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January 2010 Archives

January 3, 2010

Certificates of Need and Cost Control

The New York Times published a thought-provoking column examining the relationship between certificate of need programs and health care costs.

But there is little question that constraints on supply matter. Intriguingly, doctors and hospital executives ... thought Virginia regulators had become more lax about handing out certificates in recent years. One executive speculated that cost growth had probably picked up in recent years as a result.

Read the article here and comment on Supraspinatus.

January 6, 2010

DOH Revises Hospital Inpatient Reimbursement Regulations

The New York State Department of Health filed an emergency regulation on December 4, 2009 that makes significant changes to the hospital inpatient reimbursement regulations. The rulemaking notice was published in the December 23, 2009 New York State Register. According to the notice, the emergency rule is intended to accomplish the folowing:

Amendments to sections 86-1.2 through 86-1.89 of Title 10 (Health) NYCRR are required to implement a new payment methodology for certain hospital inpatient fee-for-service Medicaid services based on All Patient Refined-Diagnostic Related Groups (APR-DRGs). The new payment methodology proposed by these amendments provides a more transparent and simplified reimbursement system that drives reimbursement consistent with efficiency, quality and public health priorities. It develops one statewide operating base rate using an updated and more reliable cost base rather than current regional and peer group operating base rates, of which were determined by using extremely outdated costs. The APR-DRG payment system will incorporate patient severity of illness and risk of mortality subclasses to better match patient resorce utilization and provide a more precise method for equitable reimbursement.

The text of the rule is available by calling Katherine Ceroalo at (518) 473-7488 or by emailing regsqna@health.state.ny.us.

January 7, 2010

NYS Senate Committee Chairmanships Announced

Yesterday, Senate Democratic Conference Leader John Sampson announced Committee Chairmanships for the 2010 legislative session. The list included some changes to committees with health-related jurisdiction.

Senator Squadron previously chaired both the Cities Committee and the Social Services Committee. He will now only chair Social Services.

Senator Morahan will resume the role of Chair of the Mental Health Committee, a position he held under the Republican majority. Senator Shirley Huntley, the most recent chair of the committee will take on the leadership role of Deputy Majority Leader for Federal and State Relations as well as chair the Cities committee.

Senators Duane and Breslin remain chairs of the Health and Insurance Committees, respectively. Senator Diaz remains the Aging chair.

The full list of Senate Committees can be found here

January 14, 2010

HHC Agrees to Straighten Out Kings County Hospital Center

From HealthLeaders Media January 12:

The New York City Health and Hospitals Corporation has entered into a consent agreement with federal authorities to clean up the troubled psychiatric emergency department and psychiatric in-patient units in its Kings County Hospital Center in Brooklyn.

The full post discusses the KCHC federal investigation and findings in more detail.

FDA Basics aims to help consumers gain better understanding of agency

From FDA News Jan. 12 2010 (1)

FDA unveiled the first phase of its Transparency Initiative which is designed to explain agency operations, how it makes decisions, and the drug approval process. During an online presentation, the chair of the FDA’s Transparency Task Force, Principal Deputy FDA Commissioner Joshua Sharfstein, described a Web-based curriculum called “FDA Basics,” aimed at helping the public better understand what the agency does.
FDA reports that in recent months, the Task Force solicited public input on improving agency transparency through a public docket, an online blog, and two public meetings. Various stakeholders from regulated industry, consumers, patients, health care providers, and others provided hundreds of comments to the Transparency Task Force.
As a result of comments from the public, the Task Force decided to develop its recommendations in 3 phases. FDA Basics represents the result of the initial phase. In phase two of the initiative, the Task Force intends to make recommendations to the Commissioner regarding how to make information about agency activities more transparent, useful, and understandable to the public, in a manner compatible with the agency’s goal of protecting confidential information, as appropriate. In the final phase of the initiative, the Task Force intends to make recommendations to the Commissioner regarding FDA’s transparency to regulated industries....In addition, each month, different Centers and Offices at FDA will host an online session where the public can ask questions to senior FDA officials about a specific topic or just listen in to learn more about FDA.
Topics that may be featured in the coming months include one in February: Access to Investigational Drugs. (2)
(1) http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm197222.htm
(2) http://www.fda.gov/AboutFDA/Basics/ucm197102.htm

2 Medications used to reduce risk of primary breast cancer

From AHRQ news Jan 14, 2010-

New consumer and clinician summary guides on medications to reduce the risk of breast cancer in women are available from AHRQ’s Effective Health Care Program.The clinician guide summarizes the effectiveness and safety of two medications used to reduce the risk of primary breast cancer: tamoxifen and raloxifene. Both of these medications are approved by FDA to reduce the risk of primary breast cancer (defined as invasive breast cancer in women without pre-existing breast cancer).(1)
Tamoxifen and raloxifene are both selective estrogen receptor modulators (SERMs). Tamoxifen is widely used to treat early and advanced hormone-receptor positive breast cancer. Raloxifene is primarily used for the prevention and treatment of osteoporosis. Although both of these medications are approved for the prevention of primary breast cancer, currently they are rarely used for this purpose in the U.S..
The evidence about the effectiveness of tamoxifen and raloxifene for reducing the risk of primary breast cancer comes from seven large randomized controlled trials with over 55,000 participants. The source material for this guide is a systematic review of 123 research articles published between 1989 and 2008.

(1) http://www.effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=390 Medications to Reduce the Risk of Primary Breast Cancer in Women: Clinician’s Guide
http://www.effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=389 the consumer guide-Reducing the Risk of Breast Cancer with Medicine: A Guide for Women
http://www.effectivehealthcare.ahrq.gov/index.cfm/guides-for-patients-and-consumers/ The list of guides is always being updated with new research reports and reviews comparing the benefits and harms of test or treatment choices for health conditions.

January 15, 2010

AG Uses Environmental Laws to Corral Health Facility Drug Dumping

From the Attorney General's Media Center January 12:

Attorney General Andrew M. Cuomo today announced groundbreaking settlements with five health care facilities located in the New York City Watershed to immediately end the practice of disposing of pharmaceutical waste into the watershed. The agreements announced today are the first-ever settlements requiring sources of pharmaceutical releases to end this risky disposal practice.

The facilities identified in the press release include O'Connor Hospital, Margaretville Memorial Hospital, Mountainside Residential Care Center, Countryside Care Center, and Putnam Nursing and Rehabilitation Center. The bases for the settlements were AG findings of violations of federal waste management laws and pertinent state regulations and, in some instances, the federal Clean Water Act.

January 20, 2010

Governor releases Executive Budget

Governor Paterson released his Executive Budget yesterday. Facing a projected $7.4 billion shortfall for the upcoming fiscal year, the Governor proposes to balance the budget with approximately $1.7 billion coming from the health care industry. The proposals are voluminous and cannot be given proper attention in this form - however, you may access bills, briefing books and various other budget-related materials here. The Joint Legislative Budget Hearing addressing the health budget will occur on Feburary 9.

January 24, 2010

Proposed Rule for EHR Incentive Payments

On January 13, 2010, CMS published a proposed rule to implement ARRA provisions related to incentive payments to health care professionals and hospitals that adopt electronic health record technology. In 169 Federal Register pages, CMS addressed, among other things, criteria that a professional or hospital must meet to qualify for the payments, calculation of payment amounts, and payment adjustments for professionals and hospitals that adopt but do not meaningfully use EHR technology.

Read the proposed rule here.

January 26, 2010

New NYLJ Article: "Prohibited Business Practices By Clinical Laboratories"

Section Member Frank Serbaroli, with the New York office of Greenberg Traurig, writes a regular "Expert Analysis" column for the New York Law Journal. The latest article, "Prohibited Business Practices By Clinical Laboratories," appears in the January 26, 2010 edition:

This column reviews a New York law that has been in effect for more than 40 years, and that applies to all clinical laboratories licensed by the State of New York, no matter where the lab is physically located. Clinical laboratories and referring providers that are unaware of this law, or ignore it, do so at considerable risk. Known formally as the Laboratory Business Practices Act (LBPA), the law is found in New York Public Health Law §§585-588.

Link to the reprint posted on the Greenberg Traurig website.

January 27, 2010

Americans Skeptical of Electronic Health Record Privacy

In an article at Forbes magazine, Andy Greenberg looks for the next big issue in health reform:

In a study released Monday by the privacy-focused Ponemon Institute, Americans registered a deep distrust of anyone in either the federal government or private industry who might store digital health records like those that the Obama administration has encouraged hospitals to create.

The article provides some interesting statistics on public perception around electronic health records and how government agencies, health care providers, and private businesses should use or have access to such information.

To get to the good stuff, however, you have to navigate past both an annoying ad page and Greenberg's equally annoying (not to mention non-sequitur) lede:

As President Obama has learned over the last year, Americans tend to get angry when you try to fix the country’s dysfunctional health care system.

You could have fun thinking up the many different responses to that kind of statement, if the subject matter itself wasn't so darn serious. For my own part, I tend to get angry when someone tries to sell me something that isn't what they say it is. If, for example, I took my car to the shop because the brakes were working poorly, I would get angry if they proposed to "fix" the brakes by installing a large and expensive sail on the roof of the car to create extra drag, thereby slowing down the car and "solving" the braking problem. Perhaps Americans are likewise angry that the current reform proposals address symptoms instead of problems, are expensive, and don't "fix" much of anything.

January 28, 2010

Health Plan Association Sues Over Assessments

The Albany Business Review covers a recent lawsuit by the trade association for New York health plans:

The New York Health Plan Association has joined the New York Insurance Association Inc. in suing New York state over what is says are illegal assessments on insurance companies to fund agencies unrelated to insurance.

The suit, which NYIA filed in State Supreme Court in Albany on Jan. 13, challenges the levy on insurers known as the 332 assessment and how the funds are used. By state law, the assessments are to be used only for the operating expenses of the New York State Department of Insurance, but are increasingly being used for other purposes.

HPA's press release from January 26 provides some more detail:

Since 2000-2001, DOI’s budget has more than quadrupled and the amount of sub-allocations has increased by more than 22 times. Of DOI’s $555.5 million budget for the 2009-2010 State Fiscal year, only $138 million represented actual operating expenses.

January 29, 2010

Coakley Report Dives Into Health Care Costs, Finds Wide Variations in Provider Payments

Boston.com covers a preliminary report issued by Massachusetts Attorney General Martha Coakley:

Massachusetts insurance companies pay some hospitals and doctors twice as much money as others for essentially the same patient care, according to a preliminary report by Attorney General Martha Coakley. It points to the market clout of the best-paid providers as a main driver of the state’s spiraling health care costs.

The yearlong investigation, set to be released today, found no evidence that the higher pay was a reward for better quality work or for treating sicker patients. In fact, eight of the 10 best-paid hospitals in one insurer’s network were community hospitals, which tend to have less complicated cases than teaching hospitals and do not bear the extra cost of training future physicians.

The preliminary report is available on the AG's website, as is its own press release.

About January 2010

This page contains all entries posted to HEALTH LAW SECTION BLOG in January 2010. They are listed from oldest to newest.

December 2009 is the previous archive.

February 2010 is the next archive.

Many more can be found on the main index page or by looking through the archives.