How Proposed Part D Changes Are Playing On Capitol Hill

Officials at the Centers for Medicare & Medicaid Services are proposing to remove some drugs from Medicare’s prescription drug plans and limit how many plans insurers can offer. KHN’s Mary Agnes Carey and CQ Roll Call’s Emily Ethridge discuss.

>> Click here to listen to audio of the conversation.

MARY AGNES CAREY: Welcome to Health on the Hill. I’m Mary Agnes Carey.

A series of proposed changes to the Medicare prescription drug program -- also known as Medicare part D -- have been getting a lot of attention on and off of Capitol Hill. Patient groups and lawmakers in both parties say easing current requirements on what drugs plan must cover could cause hardships for some patients. There’s also bipartisan opposition to a provision that would limit the number of plans insurers could offer.

With me now to discuss these issues is Emily Ethridge of CQ Roll Call. Emily, thanks so much for coming.

EMILY ETHRIDGE, CQ ROLL CALL: Thanks for having me.

MARY AGNES CAREY: Now CMS currently -- that’s the Centers for Medicare & Medicaid Services, which oversees the Medicare part D program -- they currently require that Part D plans cover the vast majority of drugs in six specific classes. And they’re proposing to drop two of these categories next year, and another might be dropped in 2015. What are these drugs that could lose this "protected status," as they call it, and why are people so...


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Severe North Jersey winter taking a toll on insurance companies

Insurance companies are handling more claims than usual this winter to pay for damage to homes and businesses caused by cold and snowy weather. Insurance professionals say automobile claims are up, a boon for auto repair shops. Otterstedt Insurance Agency in Englewood Cliffs, a broker that represents a number of insurance underwriters, handled 298 claims in January, about 15 percent more than usual, according to Lydia Bashwiner, general counsel and claims manager. "We've had a lot of broken pipes, some ice damming, some roof collapses, and some ice and snow on trees bringing trees down," she said. Axle-breaking potholes have generated some claims from motorists who have comprehensive coverage, as have icy pavement and roads made narrower by banks of plowed snow, she said. "The body shops are happy; the insurance companies are not," Bashwiner said. Severe winter weather is the third-biggest cause of insured catastrophe losses, after hurricanes and tornadoes, accounting for 7.1 percent of all insured catastrophe losses between 1993 and 2012, according to the Insurance Information Institute, based in New York. On an inflation-adjusted basis, insurers...

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Its Déjà Vu All Over Again

Today's post is shared from Judge David Langham and I would encourage to read his blog at: http://flojcc.blogspot.com/ David Langham is the Deputy Chief Judge of Compensation Claims for the Florida Office of Judges of Compensation Claims and Division of Administrative Hearings.  Zohydro is in the news yet again. This month the new medication will become available. Its manufacturer says it will market this only to a select few physicians whose experience with pain will assure their discretion and restraint in distributing this strong pain killer. In November, I noted the approval of this new Opiod formulation, and in December, I wrote when over half the nation’s attorneys general wrote to the FDA urging that the approval receive greater scrutiny and perhaps reconsideration (Zohydro in the News Again). Well, as Yogi Bera once said “its déjà vu all over again.” Zohydro is back in the news at the end of February. Now, an “activist” group is questioning the Food and Drug Administration (FDA)and has released a letter it sent to the FDA in late February. The group is called “Fed Up!” and their points are interesting. They note that Zohydro is being marketed in the “midst of a severe drug addiction epidemic.” They note that Zohydro “will kill people as soon as it is released.” Dr. Andrew Kolodny calls it “a whopping dose of hydrocodone packed in...

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US Asbestos Import Deceased But Still Not Banned

Events, Trends, and Issues: U.S. imports decreased by 46% and estimated consumption of asbestos decreased by 7% in 2013. The large decline in imports resulted from increased imports and a buildup of inventories in 2012 and a drawdown of stocks during 2013. All asbestos imported and used in the United States was chrysotile, solely sourced from Brazil in 2013. The average unit value of imports declined in 2013. Based on current trends, annual U.S. asbestos consumption is likely to be between 900 and 1,000 tons for the near future.

World Mine Production and Reserves: Reserves from Brazil were revised based on new information from the Instituto Brasileiro de Mineraçäo. Mine production Reserves4 2012 2013e

United States — — Small

Brazil 307,000 300,000 11,000,000

China 420,000 400,000 Large

Kazakhstan 241,000 240,000 Large

Russia 1,000,000 1,000,000 Large

Other countries 300 300 Moderate

World total (rounded) 1,970,000 1,940,000 Large

World Resources: The world has 200 million tons of identified resources of asbestos. U.S. resources are large but are composed mostly of short-fiber asbestos, for which use in asbestos-based products is more limited than long-fiber asbestos.

Substitutes: Numerous materials substitute for asbestos. Substitutes include calcium silicate, carbon fiber, cellulose fiber, ceramic fiber, glass fiber, steel fiber, wollastonite, and several organic fibers, such as aramid, polyethylene, polypropylene, and polytetrafluoroethylene. Several nonfibrous minerals or rocks, such as perlite, serpentine, silica, and talc, are considered to be possible asbestos substitutes for products in which the reinforcement properties of fibers were not required.

ASBESTOS

(Data in metric tons unless otherwise noted)

Domestic Production and Use: Asbestos has not been mined in the United States since 2002. The United States is dependent on imports to meet manufacturing needs. Asbestos consumption in the United States was estimated to be 950 tons, based on asbestos imports through July 2013. The chloralkali industry accounted for an estimated 67% of U.S. consumption; roofing products, 30%; and unknown applications, 3%.

….
Jon L. Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). For over 4 decades the Law Offices of Jon L Gelman  1.973.696.7900  jon@gelmans.com  have been representing injured workers and their families who have suffered occupational accidents and illnesses.

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New Law’s Demands on Doctors Have Many Seeking a Network

Dr. Sven Jonsson, a primary care physician in this rural community, is seeing a steady tide of new patients under President Obama’s health care law, the Affordable Care Act. And so far, it is working out for him. His employer, a big hospital system, provides expensive equipment, takes care of bureaucratic chores and has buffered him from the turmoil of his rapidly changing business.

“This is just a much saner place for me right now,” said Dr. Jonsson, 52, who left private practice to work for the system, Baptist Health, in 2012. “I’m probably going to live another five years.”

About 25 miles away in the more affluent suburb of Crestwood, Dr. Tracy Ragland, 46, an independent primary care physician, is more anxious about the future of her small practice. The law is bringing new regulations and payment rates that she says squeeze self-employed doctors. She cherishes the autonomy of private practice and speaks darkly of the rush of independent physicians into hospital networks, which she sees as growing monopolies.

The Times would like to hear from Americans who have signed up for health care under the Affordable Care Act....

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Where Have All the Raises Gone?

Today's post was shared by Steven Greenhouse and comes from www.nytimes.com

Most people who work for a living know that for a long time now, raises have been few and far between. Wages typically fall or stagnate in recessions, and the Great Recession was particularly severe, exerting a drag on pay that persists to this day. But that is only a partial explanation, because declining and stagnant wages predate the latest downturn. Understanding the causes is essential for determining the policies needed to create good jobs. Research by three economists — Paul Beaudry, David Green and Benjamin Sand — goes beyond familiar explanations for wage stagnation like global competition and labor-saving technology. Examining the demand for college-educated workers, they found that businesses increased hiring of college graduates in the 1980s and 1990s in adapting to technological changes. But as the information technology revolution matured, employer demand waned for the “cognitive skills” associated with a college education. As a result, since 2000, many college graduates have taken jobs that do not require college degrees and, in the process, have displaced less-educated lower-skilled workers. “In this maturity stage,” the report says, “having a B.A. is less about obtaining access to high paying managerial and technology jobs and more about beating out less-educated workers for the barista or clerical job.” The findings help to explain the trajectory in wages for workers with...

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Second cruise ship in a week hit by illness

Another cruise ship has returned to its home port early in the wake of an outbreak of gastrointestinal illness. Princess Cruises' Houston-based Caribbean Princess arrived back in the city late Thursday, more than 24 hours ahead of schedule. More than 160 of 3,104 passengers on the vessel had fallen ill with a gastrointestinal illness that the cruise line suspected was norovirus -- a highly contagious infection that causes severe vomiting and diarrhea. The incident comes just days after a massive outbreak of a norovirus-like illness forced an early end to a sailing of Royal Caribbean's Explorer of the Seas. The ship returned to its home port of Bayonne, N.J. on Wednesday -- two days ahead of schedule -- after more than 20% of 3,071 passengers fell ill. While the Caribbean Princess' early return will allow time for a thorough cleaning before its next sailing, the decision to return ahead of schedule was prompted not by the outbreak but by a forecast for thick fog over the weekend that is likely to close Houston's port, the line says in a statement sent to USA TODAY. "We are mindful of our passengers' safety and comfort, as well as the disruption the port's closing will have on their onward travel plans," the statement says. Like Explorer of the Seas, the Caribbean Princess was on a Caribbean cruise. The ship set sail from Houston on Jan. 25 and was scheduled to return on...

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