DCMedical News: Tuesday, June 23, 2020
DCMedical News-DCMN
Washington, D.C.
Tuesday, June 23, 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).
THE BIG STORY IN HEALTH CARE
Tracking by Johns Hopkins shows on 6-22 at 8:00 p.m. EST worldwide 9,057,837 confirmed cases, following the largest one-day increase (183,000, here from Statista) during the pandemic; 470,665 deaths worldwide; 120,351 U.S. deaths (26%).
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
BLS Reports Doctors the Highest Paid Group in Every State
The Financial Times reports (here) that “A study of U.S. wage data collected by the Bureau of Labor Statistics [here] shows that medical workers are the best paid professionals in every state . . . the data help to explain the costly nature of the US medical system . . . The various specialisms account for three quarters of the top 20 best-paying occupations as of 2019.”
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Empty Hospitals and Doctors Offices: Trouble for Whom?
Cardiologist and New York Times columnist Sandeep Jauhar asks (here) “Do Americans really need the amount of treatment that our health care system is used to providing?” He notes that, in the pandemic, “Routine clinic visits were canceled or replaced by online sessions. This has resulted in grievous financial losses for hospitals and clinics. Medical practices have closed. Hospitals have been forced to furlough employees or cut pay.” [Kaiser Health News has previously reported, here, that ‘Nearly Half Of Americans Delayed Medical Care Due To Pandemic.’] Jauhar continues, “Most patients, on the other hand, at least those with stable chronic conditions, seem to have done OK. In a recent survey, only one in 10 respondents said their health or a family member’s health had worsened as a result of delayed care. Eighty-six percent said their health had stayed about the same.”
Jauhar recounts the enormous utilization variability in American medical care (e.g. here), and surveys of doctors indicating a significant percent of care to be unnecessary, generally, however, in specialties other than their own. Jauhar cites a Johns Hopkins survey (here) of more than 2,000 physicians which found “The majority of the physicians who responded to the survey said they believed that at least 15 to 30 percent of medical care is not needed. Breaking down the types of unnecessary medical care, survey respondents reported that 22 percent of prescription medications, 24.9 percent of medical tests, 11.1 percent of procedures, and 20.6 percent of overall medical care delivered is unnecessary. The median response for physicians who perform unnecessary procedures for profit motive was 16.7 percent. Physicians with at least 10 years of experience after residency and specialists were more likely to believe that physicians perform unnecessary procedures when they profit from them.”
Fiscal Cliff Coming for Some Hospitals in COVID-19 Advance Medicare Payment Repayments
Modern Healthcare reports (here) that for advance Medicare payments CMS will start recouping the money after 120 days, during July and August. “Recoupment is coming in the form of garnishing 100% of hospitals' fee-for-service Medicare claims going forward until the loans are repaid. Hospitals say that's too harsh . . . Taking them in their entirety would cut off roughly one-quarter of hospitals' total reimbursement, since that's the average percentage of reimbursement coming from fee-for-service Medicare.” Softening of terms or turning the advance payments into grants is part of the House language in the 5th pandemic relief legislation, pending.
Coding Changes for ICD for 2021
2021 ICD-10-PCS (Procedure Coding System) codes to be used for discharges occurring from October 1, 2020 through September 30, 2021 have been published, and can be found here. 3-M coding specialist Rhonda Butler reports (here) that “This year there are 544 new codes. No codes were deleted nor were code titles revised this time around.”
Oh, to be an Expert
Modern Healthcare reports (here) that experts say the top priority for hospitals now is to eliminate Stark law and anti-kickback measures which, they say, keeps doctors and hospitals from coordinating medical care, and also from engaging in “value-based” contracting. Proposals were published last October (332 pgs., here; HFM summary, here), then slowed down by the pandemic. Says the journal, “Providers were broadly supportive of the new exceptions and safe harbors put forward by CMS and HHS' Office of Inspector General, but they adamantly opposed the addition of price transparency requirements.”
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 HFM summary is here (147 pages). From that summary, “CMS makes many data files available to support analysis of the proposed rule. These data files are generally available at: https://www.cms.gov/medicare/acute-inpatient-pps/fy-2021-ipps-proposed-rule-home-page. Numbered tables that were historically included in the IPPS rule are now only available on the CMS website [which] can be found at the above hyperlink.”
The comment period on the proposed rule ends July 10.
READINGS & REFERENCES
Coronavirus Public Health Resources and References (alphabetical):
Association of American Medical Colleges Clinical Guidance Repository, here.
AMA resource page for physicians here. AMA guide to medical education and COVID-19, here.
American Public Health Association information here.
CDC information page for professionals here, Morbidity and Mortality Weekly Reports on Coronavirus, 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.
The New York Times Coronavirus coverage, here.
Reproduction rate (rt), website https://rt.live/ tracks the highest and lowest COVID-19 reproduction.
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 24, 25, 26
July 21, 22, 23, 24, 27, 28, 29, 30, 31
August, none
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.