Health, Medicine & Nutrition
Braley Introduces Bill to Keep Doctors in Iowa PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Jeff Giertz   
Tuesday, 25 October 2011 14:58

Bill would stop a scheduled end-of-year Medicare reimbursement cut to Iowa doctors

 

Washington, DC – Rep. Bruce Braley (IA-01) today introduced a bill to make sure Medicare reimbursement rates for physicians in Iowa and other rural states don’t drop precipitously at the end of the year and endanger Iowans’ access to doctors and high-quality medicine.

Legislation written by Braley and passed in 2010 ensures that doctors in Iowa and other rural states get paid by Medicare at rates closer to those of doctors in larger, more urban states.  The law is set to expire on December 31st, 2011.

Braley’s Medicare Equity Extension Act, introduced today, extends the current reimbursement rates for an additional two years.  The legislation would help Iowa retain doctors and improve patient access to quality healthcare.

“It’s funny math.  Medicare pays doctors based on geography, not quality of care,” Braley said.  “Iowa doctors rank near the top in quality of care, but get penalized for their success since Medicare pays doctors more money in big states even if quality is lower.

 

“Doctors should have an incentive to provide good care.  Instead, there’s an incentive to leave states like Iowa for bigger states with higher payment rates.

 

“The Medicare Equity Extension Act will stop Medicare from cutting payments to Iowa doctors, preventing a potential exodus of good physicians to other states and providing an incentive to doctors to provide the best care possible.”

Medicare calculates reimbursements to physicians using two indexes that factor in the cost of doctors’ labor and the cost of doctors’ physical expenses like office space and equipment.  Because Medicare considers the cost of doing business in Iowa and other rural states to be low, this negatively impacts the amount doctors are reimbursed for their services.

Current law sets a floor on the indexes, and thus a floor on reimbursements, ensuring rural states’ reimbursement rates more closely match large states’.  Those floors would expire on December 31st unless legislation is passed to extend them.  The Iowa Medical Society, among other groups, has urged an extension.

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HATCH, GRASSLEY CALL ON HHS TO EXERCISE AUTHORITY TO PREVENT WASTE, FRAUD & ABUSE WITHIN MEDICARE PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Grassley Press   
Tuesday, 25 October 2011 14:49
In Letter to HHS Secretary Sebelius, Senators ask why CMS is not utilizing tools in new health law to safeguard program

WASHINGTON –In a letter today, the top Republicans on the Senate Finance and Judiciary Committees, U.S. Senators Orrin Hatch (R-Utah) and Chuck Grassley (R-Iowa), asked Health and Human Services Secretary Kathleen Sebelius why the Centers for Medicare and Medicaid Services (CMS) is not utilizing some of the tools provided within the Patient Protection and Affordable Care Act (PPACA) to safeguard the Medicare program from waste, fraud and abuse.

Under PPACA, CMS can impose a temporary enrollment moratorium on new Medicare providers and suppliers when the agency determines that there is a significant potential for waste, fraud, or abuse by the applicant type or geographic area. While the final rule for this regulation was published more than eight months ago, CMS has failed to impose a single temporary moratorium. Today, the Department of Justice (DOJ) and the HHS-OIG are operating strike force initiatives in seven States (California, Florida, Illinois, Louisiana, Michigan, New York, and Texas), including Miami, Florida.  All of these areas, particularly Miami, have historically been vulnerable to Medicare fraud and are high risk areas for programmatic vulnerability. However, to date, CMS has failed to exercise its authority to protect against fraud. The National Health Care Anti-Fraud Association has estimated that as much as $60 billion is lost to fraud, waste and abuse across the Federal health care programs.

“It is deeply disconcerting that CMS has failed to act in the best interest of the American taxpayers and Medicare beneficiaries and prevent fraud before it occurs by exercising its moratoria authority,” wrote the Senators.  “It is not reasonable to suggest that CMS needs more time to study whether there is need to impose a temporary moratoria in certain geographical areas for certain provider and supplier types when ample evidence exists from the strike force activities to justify moratoria in these high fraud areas.”

The text of the letter to Secretary Sebelius is below and a signed copy can be found HERE:

October 25, 2011

The Honorable Kathleen Sebelius
Secretary
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Washington, DC 20201

Dear Secretary Sebelius:

As the Ranking Members of the Senate Finance and Judiciary Committees, we are writing to request that as Secretary of the Department of Health and Human Services (HHS), you exercise the discretionary authority granted to you through Section 6401(a)(6) of the Patient Protection and Affordable Care Act (PPACA) regarding the imposition of temporary moratorium on the enrollment of new providers and suppliers.  Specifically, we urge you to determine why the Centers for Medicare & Medicaid Services (CMS) is failing to use this tool provided in PPACA to prevent waste, fraud and abuse.

On February 2, 2011, CMS published a final rule with comment entitled, “Medicare, Medicaid, and Children's Health insurance Programs (CHIP); Additional Screening Requirements, Application Fees, Temporary Enrollment Moratoria, Payment Suspensions and Compliance Plans for Providers and Suppliers" in the Federal Register. In part, this regulation allows CMS to impose a temporary enrollment moratorium on new Medicare providers and suppliers when CMS determines that there is a significant potential for fraud, waste or abuse with respect to a particular provider or supplier type, geographic area or both.

Today, more than year after the publication of a proposed rule and more than 8 months after publishing the aforementioned final rule with comment, CMS has still not imposed a single temporary moratorium.  In addition, despite a specific recommendation by the HHS Office of the Inspector General (HHS-OIG) to impose a temporary moratorium on independent diagnostic testing facilities in Los Angeles, California, CMS refused.

Additionally, the Department of Justice (DOJ) and the HHS-OIG are operating strike force initiatives in seven States (California, Florida, Illinois, Louisiana, Michigan, New York, and Texas), including Miami, Florida.  All of these areas, particularly Miami, have historically been vulnerable to Medicare fraud and are high risk areas for programmatic vulnerability.  Therefore, it is deeply disconcerting that CMS has failed to act in the best interest of the American taxpayers and Medicare beneficiaries and prevent fraud before it occurs by exercising its moratoria authority in some of these areas.  It is not reasonable to suggest that CMS needs more time to study whether there is need to impose a temporary moratoria in certain geographical areas for certain provider and supplier types when ample evidence exists from the strike force activities to justify moratoria in these high fraud areas.  To better understand CMS’s failure to act, please:

1.      Explain why CMS decided not to impose a temporary moratorium on independent diagnostic testing facilities (IDTFs) in Los Angeles, California despite the OIG recent recommendation and previous work by the OIG that indicated $71.5 million in improper payments to IDTFs.

2.      Explain what steps CMS is taking to address the concerns raised by the OIG with respect to IDTFs in Los Angeles, California.  Please include a detailed timeline.

3.      Explain why CMS has not imposed a temporary moratorium of “high” or “moderate” categorical risk providers/suppliers in HHS-OIG strike force cities or other high-risk areas.

4.      Explain why CMS decided not to impose a temporary moratorium for durable medical equipment suppliers in south Florida when Daniel R. Levinson, the Inspector General for HHS-OIG, stated in his March 9, 2011 Congressional Testimony that there is “rampant fraud” among durable medical equipment suppliers in south Florida.

5.      Describe the program changes that CMS is considering to strengthen the provider enrollment process for “moderate” and “high” screening risk providers and suppliers, such as IDTFs, home health agencies, and suppliers of durable medical equipment, orthotics, prosthetics, and supplies.

6.      Provide all materials used to develop and finalize the temporary moratorium provisions found in CMS-6028-P and CMS-6028-IFC.

7.      Consistent with 42 CFR 424.570(a)(2)(i)(A), provide a list of providers and suppliers with a highly disproportionate number of providers and suppliers in a category relative to the number of beneficiaries for each State.

8.      Consistent with 42 CFR 424.570(a)(2)(i)(B), provide a list of providers and suppliers and location (city and state) where a rapid increase in the number of enrollment applications has occurred within the past twelve months.

9.      Consistent with 42 CFR 424.570(a)(2)(ii), provide a list of State Medicaid programs who have imposed a moratorium on a group of Medicaid providers or suppliers that are also eligible to enroll in Medicare.

10.  Consistent with 42 CFR 424.570(a)(2)(iii), provide a list of State-imposed moratoria on enrollment in particular geographic areas or on a particular providers, supplier types, or both.

We understand that we are requesting a substantial amount of information, but appreciate your understanding Congress’ role in overseeing that taxpayer dollars are carefully spent. Thank you for your timely attention to this matter and we request a response by December 2, 2011.

Sincerely,

HATCH
GRASSLEY

cc: Administrator Donald Berwick, M.D., Centers for Medicare & Medicaid Services
Principal Deputy Administrator and Chief Operating Officer Marilyn Tavenner, Centers for Medicare & Medicaid Services

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Grassley to Receive 2011 Distinguished Community Health Defender Award PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Grassley Press   
Tuesday, 25 October 2011 14:26

Senator Grassley to Receive Community Health Defender Award

FOR IMMEDIATE RELEASE – On Tuesday, October 25, Senator Charles Grassley will be presented with the National Association of Community Health Centers’ 2011 Distinguished Community Health Defender Award.

Senator Grassley will accept the award at 4:00 p.m. at Linn Community Care at 1201 3rd Avenue, SE in Cedar Rapids.

This award recognizes the contributions of Senator Grassley to preserve, strengthen, and expand access to America’s health centers, which are providers of high-quality, cost effective health care for America’s medically underserved.

“We are honored to present this award to Senator Grassley,” said Ted Boesen, Executive Director of the Iowa Primary Care Association (Iowa PCA). “He has long been a supporter of the community health center program and its mission to provide quality, affordable health care services to the underserved.”

The Iowa PCA’s members include the state’s 14 community health centers, which provide affordable, quality, comprehensive primary health care for more than 170,000 Iowans. For more information and a complete list of Iowa’s community health centers, visit www.iowapca.org.

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With Tips from TOPS, Halloween Doesn’t Have to Be a Fright for Your Waistline PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Kimberly Greene   
Tuesday, 25 October 2011 13:25
MILWAUKEE, WI – Healthy and Halloween are not often used in the same sentence.  Halloween is usually seen as a time to get dressed up, gather sugary treats, and enjoy the spookiness of the season.  TOPS Club, Inc. (Take Off Pounds Sensibly), the nonprofit weight loss support organization, provides tips to stock the kids’ bags with better treats, host a healthy party, and more.


Give Better Trick-or-Treating Goodies

It’s inevitable that kids will receive candy, so parents should take steps to limit sugar consumption.  Feeding children a nutritious meal before trick-or-treating will help curb their urge to snack on sweets.  Once the candy is home, adults can let kids pick out their favorite pieces and decide how much to have each day.  The remaining candy can be put out of sight, donated to charity, or thrown away.  This helps parents from overindulging, too.

Neighbors can promote healthier habits and offer alternatives to candy, so kids can enjoy the spooky evening without sacrificing nutrition.  Here are some ideas to give to trick-or-treaters:

Skip the sweets and sugar and provide healthier options.
• Animal crackers
• Granola bars
• Snack-size bags of pretzels
• Trail mix
• Graham crackers  
• Microwave popcorn
• Sugar-free gum
• Small boxes of raisins

Give treats that encourage playing rather than eating.
• Bouncy balls
• Sidewalk chalk
• Temporary tattoos
• Crayons
• Fun pencils and fancy erasers
• Yo-yos
• Spider rings
• Glow sticks


Throw a Healthy Halloween Party

There are numerous treats and fall activities that can be incorporated into a Halloween party.  Plan an event that gets guests of all ages moving and fills them with fun, good-for-you snacks.

• Replace sugary treats with nutritious party snacks. Apples with caramel or yogurt dip, roasted pumpkin seeds, apple cider, pumpkin muffins, a vegetable “skeleton,” a melon carved like a brain, and seasoned pretzels are some fall-themed options that everyone can enjoy.

Make a vegetable skeleton at your next Halloween festivity:

1. Gather red pepper, a handful of carrot sticks, broccoli, some green beans, cherry tomatoes, a cucumber, celery sticks, cauliflower, or other vegetables.

2. Get creative and assemble the skeleton.  You could use the sliced red pepper as its rib cage.  The cauliflower can serve as the skeleton’s hands and feet, and the carrots and celery could form its shoulders, arms, and legs.  Use the bowl of dip as its head.

• Get moving. Bob for apples, pin the nose on the witch or the pumpkin, go on a scavenger hunt, walk through a haunted house, or participate in a fall relay race.

• Shift kids’ focus from food to an activity. Have craft stations where children can create masks out of paper plates, make slime, color, and more.

Halloween is time for slime, according to Disney’s familyfun.go.com:

1. Materials: Two mixing bowls, measuring cups, spoons, glue, borax, green food coloring, and water.

2. Instructions: Mix together 3/4 cup warm water, one cup glue, and several drops of green food coloring in the first bowl.  Using the second bowl, combine four teaspoons borax and 1 1/3 cups warm water.  Pour the contents of the first bowl in the second bowl.  Do not stir.  Let it stand for one minute, then lift the “slime” out of the bowl.  Use plastic bags to store the slime.  Keep away from children under three years old.

TOPS Club Inc. (Take Off Pounds Sensibly) is the original weight-loss support and wellness education organization.  Founded more than 63 years ago, TOPS is the only nonprofit, noncommercial weight-loss organization of its kind.  TOPS promotes successful weight management with a “Real People. Real Weight Loss.” philosophy that combines support from others at weekly chapter meetings, healthy eating, regular exercise, and wellness information.  TOPS has about 170,000 members - male and female, age seven and older - in nearly 10,000 chapters throughout the United States and Canada.

Visitors are welcome to attend their first TOPS meeting free of charge.  Membership is affordable at just $26 per year, plus nominal chapter fees.  To find a local chapter, view www.tops.org or call (800) 932-8677.

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Governor Quinn Helps Illinois Consumers Access Important Information about their Doctors PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Nafia Khan   
Tuesday, 25 October 2011 12:46

Illinois Launches New Searchable Physician Profile Website

CHICAGO - October 19, 2011. As part of his ongoing efforts to increase consumer protections and transparency in Illinois, Governor Pat Quinn today launched a website that makes important information regarding Illinois’ physicians available to the public. Maintained by the Illinois Department of Financial and Professional Regulation (IDFPR), the site offers consumers the information they need to make good decisions about their families’ health care.

“Information is power, and we want to make sure that people get the information they need to make informed decisions about the doctors who treat them,” Governor Quinn said. “This online tool will provide valuable assistance for patients as they choose health care providers for their families.”

The website allows health care consumers to review important information about the professional and disciplinary backgrounds of the more than 46,000 physicians and surgeons licensed to practice in Illinois. It offers a search engine that is easy to use, and enables consumers to search by the physician’s name, specialty, geographic region or hospital affiliation. The program also allows consumers to compare several doctors who have similar specialties.

More than 85 percent of all licensed physicians and surgeons have provided the information necessary to create or update their profiles. Categories of information available to consumers include: the location and scope of practice; the type of insurance the physician accepts; specialties and certifications; legal and disciplinary actions taken against the physician; educational background; and professional activities or honors.

“It is clear that Illinoisans are craving this information and  they should,” said Brent Adams, Secretary of Financial and Professional Regulation. “Everyone is entitled to providing informed consent to medical treatment – not just being informed as to the procedure or medication, but also being informed as to who is recommending that course of treatment.”

The new website takes the place of Illinois’ original physician profile website, which was available between 2008 and 2010 and was removed as part of a larger Supreme Court decision. At the time, it averaged over 150,000 hits per week by over 42,000 unique visitors. The Patients' Right to Know Act (House Bill 105), signed into law by the Governor earlier this year, restored Illinois’ consumers’ right to access this important health care information.

“This legislation is needed even more today than it was in 2008, especially as more doctors are receiving performance-based pay,” Representative Mary Flowers, House sponsor of HB 105, said. “It provides valuable information to patients when they go to select a health care provider.”

"The Patients Right to Know Act will help to ensure that consumers are choosing the right physician for their needs," Senator Delgado, Chairman of the Senate Public Health Committee and Senate sponsor, said.  "The database created under this Act will enable anyone to search by a doctor's partial first or last name, city, specialty, keyword, or hospital affiliation. Patients will be able to find out ahead of time if the physician has any the specialty certifications or legal and disciplinary actions for the past 5 years in addition to being able to see their resumes."

To find a physician’s profile, visit the IDFPR’s website: www.idfpr.com, or visit DoctorInfo.illinois.gov.

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