The health insurance lobby urged federal advisers against recommending specific "essential" items or services that must be included in health plans offered on new insurance exchanges starting up in 2014.

The 10 general categories of benefits outlined in the reform law already specify an "appropriate set" of items or services that should be included in the essential health benefits package, America's Health Insurance Plans said in Thursday written testimony to the Institute of Medicine (IOM).

"Other programs, such as the Federal Employee Health Benefits Program and the Massachusetts Exchange, generally use a consistent model in which the benefit package only specifies general categories of items or services and does not indicate number and frequency of services that should be covered," wrote Carmella Bocchino, executive vice president of clinical affairs and strategic planning for AHIP.

AHIP's comments were considered in the middle of a three-day IOM meeting as the body prepares recommendations to the Department of Health and Human Services on essential health benefits.

The health insurer advocate also said the essential benefits package should not have the effect of forcing individuals and small employers to purchase a richer scope of benefits than what is currently available today.

"Broadening the scope of the essential health benefit package could have the unintended consequence of making products unaffordable and thereby limit access and consumer choice," Bocchino wrote.

The group also strongly urged against requiring plans on the exchanges to comply with state mandates. AHIP said more than 2,000 state mandates currently exist.

"It would be impossible to include this large number of existing mandates in a national essential benefit package while at the same time providing affordable access to care for consumers," the group said.

The IOM should recommend an essential benefits system that allows for plans to vary levels of co-payments, deductibles and coinsurance within different benefit categories, AHIP further recommended.

A consumer advocacy group is criticizing federal regulators for not extending new limits on acetaminophen to over-the-counter (OTC) drugs.

The Food and Drug Administration (FDA) announced Thursday it is restricting limits of acetaminophen in combination prescription painkillers to 325 milligrams (mg) because of their link to liver damage. Acetaminophen, a pain reliever found in thousands of over-the-counter products, is also combined with other ingredients in many ingredients, usually opioids such as codeine, oxycodone (Percocet) and hydrocodone (Vicodin). Some prescription products can contain up to 750 mg — double of the new FDA ceiling.

The FDA said it sought the new limits because acetaminophen overdoses are associated with serious liver damage.

"There is no immediate danger to patients who take these combination pain medications and they should continue to take them as directed by their healthcare provider," said Sandra Kweder, deputy director of the Office of New Drugs in FDA's Center for Drug Evaluation and Research. "The risk of liver injury primarily occurs when patients take multiple products containing acetaminophen at one time and exceed the current maximum dose of 4,000 mg within a 24-hour period."

A consumer watchdog says the new guidelines ignore the dangers of OTC products, which make up about 80 percent of acetaminophen's market.

“It is inexcusably poor judgment on the part of the FDA to have failed to take action concerning this major source of acetaminophen consumption and, consequently, acetaminophen toxicity,” said Sidney Wolfe, director of Public Citizen’s Health Research Group.

However, the agency is still considering new limits on OTC products, an FDA spokeswoman said.

“There are more complexities in the OTCs and the process of rulemaking occurs over a longer timeframe,” the spokeswoman said.

Higher-dose prescription combination acetaminophen products will be phased out over three years, and the FDA said the new guidelines should not create a shortage of pain medication. The agency is also recommending that boxed warnings — the strongest possible caution for prescription drugs — be added to all acetaminophen prescription products.

The new Republican majority had scheduled a vote for Wednesday, but it was postponed after the Arizona shootings.

There has been "less than adequate progress" toward eliminating most healthcare disparities, according to a new federal report that calls for more data on the subject.

It has been known for a long time that income levels, race and ethnicity, gender and other attributes play in a role in determining how likely an individual is to be healthy, sick or die prematurely, but there is insufficient evidence regarding the effectiveness of certain interventions in reducing those disparities, according to a new Centers for Disease Control and Prevention (CDC) report.

Some of the findings, based on 2007 data, include:

• low-income residents report five to 11 fewer healthy days per month than do high-income residents;

• men are four times as likely to commit suicide;

• the adolescent birth rate for Hispanics and non-Hispanic blacks are three and 2.5 times, respectively, of those of whites; and

• people with higher incomes are more likely to binge drink.

The CDC cites major gaps in national data on healthcare disparities based on disability status and sexual orientation.

"Regularly published health reports that include information on health disparities typically do not include disability status as a dimension for comparison," the report said, calling gaps in sexual orientation data "even more severe."

"Standard reporting of sexual identity/orientation or sexual behavior on national health surveys is necessary if these health inequities are to be observed and attenuated among population groups," the report said.

The report calls on future national and state surveys to consistently and routinely measure sexual identity, orientation and behavior.

Childhood nutrition advocates are hailing a new proposed rule that would tighten school lunch nutrition standards as part of the Obama administration’s effort to reduce childhood obesity.

The proposed rule would require that by the 2012-2013 school year, schools increase the availability of fruits, vegetables, whole grains and fat-free and low-fat milk in school meals while reducing their sodium and saturated-fat levels. The standards also set age-based calorie requirements.

The School Nutrition Association (SNA), which partnered with first lady Michelle Obama on childhood obesity initiatives, praised the Agriculture Department's rule that was made available online Thursday morning.

“By raising the bar for school meals nationwide, these proposed standards will promote healthier lifestyles for America’s schoolchildren,” said SNA President Nancy Rice in a statement.

The United Fresh Produce Association also praised the proposal.

“The new proposed meal requirements will raise standards for the first time in 15 years and will help improve the health and nutrition of nearly 32 million kids that participate in school meal programs every school day,” said association vice president Lorelei DiSogra in a Thursday statement.

According to the rule, its implementation would initially raise the average cost of producing and serving school lunches by almost 7 cents and school breakfasts by 37 cents for schools participating in the National School Lunch Program and the School Breakfast Program. By 2015, when new requirements kick in, the costs would increase an additional 7 cents and 13 cents, respectively.

Last month, President Obama signed a $4.5 billion child nutrition bill that expands eligibility for school meals programs, establishes school nutrition standards for all foods sold in schools and provides a six-cent increase to help cafeterias sell healthier meals.

About four-fifths of the nation’s hospitals and 41 percent of physicians are aiming for federal stimulus dollars for using electronic health records (EHRs), according to new survey results released by President Obama’s health information technology czar.

Starting this year, hospitals and office-based physicians can receive Medicare and Medicaid incentives for the “meaningful use” of EHR technology in accordance with standards established by the Medicare agency. The stimulus package enacted in the first month of the Obama administration makes available up to $45,000 in Medicare and $63,000 in Medicaid incentives to office-based physicians, while hospitals stand to receive millions for the adoption and use of EHR technology. Registration for the Medicare and some Medicaid programs began earlier this month.

About two-thirds (65 percent) of hospitals and 32 percent of office-based physicians plan to enroll in meaningful use programs by the end of 2012 in order to receive the maximum incentives, according to survey results announced Thursday morning. Fewer federal dollars will be available to hospitals and doctors that wait to adopt EHR technology, and failure to meaningfully use EHRs starting in 2015 will result in Medicare penalties.

EHR technology is meant to improve healthcare quality by making it easier for care providers to share information, but the technology’s high cost has often been cited as a main reason for the healthcare community’s reluctance to adopt it. Dr. David Blumenthal, the national coordinator for Health Information Technology (ONC), said Wednesday morning that the stimulus incentives are encouraging providers purchase EHR systems.  

“For years we have known that electronic health records would improve care for patients and bring about greater cost effectiveness in our health sector, yet adoption rates by health care providers remained low,” he said in a statement. “In 2009, Congress and the President authorized major new federal support for EHR adoption and use, and in combination with medical professional and hospital leadership. I believe we are seeing the tide turn toward widespread and accelerating adoption and use of health IT."

The American Hospital Association conducted the survey on hospitals' EHR plans, while the National Center on Health Statistics reported the office-based physician data.

Republicans signaled Wednesday that repealing a controversial tax provision in the healthcare law is one of their most pressing priorities. 

The new chairwoman of the House Appropriations Committee Financial Services subcommittee said in an interview late Wednesday that she will use the appropriations process to end a controversial tax requirement in the Obama healthcare reform act if the provision is not eliminated in a standalone bill.

Two key healthcare staffers were named Wednesday night to a powerful House committee charged with dismantling the healthcare reform law.

The Energy and Commerce Committee, chaired by Rep. Fred Upton (R-Mich.), hired John O'Shea and Julie Goon as the committee's senior health policy advisers.

From the release:

John O'Shea, M.D. - Senior Health Policy Advisor
O’Shea comes to the Committee with over 20 years experience as a practicing surgeon. He received a Masters in Public Administration with a focus on Health Policy from the Harvard Kennedy School of Government in 2006. Following graduation from the Kennedy School, he was the Harvard Graduate Fellow in health policy at The Heritage Foundation in Washington, D.C. He has worked on a number of health care issues, including the Medicare physician payment system, quality and access in the Medicaid program, the delivery of emergency medical services, medical malpractice and the effects of heathcare reform on the patient-doctor relationship. He also has a Graduate Degree in the History and Sociology of Science from the University of Pennsylvania, where he studied the history of healthcare policy in the United States.

Julie Goon - Senior Health Policy Advisor
Goon served as Special Assistant to President George W. Bush for Economic Policy at the National Economic Council (NEC) from 2006 to 2009, and was responsible for the NEC’s health care portfolio including entitlement programs (Medicare, Medicaid, and SCHIP), healthcare access issues, transparency in pricing and quality, and health information technology. Goon joined the NEC from the U.S. Department of Health and Human Services where she served as Director of Medicare Outreach and Senior Advisor to the Secretary of Health and Human Services. Goon joins the Committee from General Electric where she has been Director of healthymagination, GE's cross-business initiative built on a global commitment to reduce costs, improve quality and expand access through innovation and partnership.