First Edition: June 3, 2014

Today's headlines include coverage of Medicare data released Monday indicating that 2012 charges for some common inpatient hospital procedures dramatically increased over the previous year.   

Kaiser Health News: Insuring Your Health: Rape Victims May Have To Pay For Some Medical Services
Kaiser Health News consumer columnist Michelle Andrews writes: "The effects of a sexual assault can be long-lasting, but the medical bills shouldn't be. Yet a new study finds that despite federal efforts to lift that burden from rape victims, a hodgepodge of state rules means some victims may still be charged for medical services related to rape, including prevention and treatment of pregnancy or sexually transmitted infections. 'If you're exposed to HIV as a result of the attack, that's something the state should be paying for, especially if we can give you prophylaxis to prevent infection,' says Ilse Knecht, deputy director of public policy at the National Center for Victims of Crime" (Andrews, 6/3). Read the column.

Kaiser Health News: Capsules: Medicare Could Save Billions By Scrapping Random Drug Plan Assignment; Pre-Existing Condition Bans – Are They Really Gone?
Now on Kaiser Health News' blog, writes about a new study regarding Medicare's drug plan assignment process: "In 2013, an estimated 10 million people who participate in the Medicare prescription drug program, known as Part D, received government subsidies to help pay for that coverage. They account for an estimated three-quarters of the program's cost. Most of those low-income enrollees are randomly placed in a plan that costs less than the average for the region where the person lives" (Rovner, 6/2). 

Also on the blog, Rovner tells her own experience with insurance coverage and pre-existing conditions: "Now, as a health reporter, I knew the first letter was a mistake. The 1996 Health Insurance Portability and Accountability Act (HIPAA) provides that if you've had continuous coverage, meaning coverage without a break of more than 63 days, your new insurer may not impose a pre-existing condition waiting period. Obviously I hadn't had a break of more than 63 days. I hadn't had a break of even one day. I did that quite purposefully. But the mix up raised a broader question – What about the requirement of the Affordable Care Act that prohibited pretty much all pre-existing condition exclusions as of Jan. 1, 2014? Under the law, the only plans that may continue to exclude coverage for pre-existing conditions after that date are individual plans that are 'grandfathered,' or haven't changed substantially since the law was passed in 2010'" (Rovner, 6/2). Check out what else is on the blog.

The New York Times: Hospital Charges Surge For Common Ailments, Data Shows
Charges for some of the most common inpatient procedures surged at hospitals across the country in 2012 from a year earlier, some at more than four times the national rate of inflation, according to data released by Medicare officials on Monday. While it has long been known that hospitals bill Medicare widely varying amounts -; sometimes many multiples of what Medicare typically reimburses -; for the same procedure, an analysis of the data by The New York Times shows how much the price of some procedures rose in just one year's time (Creswell, Fink and Cohen, 6/2).

The Washington Post's Wonkblog: Further Evidence Of How Weird Hospital Pricing Is
The federal government last year for the first time released the prices that hospitals charge for the 100 most common procedures. The Medicare data from the 2011 fiscal year demonstrated wild variations in what hospitals charge the health-care program for seniors – for example, a joint replacement could be priced anywhere between $5,300 and $223,000 depending on the facility (Millman, 6/2).

The Wall Street Journal: Hospitals' Prices Common Services On The Rise
Federal data released Monday show an increase in the average price hospitals charge to treat common conditions, with vascular procedures and chest-pain treatment showing some of biggest upticks. The numbers from the Centers for Medicare and Medicaid Services include 2012 prices at 3,376 hospitals for the 100 most common inpatient stays by Medicare patients. It is the second year the agency has released such data, and it reflects $57 billion in payments from Medicare, the federal insurance program for the elderly and disabled (Armour, Weaver and Beck, 6/2).

USA Today: Cheaper Eye Drug Could Save Medicare $18 Billion
Switching from an expensive eye medication to a similar, much cheaper medication could save Medicare $18 billion over the next decade, a report released Monday finds. Lucentis to Avastin are used to treat wet macular degeneration and diabetic macular edema. Avastin costs $55 per treatment, and Lucentis costs $2,023 per treatment. Both are made by Genentech, a subsidiary of health care company Roche. The medications made headlines recently when Medicare released its provider-payment data for 2010 and showed that one Florida doctor was paid $21 million by Medicare for his use of Lucentis (Kennedy, 6/2).

The Washington Post: Anthony Brown Says He Should Have Taken Direct Role In Maryland Health Exchange Rollout
Democratic gubernatorial front-runner Anthony G. Brown said Monday that he should have taken a more direct role in overseeing Maryland's online health insurance exchange, a project that turned out to be deeply flawed. Brown, the state's lieutenant governor, made the remark during a spirited, hour-long debate with his two leading rivals that also included clashes over the candidates' commitment to expanding pre-kindergarten education in coming years and the tax environment in the state (Wagner, 6/2).

The Associated Press: Doctors Lean More Left, Political Donations Show
The first rigorous look at donor doctors also finds they've become increasingly generous, with political contributions surging to almost $200 million in recent years. An increase in female doctors -; who more often than men donated to Democrats -; and a decline in physicians working on their own or in small practices occurred during study years. Those changes likely contributed but reasons for the political shift are unclear, said study co-author David Rothman, a social medicine professor at Columbia University's medical school (6/2).

The Washington Post's Wonkblog: Doctors Are Donating Less Often To Republican Candidates
There have a few been recent hints at how the sweeping changes within the medical industry are reshaping the politics of being a doctor. But a new study suggests a profession once solidly aligned with Republicans has become more Democratic in the past 20 years, as the number of female doctors grows and the traditional small physician's office is on the wane. Researchers analyzing doctors' federal campaign contributions between the 1991-92 and 2011-12 election cycles found that doctors -; who once contributed to Republican campaigns at consistently higher rates than the entire donor population -; have become less enthusiastic donors to the GOP (Millman, 6/2).

The Wall Street Journal: Veterans Affairs Hospitals Vary Widely In Patient Care
The Phoenix facility at the heart of the crisis at the Department of Veterans Affairs is among a number of VA hospitals that show significantly higher rates of mortality and dangerous infections than the agency's top-tier hospitals, internal records show. The criticism that precipitated last week's resignation of VA Secretary Eric Shinseki has focused largely on excessive wait times for appointments across the VA's 150-hospital medical system (Burton and Paletta, 6/2).

The Associated Press: Reid Vows Quick Senate Action On VA Health Bill
A refashioned bill to address problems plaguing the Veterans Affairs Department should be approved by the Senate as soon as possible, Senate Majority Leader Harry Reid said Monday. The bill, sponsored by Sen. Bernie Sanders, I-Vt., would give the VA authority to immediately remove senior executives based on poor job performance while preventing "wholesale political firings" that Sanders said could be allowed under a similar bill approved by the House (6/2).

Politico: Harry Reid: GOP 'Double-Speak' On Veterans
Senate Majority Leader Harry Reid accused Republicans of prioritizing the wealthy over the health of military veterans, arguing that "every senator" should support Democrats' plan to boost medical care access for veterans, no matter the price tag. Reid on Monday slammed Republicans for rejecting a veterans bill written by Sen. Bernie Sanders (I-Vt.) in February. Reid accused the GOP of "double-speak" by criticizing the Veterans Affairs Department but denying the agency the funding it needs. He bashed Republicans for spending billions on Iraq paid for by "the taxpayers' of America's credit card" while failing to invest in care for those returning from overseas conflicts (Everett, 6/2).

The Washington Post: With Shinseki Out, What's Congress Going To Do About The VA? 
So now what? That's what many in Washington will be asking this week now that Veterans Affairs Secretary Eric K. Shinseki has resigned, a move that lawmakers agreed was a good "first step," but just part of a new push to overhaul the beleaguered Department of Veterans Affairs. With Shinseki's sudden departure, it's likely that Congress will take weeks, if not months, to sort out the situation. The debate will break down along familiar lines -- Democrats and Republicans agree in principle that something must be done, but the House and the Senate can't agree on how to do it. Senate Democrats are pushing to pass a comprehensive bill with several changes, while House Republicans are touting nine veterans-related measures that they've passed in recent months and seen ignored by the Senate. Meanwhile, the issue of veterans' care is fast becoming fodder on the campaign trail, with Democratic and GOP political operations already targeting incumbents and challengers for ignoring the VA scandal or voting against VA budget increases (O'Keefe, 6/2).

Los Angeles Times: Veterans Group Pushes For 'Marshall Plan' To Address VA Member Issues
As the Senate prepares to take up reform legislation growing out of the VA healthcare scandal, a group representing Iraq and Afghanistan war veterans called Monday for a "Marshall Plan" for veterans and for the president to appoint a post-9/11 veteran or someone who understands the younger generations of veterans as the next secretary of Veterans Affairs. The group also called for the Senate to swiftly pass legislation that would expand the VA secretary's authority to fire or demote senior staff for poor performance and for Congress to increase funding for VA healthcare and approve a bill designed to combat suicides among veterans (Simon, 6/2).

USA Today: Poll: Confidence In Veterans' Care Plummets To New Low
Americans' confidence in the medical care provided for soldiers returning from Iraq and Afghanistan has plummeted to new lows in the wake of the VA scandal, a USA TODAY Poll finds. Most people see the problem as widespread and systemic. Just one in five rate the job the government does in providing veterans with medical care as excellent or good, about half the percentage who said that in a Pew Research Center survey in 2011. Then, half rated the care as "only fair" or poor; now seven in 10 do (Page, 6/2).

The New York Times: Ventas To Buy American Realty Capital Healthcare For $2.6 Billion
Ventas, the nation's biggest health care real estate investment trust, said on Monday that it had agreed to acquire the American Realty Capital Healthcare Trust for $2.6 billion in stock and cash. At $11.33 a share, the offer is 14 percent above the Friday closing stock of the company, known as A.R.C. Healthcare (6/2).

The Wall Street Journal: Humana Files RICO Claim Over Medtronic Bone Drug
Humana alleges that Medtronic paid $210 million to prominent physicians who advocated the drug's use in certain neck and spine surgeries that hadn't been approved by the U.S. Food and Drug Administration, according to Humana's complaint. Humana alleges the doctors advocated these uses, in part, in medical journals (Walker, 6/2).

The Washington Post: Videos Aim To Inform Patients About Their Medical Options At The End Of Life
The video was direct and dramatic. In a demonstration of cardiopulmonary resuscitation, or CPR, a technician pushed down hard on the chest of a dummy. A white-coated doctor narrating the video laid out grim odds: "Most of the time, in patients with advanced disease, CPR does not work," she said. As a result, patients need a ventilator to help them continue breathing. Goff watched a technician maneuver a metal instrument down the dummy's throat to prepare for insertion of a tube that pushes air into the lungs. Then the camera zoomed to a close-up of an elderly patient, eyes closed, in a hospital bed. He had a breathing tube in his mouth. Equipment surrounded his bed (Sun, 6/2).

The Associated Press: Task Force To Aid NYC's Mentally Ill Inmates
Mayor Bill de Blasio announced a new task force Monday to overhaul how New York City's corrections system treats the mentally ill -; both in jail and out -; following the grisly deaths of two inmates with psychological problems (6/2).

The Associated Press: Del. Lawmakers Eye Heroin Overdose Antidote
Delaware lawmakers are eyeing legislation to help drug addicts survive heroin overdoses. State officials last year adopted a pilot basic life support protocol that allows emergency responders to treat suspected narcotic overdoses with naloxone, a heroin overdose antidote known by the brand name Narcan (6/2).


http://www.kaiserhealthnews.orgThis article was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.


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