DCMedical News: Tuesday, February 23, 2021
DCMedical News-DCMN
Washington, D.C.
Tuesday, February 23, 2021
DCMedical News is published every day both the House and the Senate are scheduled to be in session. Subscription information and archives here.
THE BIG STORY IN HEALTH CARE
Coronavirus
Tracking: Johns Hopkins (here) shows at 8:00 p.m. on 2-22-21 worldwide 111,693,547 COVID-19 cases, 28,184,218 U.S. cases, 25%. Deaths worldwide are 2,473,055, of which 500,172 are in the U.S., 20%. Cases and deaths plummet worldwide during the past week; see “Data on COVID-19 (coronavirus) by Our World in Data” on Github, here.
Medscape reports (here) that “The number of COVID-19 hospitalizations in the U.S. has dropped to the lowest level since early November, when an autumn surge caused cases and deaths to rise. About 56,000 COVID-19 patients were in hospitals across the country on Sunday . . . hospitalizations peaked on Jan. 6 with more than 132,000 patients and have fallen for 40 days in a row since mid-January. On Friday, the number dipped below 60,000 for the first time since Nov. 9. The number of patients in intensive care units also dropped below 12,000 on Sunday, and the number of patients on a ventilator dropped below 4,000 — both have decreased by half since Jan. 6 . . . Across the country, only 4.8% of coronavirus tests came back positive during the past week, the COVID Tracking Project reported. That's the first time the average has dropped below 5% since October, and it's down from a peak of nearly 14% since the beginning of January . . . 7-day averages of new daily cases and deaths have also been declining for weeks after hitting record highs in mid-January . . . [But] In 3 months, the number of Americans who have died from COVID-19 has doubled . . . Overall life expectancy in the U.S. also declined by a year during the first half of 2020, from 78.8 to 77.8 years, according to a CDC report (here).” Johns Hopkins’ Marty Makary writes in the Wall Street Journal (here) that “We’ll Have Herd Immunity by April.”
FDA: The Regulatory Affairs Professionals Society reports that the FDA Monday unveiled new guidance for vaccine development (here, “Emergency Use Authorization for Vaccines to Prevent COVID-19 Guidance for Industry Document issued on February 22, 2021”); monoclonal antibodies (including variants, here, (“Development of Monoclonal Antibody Products Targeting SARS-CoV-2, Including Addressing the Impact of Emerging Variants, During the COVID 19 Public Health Emergency February 2021”); and testing (here, “Policy for Evaluating Impact of Viral Mutations on COVID-19 Tests, Guidance for Test Developers and Food and Drug Administration Staff, February 2021”). Acting FDA Commissioner Janet Woodcock said (in a press conference, video here) “The purpose of these guidances is to address the emergence and potential future emergence of variants of SARS-CoV-2, the virus that causes COVID-19. The reason for these guidances is any of these products might be impacted by changes to the virus, particularly their efficacy or performance. Therefore, we need to identify efficient ways to modify the products that are either in the pipeline or are [emergency use authorization] EUA products to address these variants.”
Policy: InsideHealthPolicy reports that “The Senate health committee will hold its confirmation hearing Tuesday [today] on [Xavier] Becerra [to be Secretary of HHS], currently California attorney general, and Senate Finance will hold its hearing the following day. If Becerra clears the process, the next step will be confirmation hearings on newly tapped CMS Administrator-nominee Chiquita Brooks-LaSure.” Republicans express reservations about Becerra, letter here.
DOCTORS, NURSES AND OTHER HEALTH CARE PROFESSIONALS
10,000 Physicians “Chronically Unmatched”
The New York Times (here) profiles physicians who are unable to obtain residency program matches. “International medical graduates in particular have low match rates for residency programs. American medical students have a 94 percent match rate . . . However, Americans who study at international medical schools have a match rate of 61 percent.”
CMS E&M Code Update
CMS publishes a fact sheet on 2021 code updates for physician evaluation and management services (here), with a link to AMA supplementary material (here).
NPs and ARPNs Advance in Scope of Practice
The American Association of Nurse Practitioners (here) chronicles change in scope of practice legislation progressing in Kansas, Maine, Mississippi, New York, Oklahoma, Virginia and Utah.
HOSPITALS, SKILLED NURSING FACILITIES AND OTHER HEALTH CARE FACILITIES
$1.9 Trillion Bill, Health Provisions
Becker’s summarizes (here) the health provisions in the Biden Administration’s $1.9 trillion coronavirus aid package making its way through Committees with jurisdiction over component parts. Included are assistance for rural health providers, vaccine cost and testing, public health jobs and local aid.
Penalties Announced for 774 Hospitals
Kaiser Health News provides a “lookup” tool (here) for what CMS regards as excessive readmissions (up to 3% of Medicare payments for those patients) and patient safety (1%, hospital acquired infections and others) violations. The measurement period was mid-2017 to 2019. KHN reports that “Now in its seventh year, the Hospital-Acquired Condition Reduction Program has been greeted with disapproval and resignation by hospitals, which argue that penalties are meted out arbitrarily. Under the law, Medicare each year must punish the quarter of general care hospitals with the highest rates of patient safety issues. The government assesses the rates of infections, blood clots, sepsis cases, bedsores, hip fractures and other complications that occur in hospitals and might have been prevented.”
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
Special Enrollment Period for HealthCare.gov February 15-May 15
CMS has opened a special enrollment period (SEP, fact sheet here) “for individuals and families for Marketplace coverage in response to the COVID-19 Public Health Emergency, which has left millions of Americans facing uncertainty and exceptional circumstances while millions of Americans have experienced new health problems during the pandemic. This SEP will allow individuals and families in states with Marketplaces served by the HealthCare.gov platform to enroll in 2021 health insurance coverage . . . who are submitting a new application or updating an existing application. State-based Marketplaces (SBMs) operating their own platform have the opportunity to take similar action within their states.”
The Acting Secretary of HHS adds new personnel for qualified immunity to prescribe, dispense and administer treatment in the COVID-19 public health emergency, here.
READINGS & REFERENCES
Pandemics, 1918 and 2020
The American Journal of Public Health (here) chronicles similarities and differences in the pandemics 100 years apart.
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.
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.
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 CQ Congressional Calendar here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
February 24, 25, 26
March 16, 17, 18, 19, 22, 23, 24, 25
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.