The Social Security Administration (SSA) has added 52 new Compassionate Allowances (CA) conditions mainly involving neurological disorders, cancers and rare diseases. The CA program speeds up disability decisions to make sure that Americans with the most serious disabilities receive their benefit decisions within days instead of months or years. SSA is also improving its online disability application process. Learn more about how to apply for disability benefits. If you’ve already filed an application and it was denied you can file an appeal.

Assistant Secretary of Labor for the Office of Disability Employment Policy (ODEP) Kathy Martinez announced first-of-its-kind grant funding for four states – Iowa, Oregon, Tennessee and Washington – under the “Employment First” initiative. The effort helps facilitate the full inclusion of people with the most significant disabilities into the workplace and community. Learn more about the four states selected.

U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced the creation of the new Administration for Community Living that will bring together the Administration on Aging, the Office on Disability and the Administration on Developmental Disabilities into a single agency. This new agency will work on increasing access to community supports and achieving full community participation for people with disabilities and seniors.

The U.S. Department of Housing and Urban Development (HUD) has reached settlement agreements with Magna Bank in Nashville, TN, and Home Loan Center, Inc. in Irvine, CA, resolving allegations that the two lenders denied mortgage loans to women because they were pregnant and on maternity leave. The Fair Housing Act prohibits housing discrimination in lending, sales and rental transactions based on a person’s sex, family status, race, color, national origin, religion or disability. HUD announced the discrimination settlements as part of its annual Fair Housing Month commemoration kick-off.

The U.S. Department of Health and Human Services (HHS) has entered into an agreement with Simsbury, CT, that requires its recreation department to adopt a policy on diabetes management for children attending its summer camp program. A parent complained that the town didn’t provide reasonable modifications to its summer camp program so camp staff could test blood glucose and provide diabetes-related care to his daughter. Under Title II of the ADA, a public entity must provide reasonable modifications for a person with a disability, unless it significantly changes the nature of its service, program or activity.

The U.S. Equal Employment Opportunity Commission (EEOC) has filed suit against CTW L.L.C., a Wendy’s franchisee, for denying employment to a job applicant because he has a disability. The applicant had worked at another fast food restaurant before, but wasn’t hired at Wendy’s because of his hearing impairment. Under the Americans with Disabilities Act, employers must provide reasonable accommodations to an employee with a disability, unless it causes significant difficulty or expense for the employer.

The U.S. Department of Transportation has fined Frontier Airlines for violating the Air Carrier Access Act. A passenger who is quadriplegic needs a restraint to sit upright in an aircraft seat. The Federal Aviation Administration prohibits seatbelt extenders as upper body restraints. The passenger did not have an alternative restraint method on his return flight, so he was removed from the airplane. The airline did not accommodate the passenger and also did not give him adequate assistance to get on and off the plane.

HealthCare.gov shares Myrna Rodriguez Previte’s story about her struggle to get health insurance when she was faced with breast cancer. Seven insurance companies turned her down because of her pre-existing condition. As a self-employed real estate broker, she was responsible for her own health insurance but she couldn’t get coverage. Fortunately, she was able to get insurance through her husband’s plan at work. Thanks to the Affordable Care Act, beginning in 2014, it will be illegal for insurers to deny coverage to anyone due to a pre-existing condition.

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.

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.

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.

 

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.

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.

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.

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.

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.