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(c) 2010-2024 Jon L Gelman, All Rights Reserved.

Monday, September 29, 2014

Study: Cancer costs 'skyrocketed' despite drug cuts

Today's post is shared from thehill.com
The cost of treating cancer has "skyrocketed" despite a 2003 law that sought to control Medicare drug costs, including the cost of chemotherapy, according to a new study.
Research published Monday in the Journal of Clinical Oncology found that oncologists did not stop prescribing expensive cancer drugs even after Medicare cut the drugs' reimbursements in 2005.
In fact, the aggregate cost of cancer care rose by as much as 60 percent between the passage of the law in 2003 and 2013, the study noted.
"Economists expected a sharp decline in use of the most expensive drugs targeted by the [2003] law, because reimbursement to oncologists for these drugs was reduced, but that did not happen," said Mark C. Hornbrook of Kaiser Permanente Northwest, the study’s lead author.
Cutting drug reimbursements is one way federal health officials seek to influence doctors' prescribing habits.
Profit on Medicare reimbursements for chemotherapy drugs is one way cancer clinics generate profit, making the payments ripe for scrutiny by Medicare.
The study looked at 5,831 chemotherapy regimens for 3,613 patients and found the the law lowered prescriptions for affected cancer drugs "slightly" in fee-for-service cancer clinics.
The 2003 law — the Medicare Prescription Drug, Improvement and Modernization Act — is best known for creating Medicare Part D.
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Group Health Patients Win 61% of Medical Care Denial Appeals; WC Patients Lose 84% of Appeals

Today's post is shared from fbgslaw.com

Part Three in CAAA’s “What’s Wrong With This Picture?” Infographic on the contrast between the use of IMR decision in Workers’ Compensation vs. Group Health. Read the full article from CAAA below and let us know what you think in the comments section.

Insurers have Stacked the Deck Against Californians Hurt at Work

Sacramento, CA – The California Applicants’ Attorneys Association (CAAA), whose members represent Californians injured on the job, today continued its series comparing quality health care measures in workers’ compensation insurance to group health insurance. The third release compares the frequency of Independent Medical Review (IMR) upholding Utilization Review (UR) denials of doctors’ recommended medical care. Workers’ compensation IMR denied84% of patients’ appeals of denied medical treatments in one year, while group health IMR reviewers approved 61% of patients’ appeals. Group health patients win appeals of denied medical care nearly four times as often as California’s injured workers.

American doctor exposed to Ebola hospitalized at NIH facility

Today's post is shared from cidrap.umn.edu

US health care workers remain at growing jeopardy over Ebola virus.

An American doctor who was exposed to the Ebola virus while working in Sierra Leone has been airlifted back to the United States and was admitted to the National Institutes of Health (NIH) Clinical Center in Bethesda, Md., for observation.

No details were available about the patient. The Associated Press (AP) today published a photograph of a person in head-to-toe white protective gear descending the stairs of a private jet at Frederick (Md.) Municipal Airport, led by an individual who wasn't wearing any protective gear.

What We’re Learning About Drug Company Payments to Doctors

On Tuesday, the federal government is expected to release details of payments to doctors by every pharmaceutical and medical device manufacturer in the country.
The information is being made public under a provision of the 2010 Affordable Care Act. The law mandates disclosure of payments to doctors, dentists, chiropractors, podiatrists and optometrists for things like promotional speaking, consulting, meals, educational items and research.
It’s not quite clear what the data will show — in part because the first batch will be incomplete, covering spending for only a few months at the end of 2013 — but we at ProPublica have some good guesses. That’s because we have been detailing relationships between doctors and the pharmaceutical industry for the past four years as part of our Dollars for Docs project.
We’ve aggregated information from the websites of some large drug companies, which publish their payments as a condition of settling federal whistle-blower lawsuits alleging improper marketing or kickbacks. Today, in cooperation with the website Pharmashine, we’ve added data for 2013, which now covers 17 drug companies accounting for half of United States drug sales that year. (You can look up your doctor using our easy search tool.)
Here are some facts we’ve learned from the data:
Many, many health professionals have relationships with industry.
Dollars for Docs now includes 3.4 million payments since 2009, totaling more than $4 billion,...
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At Goldman Sachs, Even the Legal Fees Are Different

Goldman Sachs has the reputation of being a breed apart on Wall Street. Its employees are smarter, hungrier and quicker to the draw than those at rival firms. Thanks to these differences, Goldman sits at the apex of the nation’s investment banking hierarchy.

Whether or not you buy into that narrative, there is one way in which Goldman clearly does set itself apart from its competitors: It has more leeway to pick and choose which executives’ legal bills it will pay if they become entangled in an investigation or legal proceeding. While the corporate bylaws of other banks definitively state which employees will have legal fees covered in the course of their duties, Goldman’s bylaws are ambiguous on the matter of one group of people — its so-called officers — whose legal bills it is supposed to cover. This has the effect of letting the firm decide whose bills among this group it will pay and whose it won’t.

The vagueness in Goldman’s bylaws surfaced last week in a dissenting opinion written by Judge Julio M. Fuentes of the United States Court of Appeals for the Third Circuit in Philadelphia. A member of a three-person panel hearing a case involving Goldman’s refusal to pay a former vice president’s fees, Judge Fuentes contended that the effect of the firm’s policy was inconsistent with the law in Delaware, the state in which Goldman is incorporated.

Judge Fuentes also noted that the ambiguity in Goldman’s bylaws...

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World Heart Day — September 29, 2014

Cardiovascular events are compensable in workers' compensation. While in many jurisdictions the standard of proof is elevated they resukt in serious and sometime fatal claims.
Today's post is shared from cdc.gov

World Heart Day will be observed September 29, 2014. The focus of World Heart Day this year is creating heart-healthy environments in which persons are able to make heart-healthy choices wherever they live, learn, work, and play. Heart disease and stroke are the world's leading causes of death, claiming an estimated 17.3 million lives in 2008, and representing 30% of all deaths worldwide (1). A heart-healthy environment can help persons make healthy choices to reduce their risk for heart disease. World Heart Day 2014 encourages persons to reduce their risk for cardiovascular disease by promoting smoke-free environments, environments that encourage physical activity, access to healthy food choices, and a heart-healthy planet for all.

CDC is working to help create heart-healthy environments in multiple ways, including community-based approaches, such as the Sodium Reduction in Communities Program (SRCP), and community-clinical linkages, such as the Million Hearts Initiative. SRCP aims to increase access to and accessibility of lower-sodium food options while building the evidence base on population approaches to reduce sodium consumption at the community level. Million Hearts aims to prevent 1 million heart attacks and strokes by 2017 by bringing together communities, health systems, nonprofit organizations, federal agencies, and private-sector partners from across the country to fight heart disease and stroke and their risk factors.

Additional information about World Heart Day is available at http://www.world-heart-federation.org/?id=123. Additional information about Million Hearts, SRCP, and CDC's Healthy Community Programs is available at http://millionhearts.hhs.gov andhttp://www.cdc.gov/nccdphp/dch/programs/healthycommunitiesprogram/index.htm.
Reference
World Health Organization. Global status report on noncommunicable diseases 2010. Geneva, Switzerland: World Health Organization; 2011. Available at http://www.who.int/nmh/publications/ncd_report2010

Sunday, September 28, 2014

Federal research seeks alternatives to addictive opioids for veterans in pain

The National Institutes of Health and the Department of Veterans Affairs this week announced that they will launch a five-year, $21.7 million initiative to study the effectiveness of alternative therapies to opioids through a series of 13 research projects.
Nearly half of all troops returning home from Afghanistan and Iraq are suffering from chronic pain, more than double the civilian population, according to the Journal of the American Medical Association. Many of those veterans have been prescribed opioids.
The drugs often have disabling side effects, and some studies show they are often addictive and may exacerbate pain conditions in some patients.


The joint research program includes studies on the use of morning light to treat lower-back pain and post-traumatic stress disorder, and the use of chiropractors, self-hypnosis and meditation to reduce pain, said Josephine P. Briggs, director of the National Center of Complementary and Alternative Medicine at NIH.
Funding for the initiative comes from the NCCAM, the National Institute on Drug Abuse and the VA’s Health Services Research and Development Division. The research projects will be done at academic institutions and VA medical centers across the United States.
“This is a very urgent issue for the soldiers returning home – the magnitude of the problem is huge,” Briggs...
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