Washington Notes

April, 2007

Competitive Bidding Rule Excludes Diabetes Supplies

A final rule (CMS-1270-F) issued by the Centers for Medicare & Medicaid Services (CMS) that exempts diabetes testing products from competitive bidding requirements ensures that Medicare beneficiaries will be able to continue purchase these products from their current supplier.  Only diabetes supplies purchased via mail order will be subject to the competitive bidding requirement at this time

Democratic Panel Heads in House, Senate Introduce Bills to Expand Medicare Program

The Democratic chairman of two key House and Senate committees introduced legislation to expand Medicare to those under age 65, which they said would provide younger Americans access to quality, affordable health care at less cost than under the current health care system.

"Medicare for All" would achieve universal health care coverage over five years. The Congressional Budget Office has not scored the legislation, but the lawmakers said at a press briefing that the net additional cost of offering universal coverage could be as high as $138 billion a year.

Warning Against Increased Federal Involvement in Health Care

Health and Human Services Secretary Michael O. Leavitt warned against what he claimed was a trend toward expanding the federal government's role in health care, which he said would prevent market forces from delivering less costly, quality care. Leavitt said the fight over more federal versus private control of health care will take place this year during reauthorization of the State Children's Health Insurance Program (SCHIP).

Alarm Sounded On Medicare's Financial Health

Medicare's trustees warned that the Medicare program was in critical financial condition, setting in motion a process that could ignite a fierce debate during the 2008 presidential campaign over benefit cuts and tax increases. The trustees projected that Medicare's hospitalization trust fund would probably slip into the red in 2019. Social Security is not expected to exhaust its reserves until 2041.

CMS Says Doctors Should Get Ready Now for Quality Reporting

Physicians who want to earn extra Medicare reimbursements should be preparing for a quality reporting program that begins in July. Doctors should be selecting the quality measures that they will want to report by considering which fit best in their practice. They should also be assigning responsibilities to staff, and modifying their workflow and billing systems. In order to select the measures that best address the services provided to their patients, offices should consider the conditions treated, the type of care provided, as well as the practitioners' quality improvement goals, she said

Retail Health Clinics to Open

A Minneapolis subsidiary of pharmacy giant CVS/Caremark Corp. is the latest to bring the retail health clinic concept to the Chicago area. MinuteClinic, one of the early pioneers in development of such clinics staffed by nurse practitioners, opened five clinics in CVS pharmacies located in the Chicago suburbs. A sixth retail clinic will open in Rolling Meadows next month. MinuteClinic, which began in 2000 and was acquired last year by CVS, has 175 locations across the country.

Wal-Mart Stores, the world's largest retailer, plans to open as many as 400 in-store health clinics over two to three years and could raise the total to 2,000 in seven years. Wal-Mart called the clinic program part of moves it is making to implement "customer solutions to America's healthcare crisis." Other steps included a $4 generic drug prescription program and support for a coalition seeking comprehensive healthcare reform by 2012,

Women Likelier To Forgo Healthcare

U.S. women with health insurance are more likely than men to go without needed care because of higher premiums and related costs, a study has found. A larger percentage of women also have trouble paying their medical bills.

More women didn't fill prescriptions, skipped recommended visits with specialists, failed to get tests or just didn't seek treatment when they had a medical problem, according to a national survey by the Commonwealth Fund, a private New York-based group that supports research on health and social issues.

To read the report, go to www.cmwf.org.

Large Firms to Continue to Offer Healthcare

Large companies plan to keep offering healthcare coverage to employees, but cut costs by investing in initiatives to improve employee health, according to a survey of 448 companies by human resources consultant Hewitt Associates.

Companies' efforts at improving employee health range from simple things, such as flipping the food in company vending machines so the nutritional information faces out, to an increasing number of in-house clinics and pharmacists to help employees with primary care.

Almost 70 percent of the companies surveyed, which have an average of 18,758 employees, plan to offer tools, including health risk questionnaires and nurse hot lines, so employees can better manage their health, according to the survey.