DCMedical News: Tuesday, September 22, 2020
DCMedical News-DCMN
Washington, D.C.
Tuesday, September 22, 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
Coronavirus
Tracking: By Johns Hopkins (here) shows on 9-21 at 8:00 p.m. EST worldwide 31,186,000 confirmed COVID-19 cases; 962,343 deaths worldwide; 199,816 U.S. deaths (21%). The CDC became involved in another contretemps, this one over airborne transmission of the virus: The Hill reports that “The Centers for Disease Control and Prevention on Monday abruptly reversed itself and deleted from its website a new guidance that said the coronavirus can spread through respiratory droplets and ‘aerosol’ particles. The agency said the guidance was a draft that had been posted in error, and its recommendations are still being updated . . . Public health experts were pleased with the updated guidance, as evidence has shown COVID-19 can be transmitted beyond the recommended six feet of physical distancing . . . The World Health Organization issued a warning in July, saying that coronavirus could be spread through people talking, singing and shouting after hundreds of scientists released a letter (here) urging it to do so.” Medscape reports on the issue, here.
Excess COVID-19 Deaths in Minority Communities: Kaiser Health News and Modern Healthcare report (here) that “125,000 Californians died from March through July, up by 14,200, or 13%, from the average for the same five months during the prior three years, according to a review of data from the state Department of Public Health. By the end of July, California had logged about 9,200 deaths officially attributed to COVID-19 in county death records. That left about 5,000 ‘excess’ deaths for those months — meaning deaths above the norm not attributed to COVID-19 . . . A closer look at California's excess deaths during the period reveal a disturbing racial and ethnic variance: All the excess deaths not officially linked to COVID infection were concentrated in minority communities,” 3,350 of them Latino.
Congressional Business: The House will vote today on a Democratic proposal for a short-term Continuing Resolution (summary here) to prevent a government shutdown in ten days. One provision of the measure would limit any increase in Medicare Part B premiums to $4 a month. Bloomberg Law reports “A senior Democratic aide said the roughly $4 cap is necessary because premiums could otherwise be slated for a bigger increase after the Trump administration issued billions of dollars in Medicare advance loans to providers but hasn’t recouped the money or used emergency funds Congress appropriated to help providers affected by pandemic-related shutdowns.” Premiums for 2021 have not yet been announced; the average monthly premium is $144.60 this year, compared to $135.50 in 2019, and the annual deductible is $198, compared to $185 in 2019.
Ten health-related bills passed out of the Energy and Commerce Committee and through the House of Representatives, including H.R. 1646, Helping Emergency Responders Overcome Act or the HERO Act; H.R. 2271, Scarlett’s Sunshine on Sudden Unexpected Death Act; H.R. 3935, Protecting Patients Transportation to Care Act; H.R. 4564, Suicide Prevention Lifeline Improvement Act; H.R. 4585, Campaign to Prevent Suicide Act; H.R. 4866, National Centers of Excellence in Continuous Pharmaceutical Manufacturing Act; H.R. 4995, Maternal Health Quality Improvement Act; H.R. 5619, Suicide Prevention Act; H.R. 5663, Safeguarding Therapeutics Act; H.R. 7574, Strengthening America’s Strategic National Stockpile Act. Background, bill texts and details here.
Thirty Years of Growing Debt and Deficit: the Congressional Budget Office published (here) its 30 year projection of federal deficits and debt. From the report, “In CBO’s projections, deficits increase from 5 percent of gross domestic product (GDP) in 2030 to 13 percent by 2050—larger in every year than the average deficit of 3 percent of GDP over the past 50 years. By the end of 2020, federal debt held by the public is projected to equal 98 percent of GDP. The projected budget deficits would boost federal debt to 104 percent of GDP in 2021, to 107 percent of GDP (the highest amount in the nation’s history) in 2023, and to 195 percent of GDP by 2050. High and rising federal debt makes the economy more vulnerable to rising interest rates and, depending on how that debt is financed, rising inflation.”
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
The “Less is More” Campaign Comes to Percutaneous Coronary Interventions
The campaign now includes PCI for stable coronary disease. An editorial in JAMA Internal Medicine here points in two directions, voluntary adherence to guidelines (here), or more False Claim Act suits, here. Says the editorial, “In 2010, the Less is More series was initiated in JAMA Internal Medicine (previously Archives of Internal Medicine) to highlight situations in which overuse of medical care may result in harm . . . We now need implementation plans, quality and delivery-based measures, and rational pricing and payment to effectively and sustainably reduce low-value care. In this issue of JAMA Internal Medicine, we highlight 2 articles that demonstrate how to close the gap between evidence and practice to reduce low-value care in the context of percutaneous coronary interventions (PCIs) for patients with stable coronary artery disease (CAD), a procedure with a long history of low-value use and potential harm.”
Surgeons Don’t Like the Medicare Physician Fee Schedule for CY 2021, Either
See presentations by the Surgical Care Coalition, .
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
COVID-19 Assistance Reporting
The Healthcare Financial Management Associated reports that CMS has released Post-Payment Notice of Reporting Requirements, here, “calling for reporting on healthcare related expenses attributable to coronavirus that another source has not reimbursed and is not obligated to reimburse, which may include General and Administrative or healthcare related operating expenses; and PRF [Provider Relief Fund] payment amounts not fully expended on healthcare related expenses attributable to coronavirus are then applied to lost revenues, represented as a negative change in year-over-year net patient care operating income, net of the healthcare related expenses attributable to coronavirus. The instructions state that recipients may apply PRF payments toward lost revenue, up to the amount of their 2019 net gain from healthcare related sources. If a recipient had an operating loss in 2019, then it may apply PRF funds to break even in 2020. If recipients do not expend PRF funds in full by the end of calendar year 2020, they will have an additional six months in which to use remaining amounts.” HFMA notes that the “reporting portal” will not be available until early 2021 but that the deadline for reports for 2020 expenditures and lost revenue related to COVID is still 45 days from 12/31/20.
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 23, 24, 25, 30
October 1, 2
November 16, 17, 18, 19, 20
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.