30 May 2012

Morthland Backs Landmark Medicaid Reform

By Rep. Rich Morthland
SPRINGFIELD, IL - On a day that saw a rare, bipartisan effort to rein in state spending, State Representative Rich Morthland (R-Cordova) backed landmark Medicaid reform legislation aimed at cutting Illinois' Medicaid spending and reversing a decade long trend of exploding costs.

"Today, the Illinois House passed landmark reforms that will ensure the future viability of our Medicaid program," Morthland said. "Without meaningful Medicaid reforms, Illinois' backlog of unpaid bills would grow to approximately $21 billion by 2017, a level of spending that is simply unsustainable. So we took action to cut nearly $1.6 billion from the State's $11 billion Medicaid program, which will help get Illinois back on solid fiscal ground."

With passage of Senate Bill 2840, an estimated 300,000 individuals are expected to be removed from Illinois' Medicaid rolls because they do not meet income eligibility guidelines, are not Illinois residents, have died, or have aged-out of the All Kids program. This eligibility verification alone will save taxpayers $350 million.

The bill also provides for a moderate rate reduction for hospitals of 3.5% and exempts Critical Access and Safety Net Hospitals from the reduction.

Senate Bill 2840, which passed the House on a vote of 94-22-1, will do the following:

  • Roll back the Blagojevich expansion of Family Care by reducing the eligibility limit for parents to $30,000 for a family of four
  • Impose a $10 co-pay for emergency room visits
  • Require a $3.60 co-pay on all services and a $2 co-pay for generic medications
  • Limit prescription coverage to four prescriptions per month without doctor certification or need or specialty drug/condition exception
  • Eliminate funding for adult chiropractic services

Representative Morthland added that he voted against the so-called Obamacare expansion for Cook County, contained in House Bill 5007.

###
30 May 2012

Governor Pat Quinn Statement on General Assembly Passage of Medicaid Rescue Legislation

By Andrew Mason

SPRINGFIELD - May 24, 2012. Governor Pat Quinn today released a statement regarding the Illinois General Assembly passing Senate Bill 2840, a key part of his proposal for Medicaid restructuring.


 

"I salute Speaker Michael Madigan, House Minority Leader Tom Cross, Senate President John Cullerton, Minority Leader Christine Radogno, Rep. Sara Feigenholtz, Rep. Patti Bellock, Sen. Heather Steans, Sen. Dale Righter, members of the General Assembly and everyone who joined the working group for making significant progress today towards rescuing our Medicaid system.

 

This is the first step toward saving Medicaid for those that rely upon it. The status quo would have led to Medicaid's collapse, and I am pleased to see the General Assembly take strong action to put our Medicaid system and our state on the path to sound fiscal footing.

 

And there is more work to do.

 

The General Assembly must move quickly to pass legislation to add a dollar a pack to the cost of cigarettes, which - combined with today's legislation - will achieve the necessary $2.7 billion in savings to rescue Medicaid.

 

Raising the price of cigarettes is also sound health policy; smoking-related conditions are a significant burden on our Medicaid system, and this measure will improve the health of our people and reduce future Medicaid costs. Members of the General Assembly should not delay in taking action to reduce our Medicaid burden and access dollar-for-dollar federal matching funds by increasing the price of cigarettes.

 

###
29 May 2012

Senate Passes Grassley Bill to Ban Dangerous Synthetic Drugs

By Grassley Press

WASHINGTON -- Sen. Chuck Grassley of Iowa today received full Senate passage of his legislation to impose a nationwide ban on the chemicals used to make the dangerous drugs known as "K2" or "Spice." As Judiciary Committee Ranking Member, Grassley advanced the legislation, named for a young Iowa man who took his own life after using the drug.

 

"An 18-year-old constituent of mine tragically took his own life after using this drug," Grassley said.  "Other deaths around the country have been linked to it.  It's poison. Its manufacturing processes are largely unknown and 100 percent unregulated.  In some instances, the drug is made on the floor of a household garage.  People are spraying chemicals on a pile of dried plant clippings, putting that in an envelope and selling it to kids.  Anybody who ingests this substance is risking their lives.  A federal ban will go a long way in  preventing this poison from causing any more harm."

 

Grassley said the federal ban will prevent foreign manufacturers from getting their products into the United States in the first place.  And a federal ban is necessary to get the material out of stores in all 50 states.  The existing state bans vary from state to state and may not be broad enough to anticipate the chemical tweaks that cynical manufacturers use to evade the ban.  "And the clock is ticking on how long the current federal regulatory ban will remain in place," Grassley said.  "Congress needs to finalize a permanent, comprehensive ban effective in all 50 states."

 

Last year, Grassley introduced the David Mitchell Rozga Act, S. 605, named for the 18-year-old from Indianola who took his own life in June 2010, soon after using K2 purchased from his local shopping mall.  Poison control centers and emergency rooms around the country are reporting skyrocketing cases of calls and visits resulting from K2 use, with physical effects including increased agitation, elevated heart rate and blood pressure, hallucinations, and seizures.  A number of people across the country have acted violently while under the influence of the drug, dying or injuring themselves and others.

 

The Senate approved the Grassley legislation as part of legislation re-authorizing a key component of Food and Drug Administration funding.  The Senate also approved bans of the chemicals used to make other dangerous synthetic drugs, "bath salts," "2C-E" and others.  The measures were included in an amendment from Sen. Rob Portman.  "I appreciate Sen. Portman's attention to this issue and work to move forward on a ban," Grassley said.

 

The House of Representatives passed similar legislation last December.  Grassley said he hopes the House will give final passage to the synthetic drug ban as soon as possible.

 

"The chemicals used to produce these drugs have no household use," Grassley said.  "The manufacturers and sellers of these products are engaging in a cynical money-making ploy that plays with human life.  Until a final ban is in place, everyone should stay away from these products."

 

It's necessary for Congress to act to ban the chemicals used to make the new wave of synthetic drugs because the federal Drug Enforcement Administration's capacity to ban chemicals is limited.  Grassley's legislation treats K2 like other banned narcotics such as methamphetamine and cocaine.  The same is true for the bills on "bath salts" and "2C-E."

 

-30-
29 May 2012

Study predicts 42% of the U.S. Population will be Obese by 2030: Education to Combat Obesity

By Jennifer Eisenhofer

Fourth Annual Continuing Education Conference, to be held in Philadelphia on July 19-21, 2012, will feature nationally recognized lecturers in the field of obesity treatment.

MOUNT LAUREL, NJ – The 4th Annual Continuing Education (CME/CEU) Conference, The Science and Business of Weight Management for the New or Experienced Practitioner, beginning on July 19, 2012, in Philadelphia, will focus on the operational and treatment skills, techniques, and strategies healthcare professionals need to successfully open a new weight loss facility or enhance a current weight management program.

According to a May 2012 report in the American Journal of Preventive Medicine, about 42% of the U.S. population will be obese by 2030. Eric Finkelstein, lead author of the report, and co-authors estimate that 11% of the population will be severely obese by 2030.

Healthcare professionals are in the optimal position to improve the quality of life for individuals who are obese and overweight by reducing their weight and co-morbid conditions. As the obesity epidemic progresses, healthcare professionals should look toward educational forums to learn about the latest research advances, operational and treatment skills, techniques and strategies needed to successfully open a new weight management facility or enhance an existing program. To that end, the Annual Continuing Education Conference is pushing for education and providing an opportunity for networking and the exchange of essential knowledge.

Featured speakers at this year`s conference include : Dr. Robert F. Kushner; Judith S. Beck, PhD and Deborah Beck Busis, LSW; Thomas Wadden, PhD; John Baker, MD; John Hernried, MD; Susan Baker, MHA; and John Foreyt, MD, among others.

For more information about the 4th Annual Continuing Education (CME/CEU) Conference, The Science and Business of Weight Management for the New or Experienced Practitioner, visit www.WeightConference.com, or call Jennifer Eisenhofer at 888.519.1192, ext. 3012.

 

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23 May 2012

Is the health care reform law constitutional?

By Rep. Bobby Schilling
Dear Friend,

As you may know, the Supreme Court is in the process of deciding whether or not the federal government can require all Americans to purchase health insurance under the Constitution.  This mandate, included in the President's health care reform law, is an unprecedented form of federal action and government overreach.

When the health care reform law was pushed into law more than two years ago, we were told that the more Americans learned about it, the more they would like it.  That has not happened.  Americans remain strongly opposed to the health law and its expansion of the role of government in their lives.

Your input is important to me, and I want to hear your thoughts.


(Yes)
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Click here to take the survey.
*By filling out this survey, you are subscribing to receive my e-mail updates.

Remember that you can always send me a more detailed message with your thoughts or questions regarding any issue that is important to you by clicking here.

Thank you for taking the time to share your views with me.  My staff and I always appreciate your feedback, and are here to help.  If there is anything we can do to assist you, please do not hesitate to give any of my offices a call.  Contact information for each of them can be found at the bottom of this email.

Thank you for placing your trust in me.  It is an honor to serve you.

Sincerely,
Bobby Schilling
Member of Congress
23 May 2012

Kohl, Grassley and Blumenthal Seek to Cut Misuse of Antipsychotics

By Jill Kozeny

May 22, 2012

WASHINGTON - U.S. Senators Herb Kohl, D-Wis., Chuck Grassley, R-Iowa, and Richard Blumenthal, D-Conn., today filed an amendment seeking to combat the costly, widespread and inappropriate use of antipsychotics in nursing homes.

"The overuse of antipsychotics is a common and well-recognized problem that puts frail elders at risk and costs taxpayers hundreds of millions of dollars each year," Kohl said. "We need a new policy that helps to ensure that these drugs are being appropriately used to treat people with mental illnesses, not used to curb behavioral symptoms of Alzheimer's or other dementias."

"This amendment responds to alarming reports about the use of antipsychotic drugs with nursing home residents," Grassley said. "It's intended to empower these residents and their loved ones in the decisions about the drugs prescribed for them."

"This measure is responsive to mounting evidence that antipsychotics are being misused and overused in the nursing homes we trust to care for our loved ones," Blumenthal said. "The amendment will do what is necessary to curb this deeply concerning practice, putting the power to make key health care decisions back into the appropriate hands and eliminating unnecessary costs to taxpayers."

The amendment to S. 3187, the Food and Drug Administration Safety and Innovation Act would require the Health and Human Services Secretary to issue standardized protocols for obtaining informed consent, or authorization from patients or their designated health care agents or legal representatives, acknowledging possible risks and side effects associated with the antipsychotic, as well as alternative treatment options, before administering the drug for off-label use.

While the Food and Drug Administration (FDA) has approved antipsychotic drugs to treat an array of psychiatric conditions, numerous studies conducted during the last decade have concluded that these medications can be harmful when used by frail elders with dementia who do not have a diagnosis of serious mental illness. In fact, the FDA issued two "black box" warnings citing increased risk of death when these drugs are used to treat elderly patients with dementia.

Last year, the Health and Human Services Office of the Inspector General (HHS OIG) issued a report showing that over a six-month period, 305,000, or 14 percent, of the nation's 2.1 million elderly nursing home residents had at least one Medicare or Medicaid claim for atypical antipsychotics.

The HHS OIG also found that 83 percent of Medicare claims for atypical antipsychotic drugs for elderly nursing home residents were associated with off-label conditions and that 88 percent were associated with a condition specified in the FDA box warning. Further, it showed that more than half of the 1.4 million claims for atypical antipsychotic drugs, totaling $116.5 million, failed to comply with Medicare reimbursement criteria.

The amendment also calls for a new prescriber education program to promote high-quality, evidence-based treatments, including non-pharmacological interventions. The prescriber education programs would be funded through settlements, penalties and damages recovered in cases related to off-label marketing of prescription drugs.

 

 

23 May 2012

Medicare Q & A from the federal Medicare Agency - The Centers for Medicare & Medicaid Services

By Julie Brookhart

MAKING MEDICARE MAKE SENSE

Answers To Some of The Most Commonly Asked Medicare Questions

Q: Who Pays First If I Have Medicare and Other Health Coverage?

A: If you have Medicare and other health coverage, each type of coverage is called a "payer." When there's more than one payer, "coordination of benefits" rules decide who pays first. The "primary payer" pays what it owes on your bills first, and then your provider sends the rest to the "secondary payer" to pay. In some cases, there may also be a "third payer." Whether Medicare pays first depends on a number of things, including the situations listed in the chart below. However, this chart doesn't cover every situation. Be sure to tell your doctor and other health care provider's insurance specialist/billing staff if you have coverage in addition to Medicare. This will help them send your bills to the correct payer to avoid delays. Note: Paying "first" means paying the whole bill up to the limits of the payer's coverage. It doesn't always mean the primary payer pays first in time.

If you have questions about who pays first or if your coverage changes, call the Medicare Coordination of Benefits Contractor (COBC) at 1-800-999-1118. TTY users should call 1-800-318-8782. For example, if you need to find out about Medicare's coverage of End Stage Renal Disease and how it works with other insurance the COBC will answer your questions.   Also, to better serve you please have the following information ready when you call: your Medicare number (located on your red, white, and blue Medicare card) and one additional piece of information, such as your Social Security Number (SSN), address, Medicare effective date(s), or whether you have Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) coverage.

Below is a summary chart of who likely pays first. If you would like a copy of the Medicare booklet referenced in the chart, titled, "Medicare and Other Health Benefits: Your Guide to Who Pays First," call 1-800-633-4227, (which is 1-800-Medicare), and ask for CMS Product Number 02179, and tell them the title of the booklet.

Please note: In some cases, if you are entitled to, but don't have, the first payer coverage, the second payer won't cover you.  This can be vital information to know in some employer retiree plans and COBRA cases.  For instance, if you are 65 and older, and retired, and you do not enroll in Medicare, it is possible that your retiree coverage won't cover you.  Check with your retiree plan to be sure.

 

If You:

Situation

Pays First

Pays Second

See Page (s) (in publication no. 02179)

Are covered by Medicare and Medicaid

Entitled to Medicare and Medicaid

 

Medicare

Medicaid, but only after other coverage (such as employer group health plans) has paid

8

Are 65 or older and covered by a group health plan because you or your spouse is still working

Entitled to Medicare

The employer has 20 or more employees

 

The employer has              less than 20 employees*

 

Group health plan

 

 

 

 

 

 

Medicare

 

Medicare

 

 

 

 

 

 

Group health plan

 

8

 

 

 

 

 

 

9

Have an employer group health plan after you retire and are 65 or older

 

Entitled to Medicare

 

Medicare

 

Retiree coverage

 

10-11

 

Are disabled and covered by a large group health plan from your work, or from a family member who is working

 

Entitled to Medicare

The employer has 100 or more employees

 


The employer has less than 100 employees

 

 

Large group health plan

 

 

 

 

 

 

Medicare

 

Medicare

 

 

 

 

 

 

 

Group health plan

 

 

12

 

 

 

 

 

 

 

12

 

Are 65 or over OR disabled and covered by Medicare and COBRA coverage

 

Entitled to Medicare

Medicare

COBRA

22-23

Have been in an accident where no-fault or liability insurance is involved

Entitled to Medicare

No-fault or liability insurance for services related to accident claim

Medicare

13-15

Are covered under worker's compensation because of a job-related illness or injury

Entitled to Medicare

Workers' compensation for services related to worker's compensation claim

Usually doesn't apply. However, Medicare may make a conditional payment.

15-19

Are a veteran and have Veterans' benefits

Entitled to Medicare and Veterans' benefits

Medicare pays for Medicare-covered services.                     

 

Veterans' Affairs pays for VA-authorized services.

 

Note: Generally, Medicare and VA can't pay for the same service.

Usually doesn't apply

19-20

 

Are covered under TRICARE

Entitled to Medicare and TRICARE

Medicare pays for Medicare-covered services.

 

TRICARE pays for services from a military hospital or any other federal provider.

 

 

TRICARE may pay second.

 

20-21

 

*If your employer participates in a plan that is sponsored by two or more employers, the rules are slightly different.

 
23 May 2012

Governor Quinn Talks Pension and Medicaid Reform with Students

By Nafia Khan

Hosts Town Hall About Illinois' Future at Julian Middle School

OAK PARK - May 22, 2012. Governor Pat Quinn today hosted a town hall meeting with students at Julian Middle School about the urgent need for pension and Medicaid reform. With just 9 days left before the end of spring legislative session, the governor continued his push to stabilize Illinois' Medicaid and pension systems and educate the public about our fiscal challenges. During the visit, Governor Quinn took questions from 8th graders about their stake in what happens in Springfield this session and the impact that these two issues have on the future of Illinois.

"At its core, this battle to resolve our fiscal challenges is about the future of our children," Governor Quinn said. "If we want to educate our kids and ensure they are ready for the workforce, our moment is now. We must assume responsibility to build a better future for our children. We must work together to get these vital reforms done."

During the discussion at Julian Middle School, students had the opportunity to ask Governor Quinn questions about what state government does, how it is funded and why they should get involved in causes they believe in. The governor explained how education funding is being squeezed by the unsustainable growth in the Medicaid and pension systems, and what can be done to rescue the systems to ensure their sustainability for generations to come.

Public pensions and Medicaid currently take up 39% of state general revenue spending, and will grow to 50% next year without major reforms. Inaction could also severely limit the state's ability to fund core services like education and public safety, threaten the state's credit rating and hurt the long-term sustainability of both systems. The visit comes a day after the Medicaid restructuring legislation was filed to reform Illinois' Medicaid system and the Illinois Farm Bureau added its support to the governor's plans to rescue and stabilize Illinois' broken pension and Medicaid systems.

Governor Quinn's plan to stabilize public pensions would save taxpayers up to $85 billion, eliminate the unfunded liability over 30 years and allow public employees who have faithfully contributed to the system to continue to receive pension benefits. His Medicaid restructuring plan would create $2.7 billion in savings by cutting waste, fraud and abuse; raising the price of cigarettes by one dollar, and bringing in dollar-for-dollar federal matching funds.

For more information about the urgency of repairing Illinois' Medicaid and public pension systems and to take action, visit SaveOurState.illinois.gov.

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23 May 2012

Help Patients in Need This Memorial Day by Giving the Gift of Life

By Ben Corey

All presenting blood donors have the chance to win a prize package worth $200

PEORIA, Ill. (May 21, 2012) - Memorial Day weekends are always packed full of fun summer activities. But as individuals and families kick-off their summer plans, it's important to remember that the need for blood does not take a summer holiday.

To help ensure a stable blood supply for patients in need this Memorial Day, the American Red Cross is encouraging all eligible blood donors to make donating blood and platelets a part of their summer holiday plans. Five presenting donors who give blood from May 24 through May 30 within the American Red Cross Heart of America Blood Services Region will win a GiftCertificates.com prize package worth $200 redeemable for items of their choosing. Winning donors can choose from restaurants, department stores, books, music, electronics and more!

"With the arrival of summer, blood donations tend to decline as eligible donors fill their schedules with vacations and other summer activities, leaving little time to donate," said Shelly Heiden, CEO of the Heart of America Region. "The need for blood is constant. As donors choose how to spend their time this Memorial Day, we encourage them to make time to help give life by donating blood or platelets with the Red Cross."

As part of the Red Cross' Live Life. Give Life. summer-long promotion (May 21 - September 5), all presenting donors will also be entered to receive a prize certificate package worth $5,000 redeemable at GiftCertificates.com. One lucky donor will be able to live a little, using the prize certificate to choose from hundreds of available prize options.

How to Donate Blood
Simply call 1-800-RED CROSS (1-800-733-2767) or visit redcrossblood.org to make an appointment or for more information. All blood types are needed to ensure a reliable supply for patients. A blood donor card or driver's license, or two other forms of identification are required at check-in. Individuals who are 17 years of age (16 with parental permission in some states), weigh at least 110 pounds and are in generally good health may be eligible to donate blood. High school students and other donors 18 years of age and younger also have to meet certain height and weight requirements.

About the American Red Cross
The American Red Cross shelters, feeds and provides emotional support to victims of disasters; supplies more than 40 percent of the nation's blood; teaches skills that save lives; provides international humanitarian aid; and supports military members and their families. The Red Cross is a not-for-profit organization that depends on volunteers and the generosity of the American public to perform its mission. For more information, please visit redcross.org or join our blog at http://blog.redcross.org.

The need is constant. The gratification is instant. Give blood.™



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23 May 2012

Love Like Kids - Act Like Adults

By Ginny Grimsley
Some of the Hottest Couples are Doing It - Couple Offers Tips for Love and Happiness (Hint: Fun Matters)

Barack and Michelle do it. Brad and Angelina do it. John and Yoko did it. How?

As the divorce rate hovers near an estimated 50 percent in the United States, many blame career stress as a major cause of separations. But somehow some couples grow stronger, especially when they work together.

One couple who have worked together for nearly a decade in the stressful world of theater, producing Off-Broadway plays, has decided to share their secrets.

"In part, it is because we work together that our bond has strengthened after 10 years of marriage," says Jamillah Lamb, co-author along with her husband, David, of "Perfect Combination: Seven Key Ingredients to Happily Living & Loving Together" (www.acoupleoflambs.com).

The couple has worked together professionally in their stage company, Between The Lines Productions, Inc., for nine years. But the Lambs say even couples who aren't business partners are working together every day; because being in any relationship requires negotiating, compromising, and decision-making. Just think about the last time you had to decide whose mother's house you were going to for Christmas or where you were going to go for vacation or even which movie you were going to see last weekend.

"We get more opportunity to grow together because, between home and work, we're making 100 decisions a day instead of 10," Jamillah says.

The couple live by their guiding rule, "Love like kids, act like adults."

"That means to love freely and completely, without a fortress around your heart, and behave responsibly," David says.

A crucial ingredient for any successful marriage is friendship, the Lambs say. Here are some of their tips:

• Enjoy life: Some couples won't go to theme parks until they have children. But letting one's inner child out to play with their partner's inner child strengthens a relationship's bond.

• Forgive the small stuff: No one is always right, and no one wants to be around someone who always needs to be right.

• Appreciate individuality: Everyone needs to have their own identity, including those in a long-term relationship and couples who work together. David enjoys his comic book collection, while Jamillah keeps a library of romance novels.

• Do not misdirect anger: In psychology, it's called transference; dumping your bad day on someone else. It is poison for any relationship.

• Remember your love: Couples may fight, but guard what you say. There's no need for ugliness even when you disagree.

Couples need to remember relationships take work, but they can also be a blast of fun, David says.

"Love is worth the sacrifice," they agree. "Today, with stories of celebrity couples walking away after only days of marriage and even more people living as though sacrifice is nearly a curse word, we say: 'It's worth the sacrifice.' For us, it means that we are willing to give up something that we thought was valuable or important for something even more important: love and our happiness."

Love is, in part, the acknowledgement and deep appreciation for another human being, Jamillah says.

"Couples should never take each other for granted," she advises. "In love, as in business, everyone wants to be appreciated. The simplest gesture can go a long way to help your significant other feel like they are making a significant contribution to your life, your family, or your business."

About David & Jamillah Lamb

David and Jamillah Lamb have been married for 10 years. They founded and have run Between The Lines Productions, Inc. since 2003. Born and raised in Queens, N.Y., David attended the Woodrow Wilson School of Public and International Affairs at Princeton University and New York University School of Law. He is the playwright of "Platanos y Collard Greens." Jamillah Lamb grew up in the same Chicago neighborhood as first lady Michelle Obama. She earned her master's degree in public policy at Harvard. Together they wrote "Perfect Combination: Seven Key Ingredients to Happily Living & Loving" to share what they have learned as successful partners in love and in business.They live in Brooklyn with their daughter.

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