DCMedical News: Thursday, January 21, 2021
DCMedical News-DCMN
Washington, D.C.
Thursday, January 21, 2021
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
Biden-Harris Inauguration
The 46th President followed his and the Vice President’s swearing-in ceremonies with signing the first of an expected 53 executive orders (The Hill reports, here), aided by the first 200 high level staffers (BusinessInsider provides an interactive guide to White House staff positions, appointments and backgrounds of the appointees, here), in pursuit of the published Biden agenda (list of “day one” executive orders here, review of agency actions here).
Some staff positions will be interim: Modern Healthcare reports that no candidate has yet been put forward to run the Centers for Medicare & Medicaid Services, notwithstanding that its $1 trillion budget accounts for a quarter of federal spending. MH says, “Elizabeth Richter will serve as acting administrator for CMS, according to the agency's website on Wednesday,” and that “The career civil servant previously served as CMS' deputy center director, leading policy development and operations management for Medicare's fee-for-service program since 2007.”
Operation Warp Speed is to be renamed, possibly to “Covid Response,” and headed by former FDA Commissioner and medical school dean Dr. David Kessler.
The Biden administration’s “American Rescue Plan” (here, a name which may recall the “American Recovery and Reinvestment Act” early in the Obama-Biden administration) promises an “Emergency Legislative Package to Fund Vaccinations, Provide Immediate, Direct Relief to Families Bearing the Brunt of the COVID-19 Crisis, and Support Struggling Communities.”
Coronavirus
Tracking: Johns Hopkins (here) shows at 8:00 p.m. on 1-20-21 worldwide 96,782,733 COVID-19 cases, 24,419,844 U.S. cases, 24%. Deaths worldwide are 2,071,832, of which 405,622 are in the U.S., 20%.
Vaccines: NEJM publishes (in addition to resources shown below under “Readings”) a coronavirus vaccination page (here), reporting “noteworthy efficacy” for Moderna, results “remarkably effective” for Pfizer-BioNTech and “encouraging interim results” for Oxford/Astra Zeneca. Other vaccine news: the “FDA Sticks to Current COVID-19 Vaccine Schedules Amid Debates,” and NYC cancels 22,000 appointments for vaccinations beginning today, due to lack of vaccine. Statista reports (article here, chart here) 60% of Americans frustrated (“disorganized,” “slow”) with the vaccine roll-out.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
The “Fauci Effect?”
The Association of American Medical Colleges reports (here) that “The number of students applying to enter medical school in 2021 is up 18% from this time last year. The bump is unprecedented, and the reasons behind it are not entirely clear. ‘This large of an increase is unprecedented,’ said Geoffrey Young, PhD, the AAMC’s senior director of student affairs and programs. ‘We can’t say for sure why so many more students have applied this year. Some students may have had more time for applications and preparing for the MCAT exam after their college courses went online. Some may have been motivated by seeing heroic doctors on the front lines of the COVID-19 pandemic.’”
Surgery in the VA, A List of Good News
An article in this week’s JAMA Surgery (here) pays tribute to the development of surgical interventions pioneered or developed in the VA system, including “landmark developments in colon surgery; surgical treatments for vascular disease, including vascular grafts, carotid surgery, and arteriovenous dialysis fistulas; cardiac surgery, including implantable cardiac pacemaker and coronary artery bypass surgery; and the surgical management of many conditions, such as hernias. The birth of successful liver transplantation was also seen within the VA, and countless other achievements have benefited patients around the globe.”
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
Medicaid Enrollment at a High of 77 Million
CMS reports (here) that 77.3 million individuals were enrolled in Medicaid and CHIP in September 2020, nearly half of them (49.5%) children.
MA, Part D Rate Rules Published
CMS has published (final rule text here, “fact sheet” here, Federal Register text 894 pgs. here) the calendar year 2022 Medicare Advantage and Part D rate announcements, addressing (and resolving) comments made in response to the proposed advanced notices published on September 14 and October 30, 2020. Bloomberg reports that “the private Medicare Advantage plans that provide program benefits for roughly 27 million beneficiaries will see a nearly 4.1% revenue increase in 2022 under final payment rates,” compared to the original CMS proposal of a 2.8% increase. Bloomberg notes that enrollment in the approximately 4,800 MA plans is expected to grow by 2.5 million in 2021 to a record of 27 million, or 42% of Medicare enrollees. UnitedHealth Group, which reported annual earnings of $22 billion from operations (here), says it plans to add 900,000 MA members in 2021 (here), with other news in the earning calls transcript from Seeking Alpha, here.
A significant Part D rule change will mean that “Seniors who enroll in Medicare’s prescription drug program will be able to know in advance and compare their out-of-pocket payments for different prescription drugs,” says Bloomberg.
DRUGS & DEVICES
STAT reports that Tennessee will become the first state (here) to be allowed under federal waiver to have a closed formulary, that is to restrict medicines covered by the state Medicaid program, otherwise required to provide coverage for all treatments.
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.
CDC information page for professionals here, Morbidity and Mortality Weekly Reports on Coronavirus, here.
CMS (Centers for Medicare & Medicaid Services) Current Emergencies website, here.
HHS Protect Public Data Hub, https://protect-public.hhs.gov/datasets/state-representative-estimates-for-hospital-utilization/data?orderBy=state_name&page=4
JAMA Network’s COVID-19 resource center 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.
STAT COVID-19 Tracker, here.
State actions, Kaiser Family Foundation, here.
The COVID Tracking Project (The Atlantic Monthly), here.
UC Hastings College of Law’s “The Source” (on health care prices and competition) COVID-19 page, here.
2021 House Calendar here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
January 22, 25,26, 27, 28
February 8, 9, 10, 11, 23, 24, 25, 26
March 16, 17, 18, 19, 22, 23, 24, 25
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.