance Plans (AHIP), the Blue Cross Blue Shield
Association (BCBSA), and Premera Blue Cross.
The report
found that there is a "cost shift" of almost $90 billion due to
the under payments of Medicare and Medicaid to hospitals and physicians
forcing consumers and employers to close this gap. Richard Umbdenstock,
president and CEO of AHA said, "As businesses struggle to cut costs
to match sagging revenues, employee health benefits are increasingly
at risk. The faltering economy makes fair payment by Medicare and
Medicaid more important than ever." "As Congress and the new administration
focus on health care reform, they should confront this issue (cost
shifting)," said Karen Ignagni, AHIP president and CEO.
Information:
Travis W. Crytzer, Legislative Analyst
AAMC Government Relations
tcrytzer@aamc.org
(202) 828-0418
Joint Commission Releases Sentinel Event Alert
on HIT Implementation
The Joint Commission on the Accreditation of Healthcare Organizations
(JCAHO) Dec. 11 released a "Sentinel
Event Alert" warning that the implementation of health information
technology (HIT) and related medical devices without proper design
and adoption strategies may negatively affect the quality and safety
of patient care. The commission provides 13 recommendations for
health care organizations to implement such technologies safely.
The alert indicates that the exclusion of clinicians and other
staff in HIT planning, lack of provider consideration on the impact
of technology on care processes and workflow, and faulty or outdated
technology are the primary contributors to technology-related medical
errors.
Suggestions among the 13 specific actions to improve patient safety
include:
- Looking for possible workforce process risks and resolving these
issues prior to putting technology into place;
- Involving clinicians and staff who ultimately will use the technology;
- Training everyone who will be using the technology and providing
frequent refresher courses;
- Developing clear policies on who is authorized to use and is
accountable for technology; and
- Continually seeking ways to improve safety and discover errors.
The alert notes that organizations should pay particular attention
to certain information management standards related to planning
the management of information; safeguarding of data and information
against loss, destruction and tampering; and the requirement for
a disaster recovery plan for information systems. JCAHO also reminds
organizations to follow leadership standards that address designing
new processes and establishing a safety program and to "consider
the use of any technology in relation to the standards and be aware
of potential dangers to patients."
Information:
Will Dardani, Constituent Services Specialist
AAMC Health Care Affairs
wdardani@aamc.org
(202) 828-0541
National Biosecurity Board Considers Screening
of Select Agents Researchers
The National Science Advisory Board for Biosecurity (NSABB)
met Dec. 10 to review the status of several ongoing projects, including
possible heightening of security measures for personnel working
with select agents. The board received presentations from witnesses,
including Capt. Kenneth Cole, Ph.D., medical director in the Office
of the Special Assistant to the Secretary of Defense for Chemical
and Biological Defense and Chemical Demilitarization Programs, on
efforts to ensure the reliability of military and federal personnel
working with select agents. Concerns have been heightened following
revelations in July 2007 connecting an employee of the Army's Fort
Detrick laboratory with the 2001 anthrax attacks.
Dennis Kasper, M.D., director of the Channing Laboratory at Harvard
Medical School and NSABB chair, presented preliminary findings and
recommendations of an NSABB working group on "Personnel Reliability
Programs" that could include further screening of investigators
using select agents. While the measures under consideration by the
working group could extend to investigators in academic laboratories,
the board was critical of adopting measures that would be counter-productive
to important research with select agents. A final report from the
working group is expected in late January for review by the new
administration.
The Department of Health and Human Services is planning to release
an advanced notice of proposed rulemaking (ANPRM) revising the select
agent regulations early in 2009. The purpose of the ANPRM is to
solicit public comments on proposed revisions. The NSABB also received
recommendations for further outreach and education on issues of
"dual-use research," e.g., biological research that could be
misused to harm society, and received a status report on its proposed
framework for oversight of dual-use research, which is currently
under review by the National Science and Technology Council.
Information:
Stephen Heinig, Lead Science Policy Analyst
AAMC Biomedical Health Sciences Research
sheinig@aamc.org
(202) 828-0488
Lieberman, Collins Seek Tougher Biological Research
Regulations
Senate Homeland Security and Governmental Affairs Committee Chair
Joe Lieberman (I-Conn.) and Ranking Member Susan Collins (R-Maine)
Dec. 11 announced they would draft legislation to tighten oversight
of high containment laboratories around the country that could handle
deadly biological pathogens. The announcement came at the close
of a hearing
called to discuss the findings of the congressionally mandated "Commission
on the Prevention of Weapons of Mass Destruction Proliferation and
Terrorism," led by former-Senators Bob Graham and Jim Talent.
The report concludes
that a terrorist attack with a biological or other weapon of mass
destruction was "more likely than not" by the year 2013.
Information:
Stephen Heinig, Lead Science Policy Analyst
AAMC Biomedical Health Sciences Research
sheinig@aamc.org
(202) 828-0488
President-elect Obama Nominates Daschle as HHS
Secretary
President-elect Obama officially announced
Dec. 11 his selection of former-Senator Tom Daschle to be Secretary
of Health and Human Services (HHS). Obama also announced Daschle
will also be director of a new office of Health Care Reform. Obama
said, "He will be responsible not just for implementing our health
care plan, he will also be the lead architect of that plan." Although
the economic situation will be the first priority, Obama has signaled
a health care overhaul will be next in line for his administration.
Obama also announced a series of Health Care Community Discussions
to be held anytime from Dec. 15 to Dec. 31. The transition team
will offer moderator kits for individuals who would like to host
these discussions
in their community. Former-Senator Daschle plans to attend some
of these discussions in person.
President-elect Obama Announces Gen. Eric Shinseki
as VA Secretary
President-elect Obama Dec. 7
announced that he will nominate General Eric Shinseki to be
Secretary of Veterans Affairs. General Shinseki is a former Army
Chief of Staff and 38-year Army veteran who served two combat tours
in Vietnam. He is the recipient of numerous decorations, including
the Bronze Star, the Purple Heart, the Legion of Merit, and the
Army, Navy, Air Force, and Coast Guard Distinguished Service Medals.
In his announcement, President-elect Obama stressed the "need to
build a 21st Century VA that will better serve all who have answered
our nation's call" by "cutting red tape and easing transition into
civilian life ... eliminating shortfalls, fully funding VA health
care, and providing the benefits our veterans have earned."
On the Hill...
Senator Saxby Chambliss (R-Ga.) defeated challenger Jim Martin
(D) in a Dec. 2 runoff election, blocking Democrats' hopes for a
filibuster-proof, 60-seat Senate majority. One Senate seat remains
outstanding as a recount of ballots proceeds in Minnesota; the state
Canvassing Board is scheduled to meet Dec. 16 to review ballots
challenged by Senator Norm Coleman (R) and Democrat Al Franken.
President-elect Barack Obama Dec. 1 nominated Senator Hillary Rodham
Clinton (D-N.Y.) to be Secretary of State. If she is confirmed,
New York Governor David Paterson (D) will appoint a successor who
will fill her Senate seat until a special election in 2010. The
winner of the special election will run again for a full term in
2012. The governor reportedly is considering several candidates
for the seat, including: Caroline Kennedy, New York Attorney General
Andrew Cuomo, Buffalo Mayor Byron Brown, and state legislator Tom
Suozzi. Several House Democrats are also reportedly contenders:
Reps. Carolyn Maloney, Kirsten Gillibrand, Steve Israel, Brian Higgins,
Nydia Velazquez, and Jerrold Nadler.
Election officials in Ohio Dec. 8 certified Democrat Mary Jo Kilroy's
victory over Republican Steve Stivers for the state's 15th district
House seat. Ms. Kilroy will be the first Democrat in 42 years to
hold the seat, and will succeed retiring Rep. Deborah Pryce (R).
Republican challenger Anh "Joseph" Cao Dec. 6 defeated Rep. William
Jefferson (D-La.) in a House election delayed one month as a result
of Hurricane Gustav. Mr. Cao, an immigration attorney, is the first
Vietnamese-American elected to Congress. Rep. Jefferson has been
the subject of a corruption probe and faces trial on charges of
money laundering, racketeering and bribery, though no date has been
set.
Louisiana voters Dec. 6 also elected physician John Fleming (R)
over challenger Paul Carmouche (D) to fill the 4th district seat
vacated by retiring Rep. Jim McCrery (R). Board certified in Family
Practice, Dr. Fleming was a Medical Officer in the United States
Navy and was named Louisiana Family Doctor of the Year in 2007.
One House race remains in limbo. The Virginia State Board of Elections
Dec. 1 certified Democrat Tom Perriello's 0.23 percent victory over
incumbent Rep. Virgil Goode (R). Rep. Goode has requested a recount.
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