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New WHO guidelines for mammography screening and referral

October 31, 2014 Comments off

New WHO guidelines for mammography screening and referral
Source: World Health Organization

A new WHO position paper examines the balance of benefits and harms in offering mammography screening to women after the age of 40 in a variety of settings. WHO is also issuing new guidelines for the referral of suspected breast cancer cases in low-resources settings, applicable to primary care.

These two guidelines are part of a broader set of comprehensive breast cancer guidance that will be developed in the coming years.

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HHS OIG — Medicare Paid for HIV Drugs for Deceased Beneficiaries

October 31, 2014 Comments off

Medicare Paid for HIV Drugs for Deceased Beneficiaries
Source: U.S. Department of Health and Human Services, Office of Inspector General

WHY WE DID THIS STUDY
Under the Medicare Part D program, CMS contracts with private insurance companies, known as sponsors, to provide prescription drug coverage to beneficiaries who choose to enroll. OIG has had ongoing concerns about Medicare paying for drugs and services after a beneficiary has died.
Drugs that treat the human immunodeficiency virus (HIV) can be a target for fraud, waste, and abuse, primarily because they can be very expensive. Although this report focuses on HIV drugs, the issues raised are relevant to all Part D drugs.

HOW WE DID THIS STUDY
We based this study on an analysis of Prescription Drug Event (PDE) records for HIV drugs in 2012. Part D sponsors submit these records to CMS for each drug dispensed to beneficiaries enrolled in their plans. Each record contains information about the drug, beneficiary, pharmacy, and prescriber. We used the Beneficiary Enrollment Database, the Social Security Administration’s Death Master File, and Accurint’s Death Records to identify beneficiaries’ dates of death.

WHAT WE FOUND
Medicare paid for HIV drugs for over 150 deceased beneficiaries. CMS’s current practices allowed most of these payments to occur. Specifically, CMS has edits (i.e., systems processes) in place that reject PDE records for drugs with dates of service more than 32 days after death. CMS’s practices allow payment for drugs that do not meet Medicare Part D coverage requirements. Most of these drugs were dispensed by retail pharmacies.
This review looked only at HIV drugs, which account for one-quarter of one percent of all Part D drugs in 2012. However, our findings have implications for all drugs because Medicare processes PDE records for all drugs the same way. Considering the enormous number of Part D drugs, a change in practice would affect all Part D drugs and could result in significant cost savings for the program and for taxpayers.

WHAT WE RECOMMEND
We recommend that CMS change its practice of paying for drugs that have a date of service within 32 days after the beneficiary’s death. CMS should eliminate or-if necessary for administrative processing issues-shorten the window in which it accepts PDE records for drugs dispensed after a beneficiary’s death. Such a change would prevent inappropriate payments for drugs for deceased beneficiaries and lead to cost savings for the program and for taxpayers. CMS concurred with our recommendation.

ACA Advertising in 2014 – Insurance and Political Ads

October 31, 2014 Comments off

ACA Advertising in 2014 – Insurance and Political Ads
Source: Kaiser Family Foundation

Since the passage of the Affordable Care Act (ACA) in 2010, the law has been an often potent and divisive political issue, and has sparked an unprecedented amount of political and campaign advertising, particularly from candidates and groups that oppose the law. According to Kantar Media’s Campaign Media Analysis Group (CMAG), no other federal program or policy has resulted in the kind of advertising the ACA has caused, namely the combination of new insurance “product” advertising and sustained political advertising across multiple election cycles.

This year, Americans saw the launch of the ACA’s insurance market reforms, the implementation of the state and federal exchanges where people can shop for coverage and access subsidies, and the expansion of Medicaid in many states. Alongside these policy changes, new stakeholders began to advertise to encourage participation in the new coverage options, including state and federal governments, non-profit groups looking to boost enrollment, and health insurance companies seeking new customers. The mid-term elections have also brought a new collection of political advertising with ACA messaging. These two distinct types of advertising have different goals and aims; some encourage people to take advantage of new options under the ACA, while others encourage people to vote a certain way. With both of these types of advertising making their way into American living rooms in 2014, this analysis describes the full spectrum of ads that the American public is being exposed to regarding health care, both in the context of health insurance coverage, and as a political issue in the mid-term elections.

UK — Benefits of Investing in Cycling

October 31, 2014 Comments off

Benefits of Investing in Cycling (PDF)
Source: British Cycling

Investing in cycling will generate benefits for the whole country, not just those using a bike to get around. Eleven benefits are summarised here which can help solve a series of health, social and economic problems. This report shows how investing in cycling is good for our transport systems as a whole, for local economies, for social inclusion, and for public health.

Creating a cycling revolution in the UK requires sustained investment. In European countries with high cycling levels, levels of investment are also substantially higher than in the UK. The All-Party Parliamentary Cycling Inquiry has recommended a minimum of £10 annually per person, rising to £20, which would begin to approach the spending levels seen in high-cycling countries.

Investing in cycling will enable transport authorities to start putting in place the infrastructure we need to ensure people of all ages and abilities can choose to cycle for short everyday trips. As well as making cycle journeys more pleasant, safer and faster, it sends the signal that cycling is a normal way to travel. This is important because the perception of cycling as a marginal and minority mode is off-putting to many people.

New From the GAO

October 30, 2014 Comments off

New GAO Reports
Source: Government Accountability Office

1. Pension Plan Valuation: Views on Using Multiple Measures to Offer a More Complete Financial Picture. GAO-14-264, September 30.
http://www.gao.gov/products/GAO-14-264
Highlights – http://www.gao.gov/assets/670/666288.pdf

2. DOD Business Systems Modernization: Additional Enhancements Are Needed for Army Business System Schedule and Cost Estimates to Fully Meet Best Practices. GAO-14-470, September 30.
http://www.gao.gov/products/GAO-14-470
Highlights – http://www.gao.gov/assets/670/666294.pdf

3. Federal Real Property: More Useful Information to Providers Could Improve the Homeless Assistance Program. GAO-14-739, September 30.
http://www.gao.gov/products/GAO-14-739
Highlights – http://www.gao.gov/assets/670/666258.pdf

4. VA Health Care: Management and Oversight of Consult Process Need Improvement to Help Ensure Veterans Receive Timely Outpatient Specialty Care. GAO-14-808, September 30.
http://www.gao.gov/products/GAO-14-808
Highlights – http://www.gao.gov/assets/670/666249.pdf
Podcast – http://www.gao.gov/multimedia/podcasts/666528

5. Energy Policy: Information on Federal and Other Factors Influencing U.S. Energy Production and Consumption from 2000 through 2013. GAO-14-836, September 30.
http://www.gao.gov/products/GAO-14-836
Highlights – http://www.gao.gov/assets/670/666271.pdf

6. Disability Compensation: Review of Concurrent Receipt of Department of Defense Retirement, Department of Veterans Affairs Disability Compensation, and Social Security Disability Insurance. GAO-14-854R, September 30.
http://www.gao.gov/products/GAO-14-854R

7. DOD Space Systems: Additional Knowledge Would Better Support Decisions about Disaggregating Large Satellites. GAO-15-7, October 30.
http://www.gao.gov/products/GAO-15-7
Highlights – http://www.gao.gov/assets/670/666715.pdf

Mental Health Stigma in the Military

October 30, 2014 Comments off

Mental Health Stigma in the Military
Source: RAND Corporation

Despite the efforts of both the U.S. Department of Defense (DoD) and the Veterans Health Administration to enhance mental health services, many service members are not regularly seeking needed care when they have mental health problems. Without appropriate treatment, these mental health problems can have wide-ranging and negative impacts on the quality of life and the social, emotional, and cognitive functioning of affected service members. The services have been actively engaged in developing policies, programs, and campaigns designed to reduce stigma and increase service members’ help-seeking behavior. However, there has been no comprehensive assessment of these efforts’ effectiveness and the extent to which they align with service members’ needs or evidence-based practices. The goal of this research was to assess DoD’s approach to stigma reduction — how well it is working and how it might be improved. To address these questions, RAND researchers used five complementary methods: (1) literature review, (2) a microsimulation modeling of costs, (3) interviews with program staff, (4) prospective policy analysis, and (5) an expert panel. The priorities outlined in this report represent a first step for where additional program and policy development and research and evaluation are needed to improve understanding of how best to get service members with mental health disorders the needed treatment as efficiently and effectively as possible.

Provision of No-Cost, Long-Acting Contraception and Teenage Pregnancy

October 30, 2014 Comments off

Provision of No-Cost, Long-Acting Contraception and Teenage Pregnancy
Source: New England Journal of Medicine

We found that pregnancy, birth, and abortion rates were low among teenage girls and women enrolled in a project that removed financial and access barriers to contraception and informed them about the particular efficacy of LARC methods. The observed rates of pregnancy, birth, and abortion were substantially lower than national rates among all U.S. teens, particularly when compared with sexually experienced U.S. teens. Stratification according to factors known to be associated with sexual behavior and pregnancy risk (age and race)21 showed that this was true among both older teens (18 to 19 years of age) and younger teens, as well as among both white and black teens.

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