DCMedical News: Tuesday, March 31, 2020
DCMedical News-DCMN
Washington, D.C.
Tuesday, March 31, 2020
DCMedical News is published every day both the House and the Senate are in session. The Senate is in recess until April 20, the House until an indefinite date.
THE BIG STORY IN HEALTH CARE
Coronavirus
Tracking by Johns Hopkins shows on 3-30 at 8:00 p.m. EST worldwide 782,365 confirmed cases, 161,807 in the U.S.; 37,582 deaths; 164,566 patients recovered. Statista plots confirmed cases (as of March 15, here, and March 29, here) in selected countries from day one, an upward trajectory for the U.S. and some others, but flattened curves for China and South Korea.
Public Health Resource Pages (alphabetical):
AMA resource page for physicians here. CDC information page here. CMS (Centers for Medicare & Medicaid Services) Current Emergencies website, here. JAMA Network’s COVID-19 resource center here. Library of Congress Coronavirus Research Guide, (here) from the In Custodia Legis blog of the Library of Congress (LoC), with links to Congressional Research Service (CRS) reports. NIH information page here. National Library of Medicine Coronavirus page here, New England Journal of Medicine update here, New England Journal of Medicine Journal Watch here. The Lancet COVID-19 Resource Centre here. State actions, Kaiser Family Foundation, here. The White House open research dataset (CORD-19) here. World Health Organization COVID-19 page here.
News, General:
The Wall Street Journal reports on the impact of the Coronavirus pandemic on the health sector in Spain (here), Italy (here) and the United Kingdom (here). The British physician, moreover, is being told not to perform CPR on some [COVID-19] patients in cardiac arrest (BMJ, here). “If a patient with suspected covid-19 is in cardiac arrest they should be given cardiac compressions and be ventilated only if they are in the emergency department and the person attending them is wearing aerosol generating procedures (AGP) PPE. That means wearing an FFP3 mask, full gown with long sleeves, gloves, and eye protection.”
News, Medical:
Northwell Health’s remote monitoring of intensive care units gets a full-page treatment in The Wall Street Journal, here.
HHS, CMS and the FDA announced major regulatory changes intended to create or mobilize resources, (news here).
First, hospitals will be able to use locations other than a hospital for the care of Medicare patients. Bloomberg Law reported that “Hospitals will be able to send patients to same-day surgery centers, hotels, dorms and other locations to make room for Covid-19 patients needing care in their main facility.” Easing of some rules under an emergency declaration had taken place on March 13, here.
Second, Hospital Pricing Specialist Rick Louie notes that “The U.S. Department of Health and Human Services Office for Civil Rights (“OCR”) will not impose penalties [announcement here] against covered health care providers for noncompliance with HIPAA’s Privacy, Security, and Breach Notification Rules if such providers, in good faith, use non-public facing remote communications technologies to provide telehealth services in a manner that does not fully comply with HIPAA requirements. This means FaceTime, Google Hangouts video and Skype may be used.”
Third, the FDA issued guidance to relax requirements for personal protective equipment (gowns, gloves, masks, here) and also relaxed requirements for decontaminating respirators (here). The FDA also announced Sunday an emergency use authorization (here) for distribution of donated hydroxychloroquine sulfate and chloroquine phosphate. CMS announced (here) relaxation in “quality” reporting requirements, for Acute Care Hospitals, PPS-Exempt Cancer Hospitals, Inpatient Psychiatric Facilities, Skilled Nursing Facilities, Home Health Agencies, Hospices, Inpatient Rehabilitation Facilities, Long-Term Care Hospitals, Ambulatory Surgical Centers, Renal Dialysis Facilities, and MIPS Eligible Clinicians Affected by COVID-19. Finally, CMS announced (here) Medicare Administrative Contractor test pricing to begin tomorrow, April 1, at $35.91 for tests developed by the CDC, but $51.31 for non-CDC laboratory tests.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Today’s Hospitalist (here) reports that international medical graduates (IMGs) account for 45% of hospitalists, or at least those hospitalists responding to the magazine’s compensation and career survey. The IMGs “report being paid significantly less than their U.S.-trained colleagues, and they also report significantly lower satisfaction levels with their careers.”
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Single Use Duodenoscope
A report in Gastrointestinal Endoscopy (summary here) says “Preventing duodenoscope-transmitted infection has become a worldwide priority in gastroenterology. The widespread recognition of the fact that duodenoscopes can transmit bacteria with significant antibiotic resistance between patients has prompted investigation into novel solutions. Disposable duodenoscopes and duodenoscopes with disposable tips or caps (which provide unprecedented access to the inner workings of the duodenoscopes themselves, thus allowing more thorough cleaning) have all been developed and are becoming commercially available. A new device that fits over the tip of the most widely utilized duodenoscope has just been developed and approved by the FDA.”
Emergency Department Care Improving for Medicare Patients, Even Patients who are Sicker, Less Likely to be Admitted
Prior to the pandemic, a report (here) in JAMA Internal Medicine says “Among Medicare beneficiaries receiving ED care in the United States, mortality within 30 days of an ED visit appears to have declined in recent years, particularly for patients with the highest severity of illness, even as fewer patients are being admitted from an ED visit.”
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
MACPAC to Meet Via Webinar Thursday
The Medicaid and CHIP Payment and Access Commission will meet this Thursday via webinar at 10:00 a.m. (announcement here). “Most of the one-day meeting will be dedicated to reviewing and approving chapters that will be included in MACPAC’s June 2020 Report to Congress on Medicaid and CHIP. The report will address Medicaid’s role in maternity care and the impact of substance use disorder on maternal and infant health . . . integrating care for dually eligible beneficiaries and improving participation in the Medicare Savings Programs . . . the Commission will discuss two other topics: considerations in designing automatic Medicaid financing changes in times of crisis, and an update on how Medicaid is responding at the state and federal levels to the COVID-19 pandemic.” The group will vote on recommendations at the end of the day. MACPAC sent its March report to Congress (announcement here, report here).
MedPAC to Meet Thursday Also, in Closed Session
The Medicare Payment Advisory Commission will also meet Thursday (announcement here), but in closed session, with a transcript promised by the end of Friday. Among the topics announced: Challenges in maintaining and increasing savings from accountable care organizations; Realigning incentives in Medicare Part D; Redesigning the Medicare Advantage quality bonus program; Improving Medicare’s end-stage renal disease prospective payment system; and “moving toward models of value-based payment.”
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
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.