Friday, April 27, 2012


Today’s edition got a little longer than usual but be sure to read to the end – you don’t want to miss the part about Ben Bernanke warning that we’re about to go over a ‘fiscal cliff’.  And you’ll then want to click on the article to see how the author rephrases ‘fiscal cliff’ as ‘economic Armageddon.’  But there’s a lot of good stuff in here too so read on!

What happens if ACA struck down?  In a word, chaos, according to this story about how winding down the law would be as challenging as implementing it.  The National MS Society Public Policy Office is assessing, to the best of our ability not knowing what the decision will be, the various scenarios and how best to respond.

Support for Increased NIH funding.  As part of the Public Policy Conference MS Activists took the message to Congress to increase NIH funding, not let it be flat.  Their efforts, coupled with partner organization’s efforts, has resulted in the push for more funding being noticed.  This article highlights the broad bipartisan support generated for more research funding.  Hat’s off to all our Activists!!

Medicare Payment Change.  One element of the Affordable Care Act that seemed to make a lot of sense was the concept that providers who provided the highest quality would be rewarded, those who didn’t, wouldn’t.  Part of that equation involves ‘utilization,’ creating disincentives for physicians who over-utilize.  Sounds good, right?  Well, of course it sounds good, but for neurologists treating patients with MS, use of the MRI could now possibly get the doctor into some trouble for ‘over-utilization.’  See a recent interview at Kaiser Health and read a blunt assessment from an MS doctor here.  The Washington Post recently reported on the potential problem as well.  Needless to say, this is of great concern and the Society is working on finding solutions.

Benefits/Cost-Sharing under ACA.  Kaiser Family Foundation has a detailed piece on ‘Private Insurance Benefits and Cost-Sharing Under the ACA’ that attempts to break down some very complex  concepts  and distinctions that really matter to people who use lots of health care and coverage, namely benefits,  cost-sharing,  and actuarial value.

Medicare/Social Security Trustees.  The trustees for both Medicare and the Social Security system released reports indicating that both programs are running through money at a fast clip and that if no changes are made, funds will be ‘exhausted’ for Medicare in 2024 (12 years from now) and for Social Security in 2033.  This is nothing new and once again dictates why long-term permanent changes are necessary to ensure solvency of both programs.  New poll shows a majority of Americans support Medicare reform, so long as they don’t have to pay for it!

Health Care Workforce.  The executive director of the Deloitte Center for Health Solutions wrote a piece talking about the need to rethink workforce strategies in the new and evolving health care system.

Coverage Gap:  25%.  One quarter of working age Americans (19 to 64) experienced a coverage gap in 2011 according to The Commonwealth Fund.  A majority of those Americans were uninsured for one year or more.  This piece also talks about how the Affordable Care Act will narrow that gap.

Social Media & Health Care.  Apparently one third of Americans use social media as a source of information about medications, treatments, doctors, etc. according to a new study.

Pool Accessibility under the ADA.  This week the Department of Justice announced two free webinars that will provide information and technical assistance addressing the accessible pool entry requirements of the revised 2010 ADA Regulations and the 2010 ADA Standards as they relate to existing pools.  The first webinar will be May 2, 2012, from 2:30 - 3:45 EDT, and it will address the pool access provisions as they apply to the existing pools of public accommodations subject to title III of the ADA.  The second webinar will be May 9, 2012, from 2:30 - 3:45 EDT, and it will address how the pool access provisions apply to the existing pools of state and local governmental entities subject to title II of the ADA.  The DOJ will answer question other than those regarding pending rulemaking on this issue.  Space is limited so if you’re interested in joining the calls, contact as soon as possible.  Legislation is pending in Congress to prevent DOJ from enforcing the law as it pertains to pools so this has become a rather hot issue on the Hill.  The National MS Society, together with other groups, is advocating for implementation of the rules as soon as possible since they have already been delayed.

Affordable Care Act – federal funds tracker.  The Kaiser Family Foundation has once again published a very useful tool.  The federal funds tracker tracks how much funding from the Affordable Care Act is being spent with breakdowns per state and by category.

HHS creates Administration for Community Living.  The new office will bring together the Administration on Aging, the Office on Disability and the Administration on Developmental Disabilities into a single agency that supports both cross-cutting initiatives and efforts focused on the unique needs of individual groups, such as children with developmental disabilities or seniors with dementia. This new agency will work on increasing access to community supports and achieving full community participation for people with disabilities and seniors.  Secretary Sebelius’s Statement.

Improved Preventive Care due to health reform.  The authors of a recent study estimate that through expanded access to insurance coverage, reduced financial barriers to care, and improved quality of care delivery, an additional 9.8 million patients will receive recommended preventive services.

Music Producer with MS featured.  CNN’s Chief Medical Correspondent Dr. Sanjay Gupta introduces Noah “40” Shebib, a music producer who was diagnosed with Multiple Sclerosis  in his early 20s, on Gupta’s blog.
Supreme Court ruling favors Generics.  The Supreme Court ruled unanimously that generic drug manufacturers can file certain legal counterclaims against brand-drug companies in an effort to get their cheaper copycat medicines on the market.

The next 6 months.  Stories are again starting to circulate about a possible government shutdown as flare-ups in appropriations committees show divisions not just between Democrats and Republicans, but within the Republican majority.  Fed Chairman Bernanke is warning of the U.S. approaching a ‘fiscal cliff’ at the end of the year and unfortunately, the prospect for more congeniality and bi-partisanship in the 113th Congress isn’t looking too good as redistricting has resulted in both parties moving further to the left and right.  The 2010 election coupled with 2012 primary results to date show an ever shrinking number of moderates, of either party, remaining in Congress. 

Competitive Bidding for DME to Expand.  On the heels of a report that the competitive bidding process in Medicare saved over $200 million, it was announced that the process will expand dramatically with projected $42 billion in savings over 10 years.  Legislation has been introduced to end competitive bidding but since its end would increase the deficit, the bill is unlikely to pass.

Crystal Ball.  Larry Sabato’s ‘Crystal Ball’ has a lot of information about the Veepstakes and a really great rundown of ‘It Can’t Be Done’ – a summary of presidential elections since 1948 and the predictions that were oh so wrong.  In ’48 it was said that the election was a mere formality for soon-to-be President-elect Thomas Dewey and for 2012 Sabato’s read is . . .

“2012: YOUR CHOICE: No controversial president with unemployment over 8% could possibly be reelected. No Mormon candidate, especially one who lacks a common touch, could possibly be elected.”

He also provides a pretty intense analysis of various electoral college scenarios – great read.  After I read it I figured Sabato & Co.’s brains must hurt after they put a piece together like this one!

State Notes:
·         New York state payment system issue.  In the aftermath of a landmark settlement supposed to increase coverage for out-of-network care, the largest health insurers are altering their payment methods to shift more costs to patients, The New York Times reports. 

·         State-imposed Therapy Restrictions.  Several states are considering, and several have already implemented, caps on physical, occupational and speech therapy.  Kaiser Health News reports that in many instances, the patient ends up paying the majority of the bill.

That’s it for now . . . as you can tell, there’s no lack of activity on which to report!  Have a great weekend.  I’m off to the American Telemedicine Association meetings for the next few days to learn in greater detail various public policy issues relevant to telehealth.

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