DCMedical News: Thursday, September 10, 2020
DCMedical News-DCMN
Washington, D.C.
Thursday, September 10, 2020
DCMedical News is published every day both the House and the Senate are scheduled to be in session this year. Subscription information and archives here.
THE BIG STORY IN HEALTH CARE
The (Presidential and Other) Campaigns
Deadly Stuff: The Associated Press reports that “President Donald Trump seemed to understand the severity of the coronavirus threat even as he was telling the nation that the virus was no worse than the seasonal flu and insisting that the U.S. government had it totally under control,” according to a new book by journalist Bob Woodward. "You just breathe the air and that's how it's passed," Trump said in a Feb. 7 call with Woodward. "And so that's a very tricky one. That's a very delicate one. It's also more deadly than even your strenuous flu." "This is deadly stuff," the president repeated for emphasis.
Coronavirus
Tracking by Johns Hopkins (here) shows on 9-9 at 8:00 p.m. EST worldwide 27,699,112 confirmed COVID-19 cases; 900,203 deaths worldwide; 190,727 U.S. deaths (21%).
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
CY 2021 Physician Fee and Part B Payment Schedule
Rockpointe’s Policy & Medicine reports (here) that the Centers for Medicare & Medicaid Services (CMS) released the CY 2021 Revisions to Payment Policies “which includes proposals related to Medicare physician payment and the Quality Payment Program (QPP). Since the public health emergency (PHE) was declared earlier this year, the Administration has issued waivers to increase flexibility and reduce regulatory burden to help providers meet the demands of the Coronavirus (COVID-19) pandemic. This rule includes several proposals to make permanent, extend or transition out of these COVID-19 flexibilities.” CMS summary of the proposed rule here. Becker’s report on cuts to surgeon and other fees here. HFMA analysis of key impacts of the proposed rule here. The complete rule (592 pgs.) from the August 17 Federal Register is here. Comments on the proposed rule are due October 5. The rule would be effective January 1, 2021.
House Committee Advances Mental Health, Substance Abuse, Part B Measures
CQ reports (here) that Wednesday “The House Energy and Commerce Committee approved 38 mostly bipartisan bills, including legislation related to mental health, controlled substances, Medicare and reauthorizations of other miscellaneous health programs.”
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Free Standing (Physician-Owned) Ambulatory Surgery Centers and Race
A report in JAMA Surgery (here) notes that in a “study of 13 million patients who received ambulatory surgery in New York and Florida between 2011 and 2013, the likelihood of receiving surgery at a freestanding ambulatory surgery center compared with a hospital-based outpatient department was significantly lower among patients who were Black, had public health insurance, and resided in rural areas.”
Editorial commentary on the study in the same edition (here) notes that “public insurance coverage was associated with a significantly higher likelihood of 30-day unplanned hospital admissions in both states, and this likelihood was marked among patients with Medicaid in Florida . . . In addition, unplanned postoperative visits were less likely to occur among patients who had received surgery at a freestanding ASC compared with a hospital-based center.” The study and the commentary both note that “freestanding ASCs have tripled their volume of surgical procedures in the past 2 decades, while the volume in hospital-based ambulatory centers has remained relatively unchanged.”
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
Three Bills Advance Expanding Part B
The CQ report noted above (here) concerning action by the House Energy and Commerce Committee included three to expand Medicare Part B benefits, including authorizing coverage for marriage and family therapists; lower barriers for seniors transitioning from COBRA to Part B; and make permanent the waiver of limitations on oxygen therapy in rural areas.
Medicaid and Work Requirements
Modern Healthcare reports (here) on a study published in Health Affairs that the Arkansas work requirement did not increase employment, but did increase medical debt and delayed care. Misinformation and confusion concerning requirements were important factors. The study noted "More than 95% of Arkansas beneficiaries in our survey already met the state's Medicaid work requirements or should have been eligible for an exemption. This suggests that barriers to reporting data to the state, rather than not meeting the requirements themselves, were the main cause for coverage losses in 2018."
DRUGS & DEVICES
High Blood Pressure Control
A study in JAMA (here) on adults with controlled blood pressure (140/90) notes that “In this serial cross-sectional study that included 18,262 US adults aged 18 years or older with hypertension, with data weighted to be representative of the US population, the age-adjusted estimated proportion with controlled blood pressure increased from 31.8% in 1999-2000 to 48.5% in 2007-2008, remained stable through 2013-2014 (53.8%), and then declined to 43.7% in 2017-2018.” The report noted “Controlled BP was more likely among those with private insurance (48.2%), Medicare (53.4%), or government health insurance other than Medicare or Medicaid (43.2%) vs among those without health insurance (24.2%).”
READINGS & REFERENCES
Select Coronavirus Public Health Resources and References (alphabetical):
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.
The Guardian and Kaiser Health Network, report on health professionals dead from COVID-19, 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.
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.
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.
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
September 11, 14, 15, 16, 17, 22, 23, 24, 25, 30
October 1, 2
November 16, 17, 18, 19, 20
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.