The Centers for Medicare & Medicaid Services (CMS) and Centers for Disease Control and Prevention have issued a proposed rule that would update proficiency testing and referral requirements under the Clinical Laboratory Improvement Amendments.
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The Department of Health & Human Services’ Office of Inspector General (OIG) has issued a proposed rule that would remove the Anti-Kickback Statute safe harbor protection for drug rebates paid by drug makers to pharmacy benefit managers (PBMs), Part D plans and Medicaid managed care organizations.
In an effort to help reduce the stigma around behavioral health issues, CHA has released a new video featuring five accomplished health care executives who have faced mental health challenges. The powerful “truth telling” video is the product of the keynote session at CHA’s recent Behavioral Health Symposium.
In its first meeting of the year on Jan. 31, the CHA Board of Trustees discussed and approved CHA’s 2019 advocacy priorities, which include leading efforts to improve coverage and access to health care; exploring new approaches to making health care more affordable; ensuring adequate state and federal funding for hospitals; reducing stigma and improving access to behavioral health care; strengthening the health care workforce and increasing funding for graduate medical education; and easing statutory and regulatory burdens for providers.
My latest trip to Davos to participate in the World Economic Forum last month was a productive and exciting gaze into the future of healthcare delivery: a world of healthcare with no address, greater immersion in population health strategies and a global push to advance mental health treatment.It’s a sizable agenda for four days and many of us emerged with a renewed commitment to partner to improve outcomes and reduce costs, to continue our investments in technology that’s radically changing care delivery, and to expand the march to value.
The widespread availability of medicines has made it possible for us to avoid suffering in a way that no previous generation from any era could. But in many cases, drugs just mask the symptoms of our illnesses, discomforts and disorders without addressing the underlying disorder that cause them. This is not to denigrate pharmacological psychiatry and its many successes and advances, or clinical psychology, or molecular medicine. The alleviation of suffering is a natural and worthy aim, and often the only thing we can do.
But drugs can cause their own problems consequences: getting rid of heartburn with omeprazole and other proton-pump inhibitors, for example, can hide serious gastrointestinal issues, and might allow us to continue eating foods that are ultimately harmful. Benzodiazepines such as Valium dull anxiety but also create profound dependence, and they also can sidetrack investigation and treatment of underlying causes. Antidepressants, though often necessary and life-saving, have side effects including weight gain, constipation, drowsiness, nausea, blurred vision and sexual dysfunction; more worryingly, many appear to double the risk of suicidal ideation. And so on.
“No doctor has ever reminded me that I am black before,” the patient said, laughing and nodding his head to let me know he appreciated my advice.
Just as he was startled by my open recognition of his race, so too was I startled by his reaction.
As his physician, I felt the issue I’d raised wasn’t worth ignoring; if anything, I viewed it as the “elephant in the exam room,” desperately begging to be called out: Black patients continue to suffer higher morbidity and mortality from colon cancer, compared to any other racial group, according to a 2016 study published in the Journal of Clinical and Translational Gastroenterology, and that is a fact that warrants discussion in the doctor’s office.
Watching President Trump’s State of the Union address Tuesday night, my mind raced back to one of my patients, panting as she strung together a few words. “My difficulty breathing,” she paused, “has gotten worse in the last few weeks.” In her hospital bed, she looked gaunt and tired. She was struggling with homelessness and had stopped taking her HIV medications months ago, as she did not have insurance and could not afford the cost of her medications. As her doctor, I feared that she had a life-threatening lung infection, an unfortunate but preventable complication of her HIV.
President Donald Trump has had two years of a miserable health care record that helped drive his party’s significant midterm losses. He has undermined protections for people with pre-existing conditions, tried to cut health care coverage from 20 million Americans by repealing the Affordable Care Act, and, when that failed, he sabotaged the ACA at virtually every turn. Seven million fewer people have health insurance than when Trump’s term began.
Looking toward the next election, Trump hoped to use his State of the Union speech for a health care reset. To anyone paying the slightest attention, he failed.
In 2018, Democrats won the midterm elections on the issue of health care, specifically protecting the Affordable Care Act and its guarantee of coverage for pre existing conditions. It was a hard-earned victory: Passing the ACA was a major reason Democrats lost the House and seats in the Senate in 2010 , and polls showed the ACA was not a winner for Democrats in 2012, 2014 or 2016. Now, the question is: Having won the upper hand on health care, will Democrats give it back in 2020?
What might squander that advantage? A primary battle among Democrats who all favor universal coverage but have differences about how to get there. Candidates seeking advantage in that contest by questioning the purity of one another’s views on health care, or conversely, trying to scare voters with nightmare scenarios about those with more liberal views. And most important, a focus on internecine differences instead of on the sharp contrast between the core Democratic position and the Republican stand on the future of health coverage in our country.