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NEW MEDICAID/CHIP REGS: Final rule on payment error rate measurement in Medicaid and CHIP programs published in the Federal Register this morning: http://www.gpoaccess.gov/fr/

In brief: As called for in last year's Children's Health Insurance Program reauthorization, the new rule changes the process for reviewing cases in which states have used simplified enrollment efforts such as self-declaration for eligibility cases; eliminates duplication of effort between eligibility reviews administered in the same fiscal year; extends the timeframe for providers to submit documentation; and provides states additional time to submit corrective action plans.

MINE BLAST UPDATE: Mine safety regulators brief reporters in the morning on latest findings in April's deadly explosion at Upper Big Branch Mine in West Virginia.

Background: The telephone conference call comes as mine owner Massey Energy is claiming vindication after new findings reveal monitors showing methane rush weren't tampered with: http://bit.ly/9xWvx4. 

MSHA's response: "While some of the methane monitoring equipment has been examined, the question of tampering with these monitors is still a matter of investigation."

On the call: U.S. Assistant Secretary of Labor for the Mine Safety and Health Administration (MSHA) Joseph Main and MSHA Coal Administrator Kevin Stricklin.

Ironic twist: Federal and state mine officials had to evacuate the mine Tuesday during their investigation, the Wall Street Journal reports: http://bit.ly/bMUS7R

STATE MEDICAID HELP PRAISED: Advocates and provider groups heap praise on lawmakers after Congress passes $16 billion boost in federal Medicaid funds. A smattering:

National Association of Chain Drug Stores: http://bit.ly/dA4bB8

American Hospital Association: http://bit.ly/aYdDcL

National Community Pharmacists Association: http://bit.ly/aLcqqE

SINGLE-PAYER OUTRAGE: After White House spokesman Robert Gibbs said some left-wing critics "ought to be drug tested," Jon Walker on FireDogLake asks: Was Obama using before he became president?  http://bit.ly/9YZl11

Gibbs's original comments to The Hill: http://bit.ly/9m3wL8

Reps. Bill Young (R-Fla.) and Doris Matsui (D-Calif.) introduced legislation Monday evening that would reauthorize the national registry for people looking for a marrow donor or umbilical cord blood unit. The Senate introduced sister legislation last Thursday.

The National Marrow Donor Program applauded the lawmakers.

"I am pleased with the introduction of this legislation and continued bipartisan support," said the group's CEO, Jeffrey Chell. "The reauthorization will provide us with the opportunity to continue our efforts to increase the number of adult donors and umbilical cord blood units available through the National Program."

The group says 12,000 patients with leukemia, certain lymphomas and other life-threatening diseases searched the national registry last year. To date, the group says it has helped facilitate more than 40,000 transplants.

The Environmental Protection Agency (EPA) on Tuesday is warning consumers that bedbug-battling pesticides, applied improperly, could make consumers' homes unlivable.

"Using the wrong pesticide or using it incorrectly to treat for bedbugs can make you, your family, and your pets sick," the EPA said in a consumer alert. "It can also make your home unsafe to live in — and may not solve the bedbug problem."

With bedbug infestations on the rise in urban centers around the country, more and more consumers are reaching out to extermination companies for relief. That's led to a subsequent rise in the number of those companies, which don't always apply their chemicals correctly, EPA warns. 

In fact, the agency suggests consumers should avoid chemical solutions altogether. 

"Prevention and non-chemical treatment of infestations is the best way to avoid or eliminate a bedbug problem," EPA suggests.

Examples of preventative measures, the agency says, include frequent vacuuming, filling wall cracks and wrapping mattresses in bedbug-proof covers.

If consumers are intent on going the pesticide route, EPA says, they should first:

• Make sure the chemical is approved for fighting bedbugs. "If bedbugs are not listed on the label, the pesticide has not been tested for bedbugs and it may not be effective."

• Check that the pesticide has EPA approval. "Any pesticide product label without an EPA registration number has not been reviewed by EPA to determine how well the product works."

• Make sure the chemical is designed for use indoors. 

The consumer alert comes less than a week after the EPA joined forces with the Centers for Disease Control and Prevention to highlight the public health dangers surrounding the "alarming resurgence" of bedbug infestations in recent years.

"Many people have mild to severe allergic reaction to the bites with effects ranging from no reaction to a small bite mark to, in rare cases, anaphylaxis (severe, whole-body reaction)," the agencies wrote. "These bites can also lead to secondary infections of the skin such as impetigo, ecthyma, and lymphanigitis. Bed bugs may also affect the mental health of people living in infested homes. Reported effects include anxiety, insomnia and systemic reactions."

FMAP's BIG DAY

Governors finally get to breathe a sigh of relief if the House, as expected, passes the Senate's state-aid bill, which includes $16.1 billion in extra Medicaid funds and $10 billion in education help.

The first votes are expected around noon, according to a GOP e-mail, but could take place as early as 10 a.m. Members expect to be off the floor by 3 p.m. or 4 p.m. Next votes: Not before 6 p.m., Sept. 14.

HEAD OF EXCHANGES NAMED

Pennsylvania Insurance Commissioner Joel Ario will help create the new state health insurance exchanges created by the healthcare reform law, Pennsylvania Gov. Ed Rendell announced in naming Robert Pratter as his replacement. Ario becomes director of the Office of Insurance Exchanges within the Office of Consumer Information and Insurance Oversight at the Department of Health and Human Services.

Preventable medical errors cost the country $19.5 billion in 2008 — or roughly $13,000 for each avoidable case, according to a report published Monday by the Society of Actuaries (SOA).

And that number is likely low, according to consultants at Milliman, who crunched the data. 

"We used a conservative methodology and still found 1.5 million measureable medical errors occurred in 2008," says Jonathan Shreve, an actuary for Milliman who co-authored the report. "This number includes only the errors that we could identify through claims data, so the total economic impact of medical errors is in fact greater than what we have reported."

More than half of those costs were associated with just five avoidable medical injuries: pressure ulcers; post-op infections; mechanical troubles with devices, implants or grafts; post-laminectomy syndrome; and hemorrhages.

Aside from the direct financial effect, the 2008 errors also resulted in more than 2,500 avoidable deaths and more than 10 million missed work days.  

The report arrives as lawmakers are hoping to rein in the skyrocketing cost of healthcare by reducing waste and linking provider payments more closely to the quality of the care delivered, not just the quantity.

If the SOA study is any indication, there's plenty of savings out there to be had.

The American Heart Association on Thursday praised the Senate for passing a child nutrition bill by unanimous consent.

In a statement released soon after passage, AHA CEO Nancy Brown called for "swift approval in the House when Congress reconvenes in the fall."

"We applaud [sponsors] Senators Blanche Lincoln (D-Ark.) and Saxby Chambliss (R-Ga.) for their leadership, and Senate Majority Leader Harry Reid [R-Nev.] and other Congressional leaders for advancing the measure before the summer congressional recess," Brown said.

"The measure," she said, "will ensure that high-calorie drinks and junk foods sold in schools are out of children’s reach and increase opportunities for physical activity through enhanced school wellness policies. The bill would require local educational agencies to set goals for nutrition education, physical activity, and other school-based activities that promote student wellness."

A public education and advocacy campaign formed to bring attention to child nutrition issues also applauded passage.

"This important legislation improves the nutrition standards for meals served in schools through the national school breakfast and lunch programs as well as food sold in vending machines and other outlets on school grounds," the Child Nutrition Initiative said in a statement. "These improvements are central to the effort to combat skyrocketing obesity rates that have left almost one third of U.S. children and adolescents overweight or obese. The bill also improves access to meals for many children who rely on them as one of their most reliable sources of food. With more than 30 million children participating in school meal programs, it is critical that we provide schools with the resources they need to improve children's health and readiness to learn."

The legislation expands eligibility for school meal programs and sets nutrition standards for all foods sold in schools.

Sen. John Kerry (D-Mass.) on Thursday introduced a bill directing the Department of Health and Human Services to develop a national strategy to prevent and control viral hepatitis.

The bill would authorize funding of almost $600 million over five years to combat the disease. Some 5.3 million Americans are infected with hepatitis B or C, which disproportionately affects blacks and Asian and kills 12,000 to 15,000 Americans every year.

"Viral hepatitis is a silent killer," Kerry said in introducing the legislation. "Most people don’t even know they have hepatitis until it causes liver damage or even cancer years after the initial infection. We can easily avoid these needless tragedies with prevention, surveillance programs, and by educating Americans about this deadly disease."

Kerry's bill — the "Viral Hepatitis and Liver Cancer Control and Prevention Act" — has the support of 102 community-based organizations that provide viral hepatitis counseling, screening and treatment.

"Senator Kerry’s legislation is urgently needed to modernize our nation’s public health response to chronic viral hepatitis," Lorren Sandt, chair of the National Viral Hepatitis Roundtable, said in a statement. "Screening and early intervention are critical to achieving better outcomes for infected patients and must be a national priority. Otherwise, our system will incur — each and every year — thousands of avoidable deaths and billions of dollars in unnecessary costs."

Kerry's bill is sister legislation to the bill Rep. Mike Honda (D-Calif.) introduced in the House in October. That bill has 60 bipartisan co-sponsors.

The House oversight panel held a hearing on the issue in June and urged prompt passage of Honda's bill. The hearing came on the heels of an Institute of Medicine report that highlighted deficiencies with the federal government's response to the epidemic.

Health and Human Services Secretary Kathleen Sebelius on Thursday announced the recipients of $159.1 million in grants to support healthcare workforce training.

The funds support programs to train nurses and geriatric specialists and to improve recruitment of minority students into the medical profession.

"We cannot build a healthier America if our country continues to face a growing health professions shortage," Sebelius said in announcing the grants. "A well-trained, educated and diverse workforce is critical to meeting future healthcare demands and to reforming the nation’s healthcare system."

The grants include: 

• $106 million for nursing education (including $42 million to train nurses as primary-care providers and/or nursing faculty);

• $29.5 million to fund three geriatric education and training programs; and

• $23.6 million to support Centers of Excellence programs designed to improve the recruitment and performance of underrepresented minority students preparing for careers in healthcare.

The Centers for Disease Control and Prevention (CDC) on Tuesday awarded $42 million to 133 community-based organizations to support HIV prevention.

The awards specifically target at-risk groups including African-Americans, Latinos, gay and bisexual men, and injection drug users, according to the CDC. The nation's first-ever national strategy for combating HIV and AIDS, unveiled last month, calls for more targeted investments to prevent the spread of HIV and AIDS among at-risk groups in which the infection rate has reached epidemic levels.

"This funding is a critical part of CDC’s national HIV prevention efforts and is in line with the priorities identified in the recently released National HIV/AIDS Strategy," CDC Division of HIV/AIDS Prevention Director Jonathan Mermin said in a statement. "Governments on the federal and state levels cannot end this epidemic alone, and these resources will help to give many communities the tools they need to fight HIV locally."

The average award is about $323,000 per year for five years, according to the CDC. Funds will be used to implement HIV prevention programs for individuals living with HIV and those at high risk of infection; to increase HIV testing and knowledge of infection status in at-risk communities; and to assist in monitoring program effects and behavioral outcomes.