senate

IL considering bill limiting charges to uninsured

Thu, 29 May 2008 06:59:56 -0400

The state of Illinois is considering a bill that would set limits on what hospitals would be allowed to charge and collect from eligible uninsured patients. Under the terms of the bill, which was passed by the state House and is expected to pass the Senate, hospitals could charge no more than 135 percent of the costs for medically necessary care for eligible patients. To meet the criteria, the patient would have to be a state resident and make no more than six times the federal poverty level, or half of that in rural or critical-access regions. For patients who met these conditions, the hospital would be prohibited from collecting more than 25 percent of a patient's income each year unless the he or she had assets exceeding the income levels in the eligibility guidelines.

To learn more about the bill:
- read this Modern Healthcare piece (reg. req.)

Related Articles:
St. Louis hospitals give uninsured discounts
Catholic Healthcare West uninsureds get 35 percent refund
MN health systems pay back uninsured patients
SC court examines discounts for uninsured

Pharma gift disclosure law wins Eli Lilly support

Wed, 14 May 2008 06:59:58 -0400

While its peers appear to be firmly opposed to such rules, pharmaceutical giant Eli Lilly has decided to support federal legislation that would require drugmakers to disclose payments to doctors. Although such initiatives have floundered in the past, Lilly's support may give the new law--which would go into effect beginning March 31, 2011--a better shot at passing.

Lilly got on board with The Physician Payments Sunshine Act, as the measure is known, when legislators agreed to raise the minimum reportable payment from $25 to $500, and extended the legislation to apply to all drug and medical devicemakers rather than only those with more than $100 million in annual revenue.

Another factor that swayed Lilly is that the federal law would pre-empt similar laws currently in affect in a few states. Lilly president John Lechleiter has said that such pre-emption was important, as it would help companies like his by establishing one uniform reporting standard.

To learn more about the bill, and Lilly's position:
- read this Associated Press piece
- read Lilly's statement on the subject

Related Articles:
Drug companies plan to disclose grant funding
Senate investigates pharma influence on CME
Senate questions devicemaker payments to surgeons
Doctors weigh in on the pros and cons of accepting drug/device freebies

ALSO NOTED: Critics urge changes in Ala. CON laws; Mass. AG urges hospital changes; and much more...

Fri, 07 Mar 2008 06:59:50 -0500

> Critics are urging Alabama's governor to work changes in the state's process for approving new healthcare beds. Article

> The Massachusetts attorney general is getting involved in some hospital operations issues, urging one to give up being an academic medical center and the other to become a mental health provider. Article

> The interim CEO chosen to run Atlanta's Grady Memorial Hospital is taking heat for postponing what some say are needed management changes. Article

> Florida's Senate has approved a bill that would freeze the state's Medicaid budget, eliminating automatic cost-of-living increases. Article

And Finally... This French village has issued a decree banning death within its borders. Wonder if that will work. Article

Patients avoid genetic tests, fearing insurer backlash

Tue, 26 Feb 2008 06:59:55 -0500

As FierceHealthcare readers know, researchers soon hope to tailor treatments to patients based on their genetic profile. The thing is, it will be hard to do that if patients are reluctant to take genetic tests. Unfortunately, though, it appears that this is just what many are doing, afraid that such results will be used against them by insurers, according to a recent report in The New York Times. And while a bill outlawing genetic discrimination was filed in the U.S. House of Representatives last year, it hasn't reached the Senate yet.

Meanwhile, patient fears may be well-founded. One study by the Georgetown University Health Policy Institute found that in 7 out of 92 hypothetical underwriting decisions, insurers said they would deny coverage, charge higher premiums or exclude some conditions from coverage based on genetic test results.

To learn more about this issue:
- read this FierceBioResearcher piece
- read the piece in The New York Times

Related Articles:
CA bill requires permission for cancellations. Article
Blue Cross of CA halts patient info requests. Article
Blue Cross asks MDs for info to cancel policies. Article

Closing the children's healthcare gap

Fri, 12 Oct 2007 06:59:59 -0400

It's never fun to be reminded that big quality gaps still exist in our healthcare system. It's even more troubling to learn, as we did this week, that care for children isn't up to par with the care adults get.

As a healthcare industry observer (and, I'll admit, as a mom to a preschooler and second-grader), I'm upset by the idea that children are getting cross-the-Ts and dot-the-Is care less than half of the time. But furrowing our collective brow doesn't do anything, obviously. The question is how to address the problem.

To start with, of course, studies like this week's are great--after all, you can't fix a problem you can't define. Another worthwhile initiative is a new bill, currently being considered in the U.S. Senate, which would allocate $100 million over five years to develop quality measures specifically for children's healthcare.

But surveys and studies can only go so far. Ultimately, studies like these should spark some soul-searching by physicians and hospitals, and with any luck, some concrete examinations of how they go about keeping children well. In particular, healthcare providers could take a look at every point at which they touch children, including not only doctor-child interaction, but also their work with nurses, tech and administrative staff. There's probably lots of points at which you could engage with parents more effectively to make sure the child gets what they need.

Realistically, with a gap this large, it's going to take lot a to close the children's healthcare gap. But taking a look at small day-to-day interactions between children, parents and the entire care team seems like a good start. - Anne

Congress poised to give more power to the FDA

Thu, 20 Sep 2007 06:59:58 -0400

The U.S. House of Representatives has approved a bill designed to give the FDA more money and more authority to monitor and enforce drug safety rules. The bill, which is expected to pass the Senate this week, has pulled off the rare trick of winning over both consumer and industry groups. Not only did the president of the Consumers Union praise the measure, pharmas generally support it, too, according to the Pharmaceutical Research and Manufacturers of America. While its main immediate impact will be to reauthorize funding for the agency, it's far more than a standard reauthorization measure, observers say.

Among other things, the comprehensive bill includes a provision that will kick up fees to pharmas and drug makers which should generate an additional $400 million for the agency. The measure would also require drug makers to publicly post the results of any clinical trials involving approved medicine, and allow the agency to force drug makers to conduct new clinical trials for already-approved medications.

To get more details on the measure:
- read this article in The New York Times

Related Articles:
Researcher challenges FDA approval process. Report
Bill giving FDA more drug safety powers could pass. Report
FDA emphasizing speed over safety? Report
FDA boosts reviews for new drugs. Report
Report faults FDA's post-marketing vigilance. Report

ALSO NOTED: MI keeps volume regs for open-heart programs; Senate approves mental health parity; and much more...

Wed, 19 Sep 2007 06:59:50 -0400

> Michigan hospital regulators have re-affirmed rules which require hospitals to perform at least 300 open-heart surgeries a year to maintain their programs. Article

> The U.S. Senate has unanimously approved a bill which would require health plans to offer equivalent coverage for mental and physical illnesses when policies cover both. Article

> The state of Minnesota is backing an effort to build a state-wide health information exchange. FierceHealthIT

> Texas medical malpractice insurer Medical Protective is cutting rates an average of 7.3 percent, the fifth reduction in the last three years since tort reform passed there. Article

And Finally... Can justice be served without horsehair wigs? Article

ALSO NOTED: Senate agrees to expand SCHIP; Minnesota cardiology program takes fly-ins; and much more...

Mon, 06 Aug 2007 06:59:50 -0400

> Despite facing the threat of a veto from President Bush, the U.S. Senate agreed to add 3 million children from lower-income families to SCHIP. Article

> One Minneapolis cardiology program has begun accepting patients from as far as 210 miles away, who are being airlifted there to take advantage of its specialized care options. Article

> A South Florida children's hospital received $3 million from a real estate development to expand its facilities. Report

> The Joint Commission will soon have a new head, Mark Chassin, replacing long-time president Dennis O'Leary. O'Leary has been the president for more than 20 years. Article

And Finally... He was alone for six hours, floating overnight on the Dead Sea, but managed to survive. Article

ALSO NOTED: HHS promotes mass casualty preparations; LSU gets nurse anesthetist grant; and much more...

Thu, 05 Jul 2007 20:01:30 -0400

> HHS has awarded $430 million to states to improve hospitals' ability to respond to mass casualties. Article

> Louisiana State University's New Orleans-based nursing school has received a grant designed to help it train nurse anesthetists. Article

> North Carolina's Senate has approved a mental health parity bill. The state's House had previously approved a different version. Article

> Could statins be tied with increases in the incidence of Lou Gehrig's disease? Article

And Finally... When it comes to chattiness, don't assume women win top honors. Article

Bill would open Medicare data to research

Sun, 10 Jun 2007 20:01:34 -0400

A bill making the rounds in the U.S. Senate would open up Medicare data to private organizations that want to use it for research and analysis. The bill, sponsored by Sens. Hillary Clinton (D-NY) and Judd Gregg (R-NJ), would make claims, enrollment, survey, assessment and other available to private groups hoping to measure care quality, efficiency and effectiveness. Other stakeholders would then have the right to request reports from the research organizations. The research organizations would also be required to release any published reports to the public. If the bill passes, CMS can be sure that private groups will jump all over the opportunity to study some of its current initiatives, notably its pay-for-performance program.

To learn more about the bill:
- read this Health Data Management piece