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CRS — Title X (Public Health Service Act) Family Planning Program (September 3, 2014)

September 15, 2014 Comments off

Title X (Public Health Service Act) Family Planning Program (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

The federal government provides grants for voluntary family planning services through the Family Planning Program, Title X of the Public Health Service Act (42 U.S.C. §§300 to 300a-6). Enacted in 1970, it is the only domestic federal program devoted solely to family planning and related preventive health services. In 2012, Title X-funded clinics served 4.8 million clients.

Title X is administered through the Office of Population Affairs (OPA) in the Department of Health and Human Services (HHS). Although the authorization of appropriations for Title X ended with FY1985, funding for the program has continued through appropriations bills for the Departments of Labor, Health and Human Services, and Education, and Related Agencies (Labor- HHS-Education).

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CRS — Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act (ACA): Issues for Congress( August 26, 2014)

September 15, 2014 Comments off

Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act (ACA): Issues for Congress (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

The 2010 Patient Protection and Affordable Care Act (ACA, P.L. 111-148) requires certain health insurers to provide consumer rebates if they do not meet a set financial target known as a medical loss ratio (MLR). At its most basic, a MLR measures the share of health care premium dollars spent on medical benefits, as opposed to company expenses such as overhead or profits. For example, if an insurer collects $100,000 in premiums and spends $85,000 on medical care, the MLR is 85%. In general, the higher the MLR, the more value a policyholder receives for his or her premium dollar. The ACA requires an annual, minimum 80% MLR for individual and small group insurance plans, and an annual, minimum 85% MLR for large group plans. Congress imposed the MLR to provide “greater transparency and accountability around the expenditures made by health insurers and to help bring down the cost of health care.”

CRS — Health Care Fraud and Abuse Laws Affecting Medicare and Medicaid: An Overview (September 8, 2014)

September 15, 2014 Comments off

Health Care Fraud and Abuse Laws Affecting Medicare and Medicaid: An Overview (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

A number of federal statutes aim to combat fraud and abuse in federally funded health care programs such as Medicare and Medicaid. Using these statutes, the federal government has been able to recover billions of dollars lost due to fraudulent activities. This report provides an overview of some of the more commonly used federal statutes used to fight health care fraud and abuse and discusses some of the changes made to these statutes by the Patient Protection and Affordable Care Act (ACA).

Title XI of the Social Security Act contains Medicare and Medicaid program-related anti-fraud provisions, which impose civil penalties, criminal penalties, as well as exclusions from federal health care programs on persons who engage in certain types of misconduct. ACA amends these administrative sanctions and authorizes the imposition of several new civil monetary penalties and exclusions.

Work and Health Insurance for 50- to 64-Year Olds

September 12, 2014 Comments off

Work and Health Insurance for 50- to 64-Year Olds
Source: AARP Public Policy Institute

Work is a critical gateway to health insurance. Nearly two-thirds of 50- to 64-year olds had employer-sponsored health insurance in 2012 . But working is not a guarantee of employer-sponsored health insurance. Part-time workers and the self-employed are much less likely than full-time workers to have insurance through their employment. Getting coverage as a dependent on a family member’s employer plan plays an important role for some workers and nonworkers. Health reform offers new coverage options to workers and others who do not have access to coverage through work.

This Fact Sheet discusses the prevalence of employer coverage among 50- to 64-year-olds overall and by work status as of 2012, and new options for coverage.

Vital Signs: Sodium Intake Among U.S. School-Aged Children — 2009–2010

September 12, 2014 Comments off

Vital Signs: Sodium Intake Among U.S. School-Aged Children — 2009–2010
Source: Morbidity and Mortality Weekly Report (CDC)

Background:
A national health objective is to reduce average U.S. sodium intake to 2,300 mg daily to help prevent high blood pressure, a major cause of heart disease and stroke. Identifying common contributors to sodium intake among children can help reduction efforts.
Methods: Average sodium intake, sodium consumed per calorie, and proportions of sodium from food categories, place obtained, and eating occasion were estimated among 2,266 school-aged (6–18 years) participants in What We Eat in America, the dietary intake component of the National Health and Nutrition Examination Survey, 2009–2010.

Results:
U.S. school-aged children consumed an estimated 3,279 mg of sodium daily with the highest total intake (3,672 mg/d) and intake per 1,000 kcal (1,681 mg) among high school–aged children. Forty-three percent of sodium came from 10 food categories: pizza, bread and rolls, cold cuts/cured meats, savory snacks, sandwiches, cheese, chicken patties/nuggets/tenders, pasta mixed dishes, Mexican mixed dishes, and soups. Sixty-five percent of sodium intake came from store foods, 13% from fast food/pizza restaurants, 5% from other restaurants, and 9% from school cafeteria foods. Among children aged 14–18 years, 16% of total sodium intake came from fast food/pizza restaurants versus 11% among those aged 6–10 years or 11–13 years (p<0.05). Among children who consumed a school meal on the day assessed, 26% of sodium intake came from school cafeteria foods. Thirty-nine percent of sodium was consumed at dinner, followed by lunch (29%), snacks (16%), and breakfast (15%).

Implications for Public Health Practice:
Sodium intake among school-aged children is much higher than recommended. Multiple food categories, venues, meals, and snacks contribute to sodium intake among school-aged children supporting the importance of populationwide strategies to reduce sodium intake. New national nutrition standards are projected to reduce the sodium content of school meals by approximately 25%–50% by 2022. Based on this analysis, if there is no replacement from other sources, sodium intake among U.S. school-aged children will be reduced by an average of about 75–150 mg per day and about 220–440 mg on days children consume school meals.

Census of Fatal Occupational Injuries Summary, 2013

September 12, 2014 Comments off

Census of Fatal Occupational Injuries Summary, 2013
Source: Bureau of Labor Statistics

A preliminary total of 4,405 fatal work injuries were recorded in the United States in 2013, lower than the revised count of 4,628 fatal work injuries in 2012, according to results from the Census of Fatal Occupational Injuries (CFOI) conducted by the U.S. Bureau of Labor Statistics. The rate of fatal work injury for U.S. workers in 2013 was 3.2 per 100,000 full-time equivalent (FTE) workers, compared to a final rate of 3.4 per 100,000 in 2012.

Final 2013 data from CFOI will be released in the late spring of 2015. Over the last 5 years, net increases to the preliminary count have averaged 165 cases, ranging from a low of 84 in 2011 to a high of 245 in 2012. The revised 2011 figure was 2 percent higher than the preliminary total, while the 2012 figure was 6 percent higher.

Fiction or Not? Fifty Shades is Associated with Health Risks in Adolescent and Young Adult Females

September 12, 2014 Comments off

Fiction or Not? Fifty Shades is Associated with Health Risks in Adolescent and Young Adult Females
Source: Journal of Women’s Health

Background:
No prior study has empirically characterized the association between health risks and reading popular fiction depicting violence against women. Fifty Shades—a blockbuster fiction series—depicts pervasive violence against women, perpetuating a broader social narrative that normalizes these types of risks and behaviors in women’s lives. The present study characterized the association between health risks in women who read and did not read Fifty Shades; while our cross-sectional study design precluded causal determinations, an empirical representation of the health risks in women consuming the problematic messages in Fifty Shades is made.

Methods:
Females ages 18 to 24 (n=715), who were enrolled in a large Midwestern university, completed a cross-sectional online survey about their health behaviors and Fifty Shades’ readership. The analysis included 655 females (219 who read at least the first Fifty Shades novel and 436 who did not read any part of Fifty Shades). Age- and race-adjusted multivariable models characterized Fifty Shades’ readers and nonreaders on intimate partner violence victimization (experiencing physical, sexual and psychological abuse, including cyber-abuse, at some point during their lifetime); binge drinking (consuming five or more alcoholic beverages on six or more days in the last month); sexual practices (having five or more intercourse partners and/or one or more anal sex partner during their lifetime); and using diet aids or fasting for 24 or more hours at some point during their lifetime.

Results:
One-third of subjects read Fifty Shades (18.6%, or 122/655, read all three novels, and 14.8%, or 97/655, read at least the first novel but not all three). In age- and race-adjusted models, compared with nonreaders, females who read at least the first novel (but not all three) were more likely than nonreaders to have had, during their lifetime, a partner who shouted, yelled, or swore at them (relative risk [RR]=1.25) and who delivered unwanted calls/text messages (RR=1.34); they were also more likely to report fasting (RR=1.80) and using diet aids (RR=1.77) at some point during their lifetime. Compared with nonreaders, females who read all three novels were more likely to report binge drinking in the last month (RR=1.65) and to report using diet aids (RR=1.65) and having five or more intercourse partners during their lifetime (RR=1.63).

Conclusions:
Problematic depictions of violence against women in popular culture—such as in film, novels, music, or pornography—create a broader social narrative that normalizes these risks and behaviors in women’s lives. Our study showed strong correlations between health risks in women’s lives—including violence victimization—and consumption of Fifty Shades, a fiction series that portrays violence against women. While our cross-sectional study cannot determine temporality, the order of the relationship may be inconsequential; for example, if women experienced adverse health behaviors first (e.g., disordered eating), reading Fifty Shades might reaffirm those experiences and potentially aggravate related trauma. Likewise, if women read Fifty Shades before experiencing the health behaviors assessed in our study, it is possible that the book influenced the onset of these behaviors by creating an underlying context for the behaviors.

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