DCMedical News: Thursday, March 12, 2020
DCMedical News-DCMN
Washington, D.C.
Thursday, March 12, 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 3-11 at 8:00 p.m. EST worldwide 125,865 confirmed cases, 4,615 deaths, 67,003 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 here. Washington State (epicenter) coronavirus page here.
News, medical: A summary report (here) on investigational therapies for COVID-19. NEJM Journal Watch reports that “The World Health Organization has declared the novel coronavirus (COVID-19) outbreak a global pandemic. At a news briefing on Wednesday, WHO Director-General Dr. Tedros Adhanom Ghebreyesus noted that over the past 2 weeks, the number of cases outside China increased 13-fold and the number of countries with cases increased threefold. Further increases are expected. He said that the WHO is ‘deeply concerned both by the alarming levels of spread and severity and by the alarming levels of inaction,’ and he called on countries to take action now to contain the virus. ‘We should double down,’ he said. ‘We should be more aggressive.’” WHO guidance on preparedness and links to technical papers here.
Testing: CQ reports that “Food and Drug Administration Commissioner Stephen Hahn said at a House Agriculture Appropriations Subcommittee hearing Wednesday that manufacturers working with the government have shipped 2.5 million tests for COVID-19, the disease caused by the novel coronavirus. That means about 989,000 people can be tested since individuals are tested more than once. But Hahn declined to estimate the number of tests that labs can process per day. Meanwhile, former FDA Commissioner Scott Gottlieb released an analysis Wednesday estimating that all the labs across the country can only test, at most, 16,530 total patients per day. Durland Fish, professor emeritus of epidemiology at Yale School of Medicine, estimated by looking at the spread of COVID-19 in China that the U.S. could have 100,000 cases by May.” Some hospitals begin “drive through testing,” according to a report in Modern Healthcare, here.
News, general: The President addressed the nation at 9 p.m. EST (here), ordering a 30-day ban on travel from Europe, with exceptions, not including the UK; a possible easing of travel restrictions from the Far East; the prospect of deferred tax payments, and easier Small Business Administration loans (with $50 billion of new authority); and agreement of health insurers to waive copayments (and surprise bills) for COVID-19 treatment. The President also made proposals for payroll tax reduction and sick leave assistance (see below).
Dow drops 1464. The Boston Globe reports “Stocks fell sharply on Wall Street on Wednesday as fears of economic fallout from the coronavirus outbreak gripped markets again, with the Dow Jones industrial average entering into a bear market.” German Chancellor Angela Merkel warns that up to 70% of the German population may contract Coronavirus. A cautionary note (here) in The Wall Street Journal on interpreting the rise (and apparent fall) in the incidence of new confirmed virus cases, measures which will be heavily dependent on testing and local conditions.
The Congressional push for paid sick leave is resurrected, including a new study (report here, KFF issue brief here) on the economics: fewer employees worked when sick, on average they took two additional sick days a year, the cost to employers “relatively small.” The House prepares today to vote on a package including comprehensive sick leave, unemployment assistance and other benefit provisions.
The Center for Economic and Policy Research condemned failure of the Senate to consider a mandatory sick leave bill: “In the face of the COVID-19 pandemic, it is unconscionable that Senate Republicans have blocked an emergency paid sick leave bill from coming to the Senate floor. The Centers for Disease Control and Prevention recommends that individuals exposed to the novel coronavirus self-quarantine for 14 days. But many workers in jobs with the greatest exposure to the public are among those least likely to have access to paid sick days. The spread of COVID-19 has highlighted the absurdity of a situation in which 93 percent of the highest paid workers have access to paid sick days compared to just 30 percent of the lowest paid workers. Workers in jobs ranging from aides in nursing homes to retail clerks to childcare workers are unlikely to be able to afford to lose a week's pay and may be unable to take time off from work.”
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Surgery and the Elderly
A report in JAMA Surgery (here) on surgery in the elderly notes that “Surgeons generally believe they are good at determining whether a patient is likely to tolerate surgery. However, evidence suggests that surgeons’ clinical intuition may not always be accurate and more is needed to assess the vulnerabilities of older surgical patients.”
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Hospitals and COVID-19 Treatment
The American Hospital Association urged the President (letter to Vice President Pence, here) to declare a national emergency. The specifics: “Waiver of the Skilled Nursing Facility (SNF) 3-day qualifying hospital stay requirement for beneficiaries. This would allow SNF coverage in the absence of a hospital stay, making inpatient beds available for more seriously ill patients. Waiver of critical access hospitals' (CAH) limitation of 25 inpatient beds and the 96-hour length of stay limitation. This is crucial for rural areas that may not have other options for inpatient beds. Waiver of requirements that physicians and other health care professionals be licensed in a state in which they are providing services, so long as they have equivalent licensing in another state for Medicare, Medicaid and CHIP participants.”
DNV Issues Notice re Changes in Surveys, Accreditation
Det Norske Veritas changes accreditation protocols (here), with CMS’ agreement, for COVID-19.
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
COVID-19 and Third Parties
CMS issued a notice to Medicare Advantage and Part D plans (here), noting that “Many leading insurance companies and their industry associations announced they will be treating COVID-19 diagnostic tests as covered benefits and will be waiving cost sharing that would otherwise apply to the test. The President also directed CMS to provide more flexibility to Medicare Advantage and Part D plans to ensure they have the tools they need to provide seniors with the best coverage. As a result, CMS published a memorandum to Medicare Advantage (MA) and Part D health and prescription drug plans informing them of the flexibilities they have to provide healthcare coverage to Medicare beneficiaries for COVID-19 testing, treatments, and prevention.”
More Money in the Medically Indigent Business
Medicaid services of DXC Technology were sold (here) to a private equity firm, $5 billion in cash for services focused on Medicaid and state and local government health and human-service providers. Claims processing, fraud detection and call-center capabilities are the services involved, generating $1.4 billion per year in sales.
READINGS AND REFERENCES
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 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.