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News

Last 50 News Postings

 (Click on title to be directed to posting, most recent listed first)

Determining if Drug Price Increases are Justified
Court Overturns CMS' Site-Neutral Payment Policy
Pulmonary Disease Linked to Vaping
CEO Compensation-One Reason Healthcare Costs So Much
Doctor or Money Shortage in California?
FDA Commissioner Gottlieb Resigns
Physicians Generate an Average $2.4 Million a Year Per Hospital
Drug Prices Continue to Rise
New Center for Physician Rights
CMS Decreases Clinic Visit Payments to Hospital-Employed Physicians
   and Expands Decreases in Drug Payments 340B Cuts
Big Pharma Gives Millions to Congress
Gilbert Hospital and Florence Hospital at Anthem Closed
CMS’ Star Ratings Miscalculated
VA Announces Aggressive New Approach to Produce Rapid Improvements
   in VA Medical Centers
Healthcare Payments Under the Budget Deal: Mostly Good News
   for Physicians
Hospitals Plan to Start Their Own Generic Drug Company
Flu Season and Trehalose
MedPAC Votes to Scrap MIPS
CMS Announces New Payment Model
Varenicline (Chantix®) Associated with Increased Cardiovascular Events
Tax Cuts Could Threaten Physicians
Trump Nominates Former Pharmaceutical Executive as HHS Secretary
Arizona Averages Over 25 Opioid Overdoses Per Day
Maryvale Hospital to Close
California Enacts Drug Pricing Transparency Bill
Senate Health Bill Lacks 50 Votes Needed to Proceed
Medi-Cal Blamed for Poor Care in Lawsuit
Senate Republican Leadership Releases Revised ACA Repeal and Replace Bill
Mortality Rate Will Likely Increase Under Senate Healthcare Bill
University of Arizona-Phoenix Receives Full Accreditation
Limited Choice of Obamacare Insurers in Some Parts of the Southwest
Gottlieb, the FDA and Dumbing Down Medicine
Salary Surveys Report Declines in Pulmonologist, Allergist and Nurse 
   Incomes
CDC Releases Ventilator-Associated Events Criteria
Medicare Bundled Payment Initiative Did Not Reduce COPD Readmissions
Younger Smokers Continue to Smoke as Adults: Implications for Raising the
   Smoking Age to 21
Most Drug Overdose Deaths from Nonprescription Opioids
Lawsuits Allege Price Fixing by Generic Drug Makers
Knox Named Phoenix Associate Dean of Faculty Affairs
Rating the VA Hospitals
Garcia Resigns as Arizona University VP
Combination Influenza Therapy with Clarithromycin-Naproxen-Oseltamivir
   Superior to Oseltamivir Alone
VAP Rates Unchanged
ABIM Overhauling MOC
Substitution of Assistants for Nurses Increases Mortality, Decreases Quality
CMS Releases Data on Drug Spending
Trump Proposes Initial Healthcare Agenda
Election Results of Southwest Ballot Measures Affecting Healthcare
Southwest Ballot Measures Affecting Healthcare
ACGME Proposes Dropping the 16 Hour Resident Shift Limit

 

For an excel file with complete news listings click here.

A report from Heartwire described a letter written by Peter Wilmshurst to the AHA asking for full disclosure of conflicts of interest in the MIST trial. Wilmshurst was portrayed in SWJPCC on April 27, 2012 in our Profiles of Medical Courage series. We felt the report of the letter might be of interest to the readership of SWJPCC but there was no good section to pass along the Heartwire article. For this reason, a new Section entitled “News” has been started to report developments outside the usual medical journal purview or from other sources which might interest our readers. We encourage bringing news-worthy articles to our attention and would welcome submission of written reports of such articles.

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Entries in politics (3)

Saturday
Jan132018

MedPAC Votes to Scrap MIPS

The Medicare Payment Advisory Commission (MedPAC) voted 14 to 2 on January 11th in favor of telling Congress to do away with Merit-based Incentive Payment System (MIPS) (1). Instead they favor moving to what the panel termed a voluntary value program (2). Lawmakers mandated MIPS as part of the bipartisan 2015 Medicare Access and CHIP Reauthorization Act (MACRA) ending the sustainable growth rate formula that had repeatedly threatened to cause deep cuts in Medicare payments to doctors.

On a slide presentation before the vote, the MedPAC staff said MIPS cannot succeed. The cited the following reasons for MIPS’ probable failure (3):

  • Replicates flaws of prior value-based purchasing programs
  • Burdensome and complex
  • Much of the reported information is not meaningful
  • Scores not comparable across clinicians
  • MIPS payment adjustments will be minimal in the first two years, large and arbitrary in later years
  • MIPS will not succeed in helping beneficiaries choose clinicians, helping clinicians change practice patters to improve value, or helping the Medicare program to reward clinicians based on value

Supporters of the MedPAC approach argued for fast action. It will be difficult to dismantle MIPS if it becomes entrenched, said MedPAC panelist Rita Redberg MD (1).

One of the four physician members of the committee, Alice Coombs MD, an anesthesiologist and critical care specialist, dissented. "We have not seen one specialty physician group yet say, 'You know what, I like getting rid of MIPS and I like this [Voluntary Value Program], let's go with it.' " The American Medical Association (AMA) protested the MedPAC vote arguing to keep MIPS in place (1). "Where we are is that we'd like to fix it rather than kill it," Sharon McIlrath, assistant director of federal affairs at the AMA, told the MedPAC panelists during the public comment period. The AMA separately issued a statement from its president, David O. Barbe MD (1). "The best remedy is to fix MIPS rather than jumping into another sweeping change that has not been fleshed out and would have many of the same methodological issues as MIPS," Barbe said.

It's unclear how Congress and CMS will greet the MedPAC recommendation on MIPS. Congress in recent months has struggled with healthcare legislation, for example, reauthorization of the Children's Health Insurance Program. Routine appropriations have not yet been completed for fiscal 2018, The AMA's McIlrath told MedPAC that it doesn't appear "politically viable to think that you are going to go up there and think that you are going to get the Hill to kill MIPS (1)."

Richard A. Robbins, MD

Editor, SWJPCC

References

  1. Young KD. MedPAC backs bid to scrap MIPS Medicare pay system amid dissent. Medscape. January 11, 2018. Available at: https://www.medscape.com/viewarticle/891240 (accessed 1/13/18).
  2. Robbins RA. CMS announces new payment model. Southwest J Pulm Crit Care. 2018;16(1):29-30. Available at: http://www.swjpcc.com/news/2018/1/11/cms-announces-new-payment-model.html (accessed 1/13/18).
  3. Bloniarz K, Winter A, Glass D. Assessing payment adequacy and updating payments. Available at: http://www.medpac.gov/docs/default-source/default-document-library/jan-2018-phys-mips-public.pdf?sfvrsn=0 (accessed 1/13/18).

Cite as: Robbins RA. MedPAC votes to scrap MIPS. Southwest J Pulm Crit Care. 2018;16(1):42-3. doi: https://doi.org/10.13175/swjpcc010-18 PDF 

Tuesday
Jul182017

Senate Health Bill Lacks 50 Votes Needed to Proceed

Yesterday (7/17), two additional Senators – Sen. Roberts (R-KS) and Sen. Lee (R-NE) joined Senators Paul (R-KY) and Collins (R-ME) in announcing their intention to vote “no” on the motion to proceed on considering the Senate ACA repeal and replace legislation – effectively blocking Senate consideration of the current Senate Republican health care bill. Senators Paul, Lee and Roberts opposed the bill for not going far enough, while Senator Collins expressed her concern the bill goes too far.

With the 4 publicly announced NO votes – Senator Majority Leader Mitch McConnell does not have the 50 votes needed to begin debate on the bill, let alone assure final passage.

Speculation now turns to what happens next. President Trump has tweeted his preference to let Obamacare fail as a way to force Democrats to negotiate new legislation. Senator McConnell has suggested a series of symbolic votes on full repeal with multi-year delay to work on a replacement plan or voting on the House passed bill. However, three moderate senators, Capito (R-WV), Collins (R-ME) and Murkowski (R-AK), announced today they will not support procedural votes on an immediate ACA repeal bill.  Alternatively, Congress may abandon the health reform effort for the time being and pivot to other legislative priorities (tax reform and infrastructure). The failure of McConnell to lead the Senate effort may clear the way for a bipartisan effort to address the shortfalls of the ACA.

Please keep in mind the House repeal and replace effort “died” before the House ultimately passed its repeal legislation, so while the Senate effort looks to be “permanently stalled” it is probably premature to call it “dead.”

Nuala S. Moore

American Thoracic Society

Washington, DC USA

Cite as: Moore NS. Senate health bill lacks 50 votes needed to proceed. Southwest J Pulm Crit Care. 2017;15(1):45. doi: https://doi.org/10.13175/swjpcc093-17 PDF 

Tuesday
Sep062016

Clinton's and Trump's Positions on Major Healthcare Issues

As the presidential election nears, the positions of the two major candidates on healthcare have received more attention. Both Clinton and Trump have their healthcare positions listed on their websites (1,2). Below is a table listing their positions from their websites and occasionally other sources followed by a brief discussion of each of the issues. 

Table 1. Presidential candidate positions on healthcare issues. A questions mark denotes an unclear position.

Affordable Care Act (ACA, Obamacare)

This is a major difference between Clinton and Trump. Clinton favors its retention (1). Trump favors its repeal (2).

Access to reproductive health

Clinton supports reproductive preventive care, affordable contraception, and safe and legal abortion (1). Trump's position is unclear. He currently is pro-life but would not use Federal funds for abortion (2). Federal funding for abortions us is prohibited by law (3).

Allow importing drugs to reduce costs

Both candidates favor importation of prescription drugs to reduce prices (1,2).

Block-grant Medicaid to the states

Trump block-grants asserting that "the state governments know their people best and can manage the administration of Medicaid far better without federal overhead" (2). This idea is not new with Congressional Republicans pushing for block-granting Medicaid at least since the 1990s (4) Clinton's position is unclear (1).

Coverage of poor

Both candidates favor universal healthcare including the poor (1,2).

Healthcare for illegal immigrants

Clinton favors extending healthcare to families regardless of immigration status by allowing families to buy health insurance on the health exchanges (1). Trump's website notes that providing healthcare to illegal immigrants costs us some $11 billion annually and he favors strict enforcement of the current immigration laws (2).

Healthcare savings accounts

Trump favors savings accounts which are permitted under the ACA but with restrictions (2,5). Clinton's position is unclear.

Increase access to healthcare

Both candidates favor increased access to healthcare (1,2).

Increase income tax deductions for healthcare costs

Both candidates favor increasing income tax deductions for healthcare costs but their plans are different (1,2). Trump favors full deduction of health insurance premium payments from tax returns. Clinton favors a refundable tax credit of up to $5,000 per family for excessive out-of-pocket costs.

Price transparency

Both candidates favor increased healthcare price transparency (1,2).

Public option

Clinton favors a public option (1). Trump's position is unclear.

Reduce copays and deductibles

Clinton favors reducing copays and deductibles (1). Trump's position is unclear.

Sell insurance across state lines

Trump favors insurance companies selling healthcare insurance across state lines (2). This has been a part of the platform of every Republican presidential nominee and is permitted in 5 states but insurance companies have been reluctant to sell these policies (6). Clinton's position is unclear.

References

  1. Hillary Clinton for America. Available at: https://www.hillaryclinton.com/issues/health-care/ (accessed 9/6/16).
  2. Donald J. Trump for President. Available at: https://www.donaldjtrump.com/positions/healthcare-reform (accessed 9/6/16).
  3. Salganicoff A, Beamesderfer A, Kurani N, Sobel L. Coverage for abortion services and the ACA. Kaiser Family Foundation. September 19, 2014. Available at: http://kff.org/womens-health-policy/issue-brief/coverage-for-abortion-services-and-the-aca/ (accessed 9/6/16).
  4. Dickson V. GOP's Medicaid block-grant plan won't happen while Obama's in office. Medscape. March 19, 2015. Available at: http://www.modernhealthcare.com/article/20150319/NEWS/150319877 (accessed 9/6/16).
  5. Norris L. Under the ACA, can I still have an individual HDHP and an HSA? Healthinsurance.org. May 16, 2016. Available at: https://www.healthinsurance.org/faqs/i-have-an-individual-hdhp-and-an-hsa-will-i-still-be-able-to-have-them-under-the-aca/ (accessed 9/6/16).
  6. Cauchi R. Out-of-state health insurance - allowing purchases (state implementation report). National Conference of State Legislators. December, 2015. Available at: http://www.ncsl.org/research/health/out-of-state-health-insurance-purchases.aspx (accessed 9/6/16).

Cite as: Robbins RA. Clinton's and Trump's positions on major healthcare issues. Southwst J Pulm Crit Care. 2016;13(3):126-8. doi: http://dx.doi.org/10.13175/swjpcc091-16 PDF