DCMedical News: Monday, March 9, 2020
DCMedical News-DCMN
Washington, D.C.
Monday, March 9, 2020
DCMedical News is published every day both the House and the Senate are in session.
THE BIG STORY IN HEALTH CARE
Coronavirus News
Tracking by Johns Hopkins shows on 3-8 at 4:00 p.m. EST worldwide 109,575 confirmed cases, 3,799 deaths, 60,693 patients recovered.
Public Health Resource Pages: AMA resource page for physicians here. CDC information page here. NIH information page here. National Library of Medicine Coronavirus page here, New England Journal of Medicine update page here.
Medicare Promotes Telehealth Visits with Coronavirus Funding Bill:
A Medicare fact sheet (here) unveils new opportunities for telehealth under the $8.3 billion funding bill signed by the President March 6. The bill includes $500 million in waivers for Medicare telehealth restrictions; CMS previously provided payment for telehealth for beneficiaries in rural areas, now extended to all Medicare beneficiaries, for “non-face-to-face” care management services and remote patient monitoring services. CDC has provided clinical guidelines for virtual treatment of COVID-19.
CMS has also published FAQs on billing for laboratory and physician services (here) under Medicare Part B. Also, CMS directed state agency surveyors (here) to focus only on infection control (“Specifically, CMS is suspending non-emergency inspections across the country, allowing inspectors to turn their focus on the most serious health and safety threats like infectious diseases and abuse.”) Declining attention to infection control in hospitals (e.g., Leapfrog report from 2018, here) and nursing homes is suspected.
News and commentary: The Los Angeles Times debuts a daily coronavirus newsletter. The Financial Times provides an update here. NPR has an update here. Medscape has a summary (here) for clinicians. The New Yorker puts the spotlight on the 18 months+ it will take to develop a vaccine, here.
Hospital News:
The Boston Globe reports (here) that “Two major Boston hospitals have set up temporary facilities to test employees of the biotech giant Biogen for coronavirus, after nine cases of Covid-19 were linked to a company meeting in Boston last week. Brigham and Women’s Hospital on Friday erected a tent inside the hospital for the testing.”
Delphine O’Rourke on behalf of the Public Health System Affinity Group of the American Health Lawyers Association produces “What Hospitals Need to Do to Prepare for a Coronavirus Outbreak: Overview and Checklist.” Topics include privacy, key supplies and services, providers (contracts, insurance, credentialing and telemedicine and more). She writes, “Months and even years after an emergency is over and day-to-day operations have gone back to normal, hospital counsel will be handling the legal implications of the emergency.”
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
PAs See Steady Number of ED Patients
A study in the American Journal of Emergency Medicine reports that physician assistants saw approximately the same percentage of emergency department patients each year over an eight-year period. NEJM’s Journal Watch (here) reports that “The role of physician assistants (PAs) in the emergency department (ED) has become increasingly controversial. To identify any changes in the volume of patients seen by PAs in the ED over time, researchers queried the National Hospital Ambulatory Medical Care Survey, which included 450 hospitals that received approximately 1 billion ED visits from 2010 to 2017.”
According to the report, “During the study period, ED volumes increased 7%. PAs saw approximately 5% of all ED patients alone and another 8.2% with physician involvement, while physicians saw 76.3% of ED patients alone . . . There was no significant change in the percentage of visits involving PAs over the study period. Higher PA involvement was associated with lower acuity, younger patient age, fewer procedures and tests, shorter length of stay, and fewer hospital admissions.”
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Top Ten Hospitals in the World
Newsweek deploys its “reputational” ranking to name the top ten hospitals in the world (here), four in the U.S. (Cleveland Clinic, Mayo Clinic, Mass General, Johns Hopkins).
KFF on States with the Most For-Profit Hospitals
The Kaiser Family Foundation publishes its summary for 2018 (here) on ownership of hospitals. Three states (Texas, Nevada, Florida) have more than half their hospitals in for-profit ownership.
READINGS AND REFERENCES
Medicare Compliance: How Medicare Policy Changes Impact Utilization and Case Management
A study by MCG Health (here) with focus on local coverage determinations and Medicare (and Medicare Advantage) payment for services associated with social determinants of health. From the study: “The Medicare program has also made changes to policies regarding coverage for services related to social determinants of health, which are the conditions in which people live, work, and age that impact their health. Traditionally, Medicare has not paid for supports and services that directly address these social determinants of health.”
U.S. House of Representatives:
Members at https://www.house.gov/representatives
Committees and Members at https://www.house.gov/committees
U. S. Senate:
Committees and Members at https://www.senate.gov/committees
CQ 2020 Calendar of Regularly Scheduled Sessions, here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
March 10, 11, 12, 23, 24, 25, 26, 27, 30, 31
April 1, 2, 3, 20, 21, 22, 27, 28, 29, 30
May 12, 13, 14, 15, 18, 19, 20, 21
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.