DCMedical News: Monday, April 20, 2020
DCMedical News-DCMN
Washington, D.C.
Monday, April 20, 2020
DCMedical News is published every day both the House and the Senate are in session. The indefinite Congressional schedule means DCMN will be following the CQ 2020 Calendar of Regularly Scheduled Sessions (below).
THE BIG STORY IN HEALTH CARE
Coronavirus
Tracking by Johns Hopkins shows on 4-19 at 8:00 p.m. EST worldwide 2,394,291 confirmed cases; 164,938 deaths; 611,880 patients recovered; 3,865,864 tests in the U.S.
Public Health Resource Pages (alphabetical):
AMA resource page for physicians here. AMA guide to medical education and COVID-19, here. American Public Health Association information here. Association of American Medical Colleges Clinical Guidance Repository, here. CDC information page here. CMS (Centers for Medicare & Medicaid Services) Current Emergencies website, here. Council of State Governments, 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, Medical:
Official, Announcements:
CMS summary of alerts, here; Federal Register of 4-6-2020 on COVID-19 rules, here; OIG on coronavirus supplies, an investigation of shortages and distribution, here; OIG policy statement on exceptions to fraud, kickback rules, here; Senators’ 4-14-2020 letter on FEMA role on distribution of supplies, here; White House announcement 4-16-2020 on stages in “reopening the economy,” here.
Sermo Reports More Cases to Come
The physician blog (here) reports that 65% of surveyed (6,000 physicians globally) doctors think their region has not yet reached the peak of the outbreak. The exceptions—those who felt they had already reached the peak—were 93% of physicians in China, 88% in South Korea, 76% in Italy. Not yet reached the peak: 91% in the U.S., 90% in Canada. Other findings: physicians worried about shortages of drugs being used to treat COVID-19 patients (69%), worried about the accuracy of test results (54%). Top treatments used or seen used and reported as very or extremely effective included plasma from recovered patients (n=363 reporting), hydroxychloroquine (n=875), high dose steroids during cytokine storms (n=556) and non-approved drugs, such as Remdesivir (n=436).
News, General:
History in the Making: The U.S. Supreme Court will hear ten sets of oral arguments by telephone, with live audio available to news media, May 4, 5, 6, 11, 12 and 13.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
MacGyver, MD
Adopting equipment to new uses, clinical protocols, EHR workarounds and bureaucratic idiocy are the stuff of physician blogs, newly focused on equipment for the care of COVID-19 patients (e.g., Wall Street Journal coverage, here). The light shines for the moment on a new generation of physician blogs, EMCrit, the FOAMed (free open access medical education) movement, and others, providing candor originally found in the now more established Sermo, MD Ranger and “traditional” physician-only discussion boards.
Suicides on the Rise, Prior to Pandemic
The National Center for Health Statistics reports (here) that “From 1999 through 2018, the suicide rate increased 35%, from 10.5 per 100,000 to 14.2. The rate increased on average approximately 1% per year from 1999 to 2006 and by 2% per year from 2006 through 2018. In 2018, the suicide rate for males was 3.7 times the rate for females (22.8 and 6.2, respectively). From 1999 through 2018, suicide rates among females were highest for those aged 45–64; among males, the rates were highest for those aged 75 and over. In 2018, suicide rates were higher in the most rural counties compared with the most urban counties for both males and females.”
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
OIG Faults Inpatient Psychiatric Facility Medical Necessity and Documentation Requirements
The Office of the Inspector General of HHS reports (here) that 87% of inpatient psychiatric facility claims for the fiscal years 2014 and 2015 did not meet CMS requirements for showing of medical necessity or for medical records.
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
Part D, MA Rate Increases
CMS published (here) information about expected 2021 rate increases for Medicare Part D and Medicare Advantage Plans. The expected average change in revenue in the January and February announcements was .93%, but the final amount is 1.66%, not including a 3.56% increase expected from risk scoring coding trends.
DRUGS AND DEVICES
Groopman on Medical Devices
Harvard’s Jerome Groopman publishes (in The New Yorker, here) an article on whether medical devices do more harm than good. The subtitle: “Many are clearly lifesaving, but others have proved to be life-threatening, and dangerous implants are marketed with scant oversight.”
READINGS AND REFERENCES
Who Knew/Thought What, When?
The New York Times publishes (here) 81 pages of e-mails between government officials and private authorities on preparation (or lack thereof) for the coronavirus pandemic in the U.S.
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 21, 22, 27, 28, 29, 30
May 12, 13, 14, 15, 18, 19, 20, 21
June 1, 2, 3, 4, 9, 10, 11, 12, 15, 16, 17, 18, 23, 24, 25, 26
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.