DCMedical News: Thursday, May 21, 2020
DCMedical News-DCMN
Washington, D.C.
Thursday, May 21, 2020
DCMedical News is published every day both the House and the Senate are in session and on pre-pandemic Regularly Scheduled Session days (see CQ calendar, below). Publication will resume June 1.
THE BIG STORY IN HEALTH CARE
Coronavirus News: (reference pages below under Reading & References)
Tracking by Johns Hopkins shows on 5-20 at 8:00 p.m. EST worldwide 4,968,689 confirmed cases; 326,515 deaths worldwide; 93,214 U.S. deaths (28.5%).
Science and COVID Society
Medication and Clinical Management: New commercial website to track (here) treatments and clinical trials, and one (here) on COVID-19 management guidelines, including National Institutes of Health and the Infectious Diseases Society of America/Society of Healthcare Epidemiology of America/Pediatric Infectious Disease Society COVID-19 living guidelines. New treatment simulations exercises (here) in the NEJM.
Testing and Data: Antibody Testing: a summary (here): “A serologic test for antibodies against the SARS-CoV-2 nucleocapsid protein shows optimal specificity and sensitivity at day 14, but its prognostic role is unclear.” Data gaps generally discussed in the NEJM, here. Fudging and bungling of state data is the focus of a Modern Healthcare report, here.
More Coming in 2020? The Financial Times reports (here) that “The rapid spread of coronavirus in the southern hemisphere suggests it is likely to flare up again in the US this autumn and winter, raising the possibility of a second round of lockdowns this year . . . Robert Redfield, director of the Centers for Disease Control and Prevention, or CDC, warned the US would have to increase its disease-tracking capabilities rapidly in the next few months to avoid another public health crisis as seasonal flu coincides with a second wave of Covid-19.”
Coronavirus and the Federal Government: The now-famous CDC 60-page “reopening” guide, here, and the Tuesday Executive Order (here) instructing federal agencies to ease up, stand down and promote economic recovery.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Veterans’ Health Spending on Private Medical Care Likely to be Exempt from Budget Lid
CQ reported Wednesday night that leaders of the Senate Appropriations “Will move ahead with exempting a popular veterans health care program from annual spending caps” on community care programs “that allow access to private doctors if available Department of Veterans Affairs hospitals are ill-equipped, overbooked or far from home.” In addition, “Exempting the veterans community care funds from nondefense discretionary spending caps would free up about $12.5 billion in spending for other programs in the fiscal year set to begin Oct. 1.”
How Private Equity is Ruining American Health Care
Bloomberg Businessweek reports (here) that “Investors have been buying up doctor’s offices, cutting costs, and, critics say, putting pressure on physicians in ways that hurt patients. The pandemic could make things even worse.”
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Accelerated Medicare Payments Listed, Loans from the Medicare Trust Funds
CMS published (here) the Accelerated and Advance Payment (AAP) Program payments, to increase cash flow to Medicare providers and suppliers impacted by the 2019 Novel Coronavirus (COVID-19) pandemic. “The advance and accelerated payments are a loan that providers must pay back. It is important to note, this funding is separate from the $100 billion provided in the Coronavirus Aid, Relief, and Economic Security (CARES) Act. The CARES Act appropriation is a payment that does not need to be repaid.”
Purchasing Muscle Exercised for Development of Domestic Suppliers
Premier, a major group purchaser for hospitals announced (here) that it is undertaking an effort to promote domestic production of medical supplies. A report in Modern Healthcare noted “Premier will invest in domestic suppliers of personal protective equipment—about 80% of which is sourced from Southeast Asia—as well as other medical commodities that are in short supply.”
MEDICARE, MEDICAID, AND COMMERCIAL HEALTH INSURANCE
Proposed FY 2021 IPPS Rule
The FY 2021 proposed payment rule known as the Inpatient Prospective Payment System has its own “home page,” here. The proposal (to be published in the May 29 Federal Register) is here, CMS Fact Sheet here, HFM Executive Summary here.
In the proposed rule CMS proposes to address the “Hahnemann” challenge—the closing of a safety net hospital controlled by a private equity firm which stranded hundreds of residents in training, as follows: “CMS is proposing policy changes related to closing teaching hospitals and closing residency programs to address the needs of residents attempting to find alternative hospitals in which to complete their training and to foster seamless Medicare indirect medical education and direct graduate medical education funding. This proposal would expand the existing definition of who is considered a displaced resident (beyond residents who are physically present at the hospital training on the day prior to or the day of hospital or program closure). These proposed policies would provide greater flexibility for the residents to transfer while the hospital operations or residency programs were winding down and would allow funding to be transferred for certain residents who are not physically at the closing hospital/closing program.”
READINGS & REFERENCES
Coronavirus Public Health Resources and References:
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 and real-time dashboard to monitor clinical trials, here. State actions, Kaiser Family Foundation, here. UC Hastings College of Law’s “The Source” (on health care prices and competition) COVID-19 page, here. The White House open research dataset (CORD-19) here. World Health Organization COVID-19 page here.
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
June 1, 2, 3, 4, 9, 10, 11, 12, 15, 16, 17, 18, 23, 24, 25, 26
July 21, 22, 23, 24, 27, 28, 29, 30, 31
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.