Archive for November, 2012

CMS Provides Medication Management & Caregiver Resources on Youtube

Thursday, Nov. 29th 2012 4:12 PM

Medication management and good communication between caregivers and providers are two crucial factors to promoting successful patient recoveries, especially during transitions to and from hospital, long-term care, and home care settings. Caregivers often provide clinicians with valuable information that may not be available from the patient; they also provide continuity for the patient and help that would not be available anywhere else. Because of this importance in drug management and communication, the Centers for Medicare & Medicaid Services (CMS) and the United Hospital Fund of New York’s Next Step In Care Campaign produced a series of educational podcasts: Helping Patients and Caregivers Take the Next Step in Care: Medication Management. These podcasts are featured on the CMS YouTube channel.

These free podcasts can be used for provider staff and caregiver trainings, or just played in providers’ waiting rooms. For more information for caregivers and providers, see the “Ask Medicare” section of Medicare.gov.

Posted on Thursday, Nov. 29th 2012 4:12 PM | by Share of Cost | in Share of Cost | No Comments »

CNBC Presents “Health Care Hustle” Tonight 4/9 at 9p.m.

Tuesday, Nov. 27th 2012 4:12 PM

If you’re available at 9p.m. tonight, CNBC is airing their 1-hour documentary on health care fraud.  Senior correspondent Scott Cohn and others on CNBC’s investigation crew joined a fraud strike team over a period of 6 months to get a firsthand experience of the fraud problem, and the new multi-agency, collaborative efforts and tactics being used the past 2 years since health care reform to find, prosecute and prevent criminals from milking the Medicare and Medicaid system.

Fraud is one of the most expensive aspects of our health care system, costing American taxpayers and the Medicare system an estimated $80 billion per year — yet many say the real number could be as much as $160 billion. This is money going into the hands of fraudsters instead of into people’s care.

View a press release on tonight’s documentary.

See our Medicare fraud section for more information and resources on health care fraud, and for information on how to become a volunteer with our Senior Medicare Patrol project.

Posted on Tuesday, Nov. 27th 2012 4:12 PM | by Share of Cost | in Share of Cost | No Comments »

OIG Features Fraud Alerts via Podcasts, Learn About Diabetes Phone Scams

Sunday, Nov. 25th 2012 4:12 PM

The Office of Inspector General (OIG) has featured podcasts on its website covering a variety of current fraud alerts and topics. This is an easy way to listen and learn.

Below is an excerpt of some helpful Q&As from their latest podcast on diabetes supplies phone scams. Note that while they direct people to report suspected fraud to their OIG hotline, we also request that you first contact your local California Senior Medicare Patrol (SMP) project. We will forward such reporting to the OIG and/or other government agencies as appropriate. Our California SMP helpline is 1-855-613-7080.

Excerpt from the Podcast: Fraud Alert for People with Diabetes

How do you know if a call is a scam?

You should be suspicious of anyone who offers free Medicare items or services. Medicare does not make calls offering supplies or services to patients. So if someone calls you claiming to be from Medicare, it’s a red flag.

Be wary of unsolicited calls because medical suppliers are not supposed to call you without prior permission. So if you receive an unsolicited call offering free supplies or other medical goods, you should be on alert.

What if they ask you for financial information?

You should be particularly suspicious of any callers who ask for your Medicare or any other financial information. These scammers may want to trick you into revealing your personal information by asking you to verify your Medicare number. Don’t give your Medicare number or other personal information to the caller. Once your Medicare information is in the hands of a criminal, not only can they charge items and services to Medicare in your name, but you are prone to further scams, such as identity theft.

Can you give an example of diabetes supplies and some of the items that they’re offering?

Typically, free diabetic supplies, such as glucose meters, diabetic test strips, or lancets. And the caller may also offer other medical supplies such as heating pads, foot orthotics, or joint braces, all in exchange for your Medicare number or banking information. Although the caller may claim these items are “free,” these are not free. They’re still billed to the Medicare program and still cost taxpayers money. We also have reports of people receiving excessive diabetic supplies and other medical supplies that they don’t want or need. Just know you are under no obligation to accept these items that you didn’t order. So instead, you should refuse the delivery and return it to sender.

What should people do if they think they’ve been scammed and have received a suspicious call?

You should report it to the OIG Hotline. That number is 1-800-HHS-TIPS. You can also report it online at our website OIG.HHS.gov. And, click on the big red button that says “Report Fraud.” As part of the report, it’s important to provide as much detail as you can about the call, such as the company’s telephone number and address, the company name, and a summary of the conversation you had. The more information you provide to us, the greater chance we can identify who the scammers are.

What if you get medical equipment that you haven’t ordered?

As I said, you should not accept items that you did not order. Instead, refuse the delivery and return to sender. And report this to the OIG Hotline, including the items that you received and the sender’s name.

Are you concerned about medical identity theft as a result of these unsolicited calls?

Absolutely. I want to emphasize how important it is to protect your personal information. You should not provide callers with your Medicare number, bank account information, or credit card numbers. I’d also like you to alert your friends and family about this scheme as well. Remind them not to provide strangers with their Medicare numbers or personal information. This Medicare number is basically the keys to the Medicare program, and they cannot commit fraud without it.

Is there anything you want to add that you think is important?

It is very important that you check your Medicare Summary Notices for items you didn’t order and didn’t receive. So be on the lookout for diabetic supplies that were billed multiple times. And report any irregular activity to your health care provider or call us at 1-800-HHS-TIPS.

 

Posted on Sunday, Nov. 25th 2012 4:12 PM | by Share of Cost | in Share of Cost | No Comments »

A Global Road Map Is Needed For Vaccine Research, Development, And Deployment

Friday, Nov. 23rd 2012 3:40 PM

The world is witnessing a tremendous interest in the discovery, development, and use of vaccines as an important contributor to disease prevention and control. However, current global vaccine efforts are not coordinated, and they face many challenges. One is scientific: Most vaccines in use today are based on the scientific knowledge of past centuries. To usher in a new era, there is an urgent need to draw upon new science and scientific disciplines and recruit a new generation of talent trained in the basic and computational sciences of the twenty-first century. In addition, a global road map is urgently needed for making the scientific discoveries necessary to produce new vaccines; developing these into effective vaccines; and drawing up priorities and undertaking the necessary planning for rolling out these vaccines in developing countries. The developing countries themselves must play the lead role in these activities and contribute their own resources as well. This article aims to initiate a wide-ranging debate and discussion that will ultimately result in some agreement on the future of vaccine development and deployment.

Posted on Friday, Nov. 23rd 2012 3:40 PM | by Share of Cost | in Share of Cost | No Comments »

Driving Population Health Through Accountable Care Organizations

Wednesday, Nov. 21st 2012 4:24 PM

Accountable care organizations, scheduled to become part of the Medicare program under the Affordable Care Act, have been promoted as a way to improve health care quality, reduce growth in costs, and increase patients’ satisfaction. It is unclear how these organizations will develop. Yet in principle they will have to meet quality metrics, adopt improved care processes, assume risk, and provide incentives for population health and wellness. These capabilities represent a radical departure from today’s health delivery system. In May 2010 the Premier healthcare alliance formed the Accountable Care Implementation Collaborative, which consists of health systems that seek to pursue accountability by forming partnerships with private payers to evolve from fee-for-service payment models to new, value-driven models. This article describes how participants in the collaborative are building models and developing best practices that can inform the implementation of accountable care organizations as well as public policies.

Posted on Wednesday, Nov. 21st 2012 4:24 PM | by Share of Cost | in Share of Cost | No Comments »

Despite Criticism Of The FDA Review Process, New Cancer Drugs Reach Patients Sooner In The United States Than In Europe

Monday, Nov. 19th 2012 3:40 PM

The US Food and Drug Administration is often criticized as inefficient compared to its European counterpart, the European Medicines Agency. This criticism is especially common in the field of oncology, where severely ill patients have few therapeutic options. We conducted a direct drug-to-drug comparison of the two regulatory agencies’ approvals of new oncology drugs. We found that contrary to public assertions, the median time for approval for new cancer medicines in the United States was just six months—and that these new anticancer medicines are typically available in the United States before they are in Europe. Our findings reinforce the need for strong financial and public support of the Food and Drug Administration, so that such medicines can continue to be made available speedily to patients in need.

Posted on Monday, Nov. 19th 2012 3:40 PM | by Share of Cost | in Share of Cost | No Comments »

Private-Payer Innovation In Massachusetts: The ‘Alternative Quality Contract’

Saturday, Nov. 17th 2012 4:24 PM

In January 2009 Blue Cross Blue Shield of Massachusetts launched a new payment arrangement called the Alternative Quality Contract. The contract stipulates a modified global payment (fixed payments for the care of a patient during a specified time period) arrangement. The model differs from past models of fixed payments or capitation because it explicitly connects payments to achieving quality goals and defines the rate of increase for each contract group’s budget over a five-year period, unlike typical annual contracts. All groups participating in the Alternative Quality Contract earned significant quality bonuses in the first year. This arrangement exemplifies the type of experimentation encouraged by the Affordable Care Act. We describe this unique contract and show how it surmounts hurdles previously encountered with other global-payment models.

Posted on Saturday, Nov. 17th 2012 4:24 PM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, Stop pretending it was a government takeover of healthcare

Thursday, Nov. 15th 2012 4:24 PM

If the Obama healthcare bill is just a “government
takeover,” why are healthcare industry CEOs being rewarded with so much
money?

The alleged expropriation of healthcare by big government is,
of course, a major story line of the right and the new leadership of the House
which is planning the useless exercise of a vote to repeal the law.

But if the private companies who actually do control our
health are hurting so badly, why are they shelling out so much to their top
executives?

A report from Kaiser Health News exposes lavish pay
packages for some of the biggest players in the private healthcare industry. Billy
Tauzin, the head of PhRMA, raked in more than $9 million last year, for example,
while his counterpart Scott Serota at Blue Cross/Blue Shield earned a
comparitively-miserly $7.1 million.

Other major corporate healthcare figures receiving huge
executive pay packages were from the hospital, medical technology, and biotech
industry.

Posted on Thursday, Nov. 15th 2012 4:24 PM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, Vaccines as a Global Imperative a Business Perspective

Tuesday, Nov. 13th 2012 3:40 PM

During the past thirty years, vaccines have experienced a renaissance. Advances in science, business, and distribution have transformed the field to the point where vaccines are recognized as a “best buy” in global health, a driver of pharmaceutical industry growth, and a key instrument of international development. With many new vaccines available and others on the horizon, the global community will need to explore new ways of ensuring access to vaccines in developing nations. So-called tiered pricing, which makes vaccines available at different prices for countries at different levels of economic development; innovative financing mechanisms such as advance market commitments or offers of long-term and high-volume contracts to vaccine producers; and technology transfers such as sharing intellectual property and production techniques among companies and countries can all play a part in bringing new life-saving vaccines for pneumonia, rotavirus, malaria, and other diseases to developing countries.

Posted on Tuesday, Nov. 13th 2012 3:40 PM | by Share of Cost | in Share of Cost | No Comments »

New Cardiac Surgery Programs Established From 1993 To 2004 Led To Little Increased Access, Substantial Duplication Of Services

Sunday, Nov. 11th 2012 8:40 AM

Despite decreasing demand for bypass surgery, 301 new cardiac surgery programs opened between 1993 and 2004. We used Medicare data to identify where the new programs opened and to assess their impact on access and efficiency. Forty-two percent of the new programs opened in communities that already had access to cardiac surgery, which suggests that their creation has led to a fight for shares of a shrinking market. New programs were much more likely to open in states that did not require them to show a certificate-of-need.

Overall, travel time to the nearest cardiac surgery program changed little, which suggests that these programs have done little to improve geographic access. The duplication of services that resulted in many areas may have engendered competition based on quality, price, or both, but it may also have increased surgical rates, with unknown results. We observe that certificate-of-need requirements may help avoid unnecessary duplication of services by preventing new programs from opening in close proximity to existing ones.

Posted on Sunday, Nov. 11th 2012 8:40 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, Federal News Digest for June 24, 2011

Friday, Nov. 9th 2012 3:40 PM

Washington Post

U.S., allies to release 60 million barrels from oil reserves – Steven Mufson and Zachary A. Goldfarb report that the U.S. will sell 30 million barrels from its Strategic Petroleum Reserve over the next 30 days to bring down oil prices and kick-start the economy, but some in Congress say the effect will be limited and that reserves should be held for energy emergencies

Targeted HIV-testing program finds 18,000 new patients – David Brown reports on a Centers for Disease Control and Prevention program that targeted 25 cities and states to identify persons with the HIV virus who did not know they had it; the CDC’s relaxation of testing rules paved the way for the program

Where are the new obesity drugs? – Ken Fujioka, a physician who treats obese patients, says the Food and Drug Administration’s standard for approving obesity drugs is too rigid because some risks are worth the benefit to obese patients who develop life-threatening conditions

How to hire a federal watchdog – Ian Ayres, a professor at Yale, suggests that to break the logjam in Congress over the Consumer Financial Protection Bureau, the president should appoint Elizabeth Warren under a recess appointment and simultaneously nominate Sarah Raskin who was recently confirmed as a Federal Reserve Board Governor

Michael Copps, the FCC’s voice for media democracy – Katrina vanden Heuvel highlights the latest crusade by Federal Communications Commissioner Copps to bring attention to the crisis in local news coverage which he says is a threat to democracy; Copps fought deregulation and consolidation, and is a “tenacious advocate for a public-interest approach to regulating the media” in her view

Petraeus calls CIA a “bargain” at confirmation hearing – Walter Pincus reports that nominee to head CIA, Gen. David Petraeus defended the agency’s annual budget of $6 billion at his confirmation hearing

New York Times

Consumer agency asks for definitions of nonbanks – The Consumer Financial Protection Bureau is asking for comments on non-banks that fall under its jurisdiction under the Dodd-Frank financial reform law, which defined them vaguely as larger market participants; the CFPB proposes that it regulate debt collection; consumer reporting; consumer credit and related activities; money transmitting, check cashing and related activities; prepaid cards; and debt relief services

F.T.C. is said near a move on Google – Edward Wyatt and Michael Helft report that the Federal Trade Commission is about to open an antitrust investigation of Google’s search functions and related advertising practices

Republican challenges administration on plans to override education law – Sam Dillon reports that Rep. John Kline (R-MN) the chairman of the House education committee announced plans to amend the No Child Left Behind law so that Education Secretary Duncan could no longer grant waivers to states of provisions of the law that are too difficult to meet

Wall Street Journal

Nuclear agency scientists blast bosses over Yucca decision – Ryan Tracy and Stephen Power report that scientists at the U.S. Nuclear Regulatory Commission who had worked for years on the now halted project to determine whether the Yucca Mountain nuclear waste disposal plan met NRC health and safety regulations criticized Gregory Jaczko, the NRC chairman and other senior NRC management for suppressing their views

Posted on Friday, Nov. 9th 2012 3:40 PM | by Share of Cost | in Share of Cost | No Comments »

The Moral Case For The Routine Vaccination Of Children In Developed And Developing Countries

Wednesday, Nov. 7th 2012 3:40 PM

In developed countries some parents have decided not to provide routine vaccinations for their children, while in many developing countries there are inadequate rates of vaccination for various reasons. The consequences for children, and members of the community in which they live, can be significant and even tragic. Although some parents may worry that vaccines will harm their child, there is a broader moral case for vaccination that parents and policy makers should consider. This case has four components: benefits and harms, best interests, community benefits, and justice. This moral case should be central to deliberations about vaccination by parents and policy makers.

Posted on Wednesday, Nov. 7th 2012 3:40 PM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, Federal News Digest for June 28, 2011

Monday, Nov. 5th 2012 3:40 PM

Washington Post

Lessons from the Gates war room – Greg Jaffe examines the tenure of outgoing Defense Secretary Robert Gates, who marshaled his years of Washington experience under 8 presidents to become a successful Pentagon chief in time of war, and who says he had no time to be a “visionary”

Supreme Court to hear FCC challenge – Cecelia Kang reports that the Supreme Court will hear a case challenging the Federal Communications Commission’s “decency” rules on the grounds that they violate First Amendment free speech rights; the rules prohibit “indecent” speech such as nudity and curse words on TV between 6 a.m. and 10 p.m. when children could be watching, and violations could result in fines or revocation of broadcast licenses

Which Petraeus will arrive at the CIA: The officer or the gentleman? – Walter Pincus considers Gen. Petraeus’s testimony at his confirmation hearing to be CIA chief and on his preparation for the transition from revered military leader to head of a civilian agency

Obama enters debt talks – Paul Kane and Rosalind S. Helderman report on the president’s one-on-one meetings with the Senate Majority and Minority leaders to jump-start negotiations on the debt, which will reach its limit in 6 weeks; Republicans are holding out for more than the $1.3 trillion in cuts in government spending that the administration has proposed

FCC dodges answers on wireless industry competition – Cecelia Kang reports that the Federal Communications Commission sidestepped the question of whether the wireless industry is competitive in its 15th annual report on the state of the industry; the issue is critical to regulators’ consideration of the merger of wireless giants AT&T and T-Mobile

FCC’s net neutrality rules about to be official, and invite lawsuits – Cecelia Kang reports that the Federal Communications Commission will finally submit its net neutrality rules, which it approved last December to the Office of Management and Budget, one of the final steps in implementing the open Internet requirements

Human trafficking: A scourge needs greater attention – The Post says the U.S. and other countries need to step-up efforts to eliminate human trafficking following release of the State Department’s annual “Trafficking in Persons” report

New York Times

Nuclear plant’s vital equipment dry, officials say – Matthew L. Wald reports on the tour by the head of the Nuclear Regulatory Commission, Gregory B. Jaczko of the Fort Calhoun nuclear plant north of Omaha, Nebraska, which is threatened by flooding

Los Alamos laboratory is on alert for a wildfire – Kirk Johnson reports on a wildfire near the military’s nuclear research facility that led to evacuation of the town of Los Alamos; officials say nuclear materials are safely stored

Wall Street Journal

U.S. endorses Lagarde for IMF – Sudeep Reddy reports on Treasury Secretary Geithner’s announcement that the U.S. is supporting the candidacy of French Finance Minister Christine Lagarde to head the International Monetary Fund, giving Lagarde a majority of votes of IMF member nations

Senator blocks NRC Commissioner Ostendorff’s bid for 2nd term – Stephen Power and Corey Boles report that Senator Bernie Sanders (I-Vt) is holding up the nomination because of Ostendorff’s intervention in a decision by Vermont to prohibit Entergy Corp. from managing the Vermont Yankee nuclear plant; meanwhile, Republicans are calling for the resignation of NRC chairman Gregory Jaczko based on a report of his withholding information from other commissioners

Posted on Monday, Nov. 5th 2012 3:40 PM | by Share of Cost | in Share of Cost | No Comments »

New Forecasting Methodology Indicates More Disease And Earlier Mortality Ahead For Today’s Younger Americans

Saturday, Nov. 3rd 2012 3:40 PM

Traditional methods of projecting population health statistics, such as estimating future death rates, can give inaccurate results and lead to inferior or even poor policy decisions. A new “three-dimensional” method of forecasting vital health statistics is more accurate because it takes into account the delayed effects of the health risks being accumulated by today’s younger generations. Applying this forecasting technique to the US obesity epidemic suggests that future death rates and health care expenditures could be far worse than currently anticipated. We suggest that public policy makers adopt this more robust forecasting tool and redouble efforts to develop and implement effective obesity-related prevention programs and interventions.

Posted on Saturday, Nov. 3rd 2012 3:40 PM | by Share of Cost | in Share of Cost | No Comments »

Pfizer Files With The FDA For Review Of Axitinib For Patients With Advanced Renal Cell Carcinoma

Thursday, Nov. 1st 2012 3:40 PM

Pfizer Inc. announced today that the U.S. Food and Drug Administration (FDA) has accepted Pfizer’s filing for standard review of axitinib for patients with advanced renal cell carcinoma (RCC). This submission was based on Phase 3 data from the AXIS 1032 trial, comparing axitinib with sorafenib in patients with previously treated advanced RCC, which Pfizer recently presented at the 47th Annual Meeting of the American Society of Clinical Oncology (ASCO).

Posted on Thursday, Nov. 1st 2012 3:40 PM | by Share of Cost | in Share of Cost | No Comments »