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Category Archives: Medicine

Medicare Beneficiaries Paid Nearly Half of the Costs for Outpatient Services at Critical Access Hospitals

HHS IG Report (OEI-05-12-00085), October 7, 2014

“The Critical Access Hospital (CAH) certification was created to ensure that rural beneficiaries would have access to hospital services. Medicare reimburses CAHs at 101 percent of their “reasonable costs,” rather than at the predetermined rates set by the Outpatient Prospective Payment System (OPPS). The system that Medicare uses to calculate outpatient coinsurance amounts for beneficiaries who receive services at CAHs differs from that used for beneficiaries who receive services at acute care hospitals. Beneficiaries who receive services at CAHs pay coinsurance amounts based on CAH charges, whereas beneficiaries who receive services at acute care hospitals pay coinsurance amounts based on OPPS rates. CAH charges are typically higher than the reasonable costs associated with CAH services or the OPPS rates that acute-care hospitals receive. HOW WE DID THIS STUDY – We used 2009 and 2012 claims data to calculate the percentages and amounts of coinsurance that Medicare beneficiaries paid toward the costs for outpatient services at CAHs. Additionally, we calculated the percentages and amounts of coinsurance that beneficiaries would have paid at acute-care hospitals for 10 outpatient services that were frequently provided at CAHs. WHAT WE FOUND –  Because coinsurance amounts were based on charges, Medicare beneficiaries paid nearly half the costs for outpatient services at CAHs. In 2012, beneficiaries paid approximately $1.5 billion of the estimated $3.2 billion cost for CAH outpatient services. Additionally, the average percentage of costs that beneficiaries paid in coinsurance for these services increased 2 percentage points between 2009 and 2012. Finally, for 10 frequently provided outpatient services at CAHs, beneficiaries paid between 2 and 6 times the amount in coinsurance that they would have for the same services at acute-care hospitals.”

Ebola crisis in West Africa brings hightened focus to need for vaccine

WSJ – Ebola Vaccine Push Ramps Up – After Years of Delay, Researchers Rush to Field Test a Shot to Prevent the Disease “The world had little interest in Ebola in 1997, which is why cell biologist Nancy J. Sullivan thought she might be able to make a mark. Today, if the scientific world is to haveContinue Reading

Federal and State Quarantine and Isolation Authority

CRS – Federal and State Quarantine and Isolation Authority, Jared P. Cole, Legislative Attorney. October 9, 2014. “In the wake of increasing fears about the spread of highly contagious diseases, federal, state, and local governments have become increasingly aware of the need for a comprehensive public health response to such events. An effective response could include the quarantine of personsContinue Reading

Questions and Answers about Ebola and Pets

CDC – “The ongoing epidemic of Ebola in West Africa has raised several questions about how the disease affects the animal population, and in particular, the risk to household pets. While the information available suggests that the virus may be found in several kinds of animals, CDC, the US Department of Agriculture, and the AmericanContinue Reading

HHS releases 13th Report on Carcinogens

“Four substances have been added in the U.S. Department of Health and Human Services 13th Report on Carcinogens, a science-based document that identifies chemical, biological, and physical agents that are considered cancer hazards for people living in the United States. The new report includes 243 listings. Ortho-toluidine, used to make rubber chemicals, pesticides, and dyes, hasContinue Reading

New GAO Reports – Medicaid, Private Health Insurance

MEDICAID: Information on Inmate Eligibility and Federal Costs for Allowable Services, GAO-14-752R: Published: Sep 5, 2014. Publicly Released: Oct 6, 2014: “In 2013, the Medicaid program financed health care services for more than 72 million individuals, and an additional 7 million beneficiaries are expected to enroll in 2014 as a result of states choosing to expand Medicaid eligibilityContinue Reading

New GAO Reports – 202 Census, Compound Drugs

2020 CENSUS: Census Bureau Can Improve Use of Leading Practices When Choosing Address and Mapping Sources, GAO-15-21: Published: Oct 2, 2014. Publicly Released: Oct 2, 2014. COMPOUNDED DRUGS: TRICARE’s Payment Practices Should Be More Consistent with Regulations, GAO-15-64: Published: Oct 2, 2014. Publicly Released: Oct 2, 2014.

PulseNet – connecting foodborne illness cases together using DNA “fingerprinting” of the bacteria making people sick

“PulseNet connects cases of foodborne illness to potential outbreaks. PulseNet is a national laboratory network  made up of 87 laboratories−at least one in each state. PulseNet  connects foodborne illness cases together to detect and define outbreaks using DNA “fingerprinting” of the bacteria making people sick  using a standardized process called pulsed-field gel electrophoresis (PFGE). Every state hasContinue Reading

Measuring the Impact of Ebola: Will it Reach 1.4 Million?

Josh Michaud and Jennifer Kates, Kaiser Family Foundation, September 29, 2014. “More than six months have passed since Ebola was first identified in West Africa, and the scale of the crisis continues to grow. Over the last few weeks cases and deaths have increased significantly in the two most affected countries – Liberia and SierraContinue Reading

National Prescription Drug Take-Back Day

“The National Prescription Drug Take-Back Day aims to provide a safe, convenient, and responsible means of disposing of prescription drugs, while also educating the general public about the potential for abuse of medications.” Locate a Collection Site Near You For use by the general public to locate a collection site by Zip Code or County/City/State. LawContinue Reading

Interactive Map Shows Recent Evolution of State Policies Shaping Access to Abortion Coverage in Medicaid and Private Insuranc

“A new interactive map from the Kaiser Family Foundation provides a broad look at states’ laws shaping access to coverage for abortion in Medicaid and private insurance. The map includes the ability to view snapshots showing the extent of such limitations in states across the nation for the years 2000, 2010 and 2014. Taken together, the mapsContinue Reading

CDC data show declines in 5 major diabetes-related complications among U.S. adults

“A new CDC study shows that rates of five major diabetes-related complications have declined substantially in the last 20 years among U.S. adults with diabetes. The study, Changes in Diabetes Related Complications in the United States, 1990 -2010, published in the current issue of the New England Journal of Medicine, used data from the National Health Interview Survey, National HospitalContinue Reading