Health, Medicine & Nutrition
Study May Prove PTSD is a Medical, Not Psychological, Condition PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Ginny Grimsley   
Monday, 19 March 2012 07:22

A Chicago physician is recruiting veterans with PTSD for a study of a medical treatment that erases symptoms in 30 minutes.

With $82,000 in funding from the state of Illinois, Dr. Eugene Lipov (, author of Exit Strategy for Post-Traumatic Stress Disorder, plans to treat 10 patients and follow up with biological marker tests that would help prove his theory that PTSD is a medical, not a psychological, condition. He’s seeking corporate donations to broaden the study in order to hasten the Veterans Administration’s acceptance of the procedure, which has been used to treat 95 patients.

“The Veterans Administration’s treatment for PTSD involves intensive psychological therapy and psychotropic drugs that works only about half the time and can take months or years,” Lipov says. “My treatment, stellate ganglion block (SGB), involves two injections and works very quickly. In 80 to 85 percent of patients, it completely erases symptoms.”

Lipov has treated 50 patients with SGB, an injection of anesthesia into a cluster of nerves in the neck. His success stories date back to his first patient, who remains symptom-free after three years. Another 45 or so veterans have undergone the treatment at four military institutions, including a small study still underway at the Naval Medical Center San Diego.

He theorizes that SGB works because it reduces excessive levels of cortisol, nerve growth factor and norepinephrine in the brain, all stimulated as an organic response to stress.

“This study will be the first that includes checking for post-treatment biomarkers,” Lipov says. “If I can show there’s a biological change, that the treatment’s success isn’t just a placebo effect, I can get more acceptance. Right now, part of the problem is credulity – people can’t believe there’s such a simple solution to a complex problem.”

Treating PTSD with SGB is a new application for a procedure that’s been safely used to treat other conditions since 1925. Lipov has FDA approval for its use for PTSD and recently it was approved for experimental studies by the Institutional Review Board.

But despite congressional support, he has been unable to secure federal funding for a large study that would hasten the treatment’s acceptance by the Veterans Administration. So he’s seeking private and corporate donors to match Illinois’ contribution to his non-profit, Chicago Medical Innovations, so he can expand the biomarker study. People who buy his book Exit Strategy, about the latest PTSD developments, also help fund veterans’ treatments; Lipov donates $5 from each book sale toward the two $1,000 injections.

“The more money I raise, the more patients I can treat, and the more veterans who get better, the more I can publish the results,” Lipov said. “Basically, the more impressive the numbers, the more lives are saved.”

An estimated 300,000 veterans of Iraq and Afghanistan suffered post-traumatic stress disorder or major depression, according to a Rand Corp. report. The debilitating condition is characterized by outbursts of rage, terrifying flashbacks, nightmares, anxiety and other issues that lead to substance abuse, violent crimes, joblessness and homelessness.

About Dr. Eugene Lipov

Dr. Lipov graduated from Feinberg School of Medicine at Northwestern University and completed two-year residencies in surgery and anesthesiology before receiving advanced training in pain management at Rush University Medical Center, where he worked as an assistant professor of pain management. Today he is the medical director of Advanced Pain Centers in Hoffman Estates, Ill. He has published research articles in several medical journals.

discount drug program accounting sought PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Grassley Press   
Wednesday, 14 March 2012 13:44

Grassley, Enzi, Hatch, Pitts Seek Details of Discount Drug Program


WASHINGTON – Sen. Chuck Grassley, Sen. Michael Enzi, Sen. Orrin Hatch,  and Rep. Joe Pitts today asked a wide range of stakeholders for a detailed accounting of how they operate the 340B program, a discount drug program that’s meant to supply federally funded grantees and other safety net health care providers but whose exploding growth raises questions about program integrity.


A June 2011 Health and Human Services Inspector General report raised questions of program integrity without proper federal oversight of taxpayer dollars.  Likewise, a report from the Government Accountability Office issued in September 2011 said federal oversight of the program is “inadequate” to ensure that covered entities and manufacturers are in compliance with program requirements.


“With the reliance on self-policing among participating manufacturers and covered entities and the increase in the number of new settings in which the program is offered, the risk of improper purchases or diversion of 340B drugs has significantly increased,” the members wrote.  “The problems identified by the GAO as it relates to the oversight responsibilities of each party and the expansion of the program need resolution.”


Grassley, Enzi, Hatch, and Pitts wrote to the Pharmaceutical Research and Manufacturers of America; the Biotechnology Industry Organization; Apexus, Inc.; and the Safety Net Hospitals for Pharmaceutical Access.  The legislators said that with so many stakeholders involved in the program, everyone must work together to ensure the program is serving the intended beneficiaries.


The members’ three letters are available here, here and here.



Nursing home quality tool needs better oversight PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Grassley Press   
Wednesday, 14 March 2012 13:15

WASHINGTON – U.S. Senators Chuck Grassley, R-Iowa, and Herb Kohl, D-Wis., today released a report urging the Centers for Medicare and Medicaid Services (CMS) to improve oversight of the new system being created to monitor the quality standards in nursing homes.

The Government Accountability Office (GAO) report, entitled, “Nursing Home Quality: CMS Should Improve Efforts to Monitor Implementation of the Quality Indicator Survey,” urges CMS to improve efforts to monitor implementation of the Quality Indicator Survey (QIS) for nursing homes.  The full report can be found here.

CMS started moving toward the QIS process in 2005 after reports indicated a need for improvements in the traditional survey process.  But the agency has decided to temporarily suspend implementation until a number of concerns raised by states and regional CMS offices have been resolved.

“The report shows CMS doesn’t do enough to monitor and facilitate states’ implementation progress,” Grassley said.  “After six years of implementation, 26 states had trained or started training surveyors to use the system, but uncertainty about progress by these states led CMS to suspend implementation for the rest of the country.  If CMS were better tracking state implementation from the beginning, the agency could have identified these problems earlier and helped the states that are struggling.”

“There’s an obvious need for a clear, consistent and efficient system for monitoring nursing home quality,” Kohl said. “QIS has the right goals in mind, and has the potential to make a positive difference in the consistency and accuracy of state survey work across the country -- but implementation needs to be done well, and the agency’s goals need to be realized sooner rather than later.”

Grassley and Kohl have worked together on nursing home quality for many years.  Most recently, their bill, the Nursing Home Transparency and Improvement Act of 2009, was passed into law.  Through the Senate Special Committee on Aging, the senators have pressed the federal government and states to improve the quality of nursing home care through more rigorous inspections and better information about inspection results for consumers through the federal Nursing Home Compare database.  Kohl is chairman of the Aging Committee.  Grassley is former chairman.  A landmark GAO report from 1998 was the subject of Aging Committee hearings Grassley convened.  The hearings exposed serious quality of care problems in nursing homes, exacerbated in part by highly predictable annual inspections and few citations for serious deficiencies.  After the hearings and at the urging of the Aging Committee, the Clinton Administration took steps to improve the inspection process.  Grassley and Kohl have urged continued attention and refinements.


Quad City Gastroenterologists Combine Forces To Raise Colon Cancer Awareness in March PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Jake Glimco   
Wednesday, 14 March 2012 13:07

Quad Cities, USA (February 17, 2012) –March is Colon Cancer Awareness Month and staff from Digestive Disease Center, Gastroenterology Consultants, Digestive Disease Specialists and Trinity Medical Center have joined forces, once again, to form the Colon Cancer Free QCA Coalition.  This group consists of Gastroenterologists and other health care professionals who have come together to promote one simple message, Colonoscopies save lives.  The physicians will be meeting with various groups and family physicians this month to discuss the important role colonoscopies play in the early detection of colon cancer.

“Colon cancer is easily preventable by the removal of precancerous polyps during a screening colonoscopy.  If cancer is detected during a colonoscopy, it is easily curable in the early stages, as opposed to cancers that are detected at later stages which are often lethal.  These two facts make screening colonoscopy a no-brainier in maintaining a healthy lifestyle. Please make sure you and all of your loved-ones get screened, since everyone is at risk of developing this common cancer,” says Dr. Arvind Movva, Gastroenterology Consultants.

In addition to spreading general awareness, Colon Cancer Free QCA will be working with Good Samaritan Clinic in Moline to provide free colonoscopies to a number of uninsured patients. Doctors, nurses, and support staff, from each practice, have volunteered their services to make this free screening possible.  The exams will be performed free of charge for patients who have been previously identified as being at a high-risk for colon cancer by the Good Samaritan Clinic.

Each year, over 140,000 Americans are diagnosed with colon cancer making it the third most common cancer diagnosis in the United States. “Colorectal cancer is the 2nd leading cause of cancer death among men and women in the U.S.  However, if we can raise awareness of the role a colonoscopy can play in the prevention of colon cancer, we can decrease the mortality from colorectal cancer significantly in our area”, says Dr. Linda Tong of Digestive Disease Specialists.

Dr. Sreenivas Chintalapani of The Center for Digestive Health states, "The need for colorectal cancer screening is obvious with 150,000 new cases a year and 50,000 deaths. The technology and skills to detect and prevent colon cancer are available to most of us. It's just that that we need to get ourselves to your gastroenterologist and get your colonoscopy."  Colon Cancer remains among the top three cancer killers, even though it is also the most preventable form of deadly cancer.

The most effective means of preventing colon cancer is a colonoscopy.  In this procedure, pre-cancerous polyps are removed before they turn to cancer and early cancers are seen and biopsied, often before they cause symptoms.  If this cancer is detected early, often before symptoms appear, a person’s chance of survival is about 90 percent; however, if a person waits until symptoms develop, this percentage drops dramatically. People with an average risk for colon cancer should be tested at age 50.  However, screenings should begin at age 40 if you have a family history of colon cancer or other high risk factors.   Colon cancer affects men and women equally, crossing all socio-economic lines.



Grassley Seeks Information on State Rate-setting for Medicaid Managed Care Plans PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Grassley Press   
Wednesday, 14 March 2012 12:54

WASHINGTON – Sen. Chuck Grassley of Iowa has asked each state for information to help determine whether the states and the federal government are conducting enough oversight of their rate-setting for Medicaid managed care plans.


“In light of the billions of dollars already spent on Medicaid, including managed care, and the planned expansion of Medicaid, it’s important to look at whether states are setting their managed care payment rates appropriately and in keeping with federal law,” Grassley said. “If the payment rates are out of whack, and scrutiny is lacking, Medicaid money could be ill-spent to the detriment of vulnerable beneficiaries and the taxpayers.  The risk could be especially high when Medicaid provider payment rates are boosted to match higher Medicare rates for two years as Medicaid is expanded under the new federal health care law.”


Grassley’s inquiry comes after the Government Accountability Office in 2010 found inconsistent scrutiny from the federal government of state rate-setting in this area.  GAO cited two states – Tennessee and Nebraska – as examples of those that received inadequate oversight from the federal Centers for Medicare and Medicaid Services.  Now, the state of Minnesota and its contractor non-profit health plans are drawing scrutiny in the state for what some analysts consider high operating margins. States are required to set rates for Medicaid managed care that are actuarially sound, but it’s unclear if the requirement is clearly defined or enforced.


Grassley wrote in his letter to each state, citing the GAO report, “In the 18 months since that report was issued, I have seen nothing to convince me CMS or the states have improved in their ability to confirm that managed care entities are appropriately and correctly reimbursed for the services provided. If an entity is paid too little, the access to and quality of care provided to beneficiaries is jeopardized.  If an entity is paid too much, scarce Medicaid resources are diverted away from providing services to beneficiaries.”


Grassley’s letter includes questions such as whether states have an independent audit requirement for managed care entities and if so, whether the audit entails certain elements; for a list of all managed care entities operating in the state and an accounting of audit occurrences and results; the state’s definition of allowable medical costs under the managed care contracts; and whether states have received any guidance from CMS or sought guidance from CMS on Medicaid managed care rate-setting.


The federal government will spend nearly $4.5 trillion on Medicaid over the next decade.  That’s only the federal share.  State governments spend additional, significant amounts of money on Medicaid.  “Every dollar that’s spent improperly doesn’t help a Medicaid beneficiary,” Grassley said.  “Getting a handle on managed care payment rates is necessary for the program’s bottom line.”


The new federal health care law boosts federal Medicaid payments to primary care physicians for two years, from Jan. 1, 2013, to Dec. 31, 2014.  For that period, the doctors will receive Medicare payment rates, which are higher than Medicaid payment rates.  At the same time, Medicaid programs and providers will cover more patients, as required under the health care law.


A copy of Grassley’s letter to each state is available here.  The letters are identical.  The 2010 GAO report is available here.



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