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  August 4, 2011, 12:03 pm

Healthcare law has saved seniors $460M on drugs, HHS says

By Sam Baker

Nearly 900,000 seniors have received a pharmaceutical industry discount for brand-name prescription drugs according to Health and Human Services. 

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  August 4, 2011, 10:34 am

Critics say restrictions on food marketing would block ads for popular, healthy foods

By Sam Baker

Proposed restrictions on food marketing would ensnare many popular — and ostensibly healthful — products, according to critics of the proposal.

A working group of federal agencies recently released a set of marketing rules it wants the food industry to adopt voluntarily. Industry and business groups have blasted the proposals, which seek to limit the marketing of unhealthy food to children.

The Sensible Food Policy Coalition said Thursday that the proposed restrictions would prohibit marketing of 88 of the 100 most popular food items in the U.S., including products such as yogurt and whole-wheat bread.

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  August 4, 2011, 8:28 am

Seventeen states fall short on appeals processes, HHS says

By Sam Baker

The federal government might end up administering rules for appealing insurance companies' coverage denials in at least 17 states.

The healthcare reform law requires insurers to have in place certain protections that give consumers the ability to more easily file an appeal when their claims are denied. The Health and Human Services Department has said it will defer to state laws as long as they meet a set of minimum criteria established by state insurance commissioners.

Twenty-three states have external review laws that meet those criteria, according to a list HHS posted on its website Wednesday. Another 10 have similar laws in place, giving them until 2014 to tweak their standards. The remaining 17 states, as well as Washington, D.C., don't meet either standard, meaning insurers in those states have to use either an HHS-admininstered process or seek out an accredited third-party reviewer.

States have until Oct. 1 to argue that they're in the wrong category on HHS's list. And if they change their laws on external review, they can ask for a new determination at any time.

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  August 4, 2011, 8:06 am

News bites: Cantor says entitlement promises will be broken

By Sam Baker

House Majority Leader Eric Cantor (R-Va.) said the promises of entitlement programs like Medicare "are not going to be kept for many," Talking Points Memo reports.

Massachusetts hospitals have gained disproportionately from a loophole in the healthcare law and subsequent regulations, The Associated Press finds.

California Healthline takes a look at healthcare cooperatives, a piece of healthcare reform that provokes deep skepticism among some health policy experts but might hold promise in rural areas.

SCOTUSblog has been playing host for the past few days to a great debate over the constitutionality of the individual mandate. All of the posts (so far) in the blog's "symposium" are available here.

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  August 3, 2011, 5:32 pm

OVERNIGHT HEALTH: Trigger gets a second look

By Healthwatch staff

Trigger happy: Healthcare stakeholders went into a bit of a panic at the prospect of a flat 2 percent cut in Medicare spending under the debt-ceiling agreement. If the debt law's "supercommittee" doesn't come up with $1.5 trillion in reductions that are signed into law, across-the-board cuts are triggered.

But the trigger might be a better outcome than the supercommittee for some health groups. For starters, Medicaid is insulated from the trigger mechanism. So groups that are focused more on Medicaid than Medicare have more to lose from the supercommittee. And the same could be true for some sectors mostly concerned with Medicare. An across-the-board cut would likely hit some specialties harder than others.

Healthwatch's Sam Baker has the story.

Utah waiver: Medicaid advocates are urging federal regulators to reject Utah's request to pare down coverage for children and charge co-pays in the state-federal program for low-income Americans. Their letter comes as California advocates meet with Medicare and Medicaid boss Donald Berwick to urge him to reject a proposed 10 percent cut to Medicaid providers in the Golden State. Read the Healthwatch post.

Another (small) ACA victory: The 3rd Circuit Court of Appeals on Wednesday upheld a lower court's decision to toss out a healthcare reform challenge from a New Jersey doctor and one of his patients. Healthwatch's Julian Pecquet has the story.

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  August 3, 2011, 4:50 pm

‘Trigger’ in debt deal might be lesser evil for health sector

By Sam Baker

The political divisions over cuts to healthcare programs could be even sharper during the next round of deficit-reduction talks.

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  August 3, 2011, 3:49 pm

Groups urge regulators to reject Utah Medicaid waiver request

By Julian Pecquet

Medicaid advocates are urging federal regulators to reject Utah's request to pare down coverage for children and charge co-pays in the state-federal program for low-income Americans.

The request would "remove important protections that help ensure low-income children have access to affordable care," says a letter sent Wednesday to Health and Human Services Secretary Kathleen Sebelius. The letter is signed by 18 groups, including the American Academy of Pediatrics.

Utah wants to be able to limit Medicaid's Early and Periodic Screening, Diagnosis and Treatment benefit for children. The state proposed to set up a prioritized list when growth in per capita Medicaid spending outpaces the state budget.

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  August 3, 2011, 2:53 pm

CDC: About 50,000 infected with HIV each year

By Julian Pecquet

Some 50,000 Americans were infected with HIV every year between 2006 and 2009, the Centers for Disease Control and Prevention estimated in a new report.

The report found that the rate of infection is relatively stable overall, but infections among black men who have sex with other men saw a sustained increase. The report is the first to base HIV estimates on direct measurement of infections using a laboratory test that can distinguish recent infections from long-standing ones. 

The new tool gives researchers a better idea of whats happening, Dr. Thomas Frieden, CDCs director, told reporters.

While were glad its not increasing, its not good enough, he said. HIV is preventable, and we need to do more to prevent it.

He emphasized the need for people to get tested, reduce risky behaviors and get treatment.


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  August 3, 2011, 1:49 pm

Medical groups to Obama: Finalize smog rule ‘immediately’

By Ben Geman

A host of medical and public health associations are pressing the White House to quickly complete delayed rules that tighten Bush-era smog standards.

Their letter to President Obama Wednesday seeks to counter major industry and business groups, such as the U.S. Chamber of Commerce, that are lobbying to scuttle the Environmental Protection Agency’s ozone rule.

“The ozone health standard must protect those who are most vulnerable from the dangerous health impacts of ozone, including infants, children, older adults, and those with chronic diseases. To safeguard the health of the American people, help to save lives, and reduce health care spending, we support the most protective standard under consideration: 60 parts per billion (ppb) averaged over eight hours,” the letter states.

It is from 14 groups, including the American Academy of Pediatrics, the American Association of Cardiovascular and Pulmonary Rehabilitation, and the American College of Preventive Medicine.

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  August 3, 2011, 11:35 am

Consumer protections touted as essential benefit of health law

By Julian Pecquet

Federal regulators should adopt strong patient protections if the healthcare laws benefits are going to work for people with disabilities and chronic conditions, a leading advocacy group argues in a new report.

The healthcare reform law requires health plans to offer yet-to-be-defined essential health benefits if they want to sell their products on federally subsidized insurance exchanges starting in 2014. Much of the attention so far has focused on the types of services covered by the benefit — and their cost — but the National Health Council says consumer protections will be just as important.

The regulations should define not only a fair and balanced benefit, the report states, but also strong patient protections for the millions of people with chronic diseases and disabilities and their family caregivers who will rely on [essential health benefit] policies.

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