Category: Federal agencies

$6·5 billion proposed for new US health research agency

Volume 397, Issue 10288
22 May 2021

WORLD REPORT The Advanced Research Projects Agency for Health would fund high-risk, high-reward medical research, but its short-term planning could stymie basic research. Susan Jaffe reports.

During his first address to a joint session of Congress last month, US President Joe Biden drew little applause from Republicans in the physically distanced, masked audience. A rare exception to their steadfast silence came when he unveiled an ambitious plan to eradicate cancer.

To help reach this goal, Biden would establish a new biomedical research agency within the National Institutes of Health (NIH) called the Advanced Research Projects Agency for Health (ARPA-H). The agency would provide a fast track for transforming basic science into real-world applications. [Continued here.]

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Under New Cost-Cutting Medicare Rule, Same Surgery, Same Place, Different Bill

By Susan Jaffe  | Kaiser Health News | March 21, 2021 | This KHN story also ran in The Washington Post

For years, Medicare officials considered some surgeries so risky for older adults that that the insurance program would cover the procedures only for patients admitted to the hospital. Under a new Medicare policy that took effect this year, these operations can be provided to patients who are not admitted. But patients still have to go to the hospital. The change saves Medicare money while patients can pay a larger share of the bill — for the same surgery at the same hospital.  [Full story in The Washington Post and Kaiser Health News.] 

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Biden’s first legislative victory: $1·9 trillion for COVID-19

Volume 397, Issue 10279
20 March 2021

WORLD REPORT US President Joe Biden’s first legislative triumph will fund the COVID-19 response and economic recovery, and address social determinants of health. Susan Jaffe reports from Washington, DC. 

By narrowly approving a massive COVID-19 response and economic relief package last week, Democrats in Congress handed President Joe Biden his first legislative victory after only 50 days in the White House. The US$1·9 trillion, 628-page, American Rescue Plan Act is a signature achievement so monumental that it has been compared to President Lyndon B Johnson’s sweeping Great Society legislation that raised many Americans out of poverty, with a safety net of social and health services, including the Medicare and Medicaid insurance programmes.

…As the government begins to roll out these benefits, Biden promised “fastidious oversight to make sure there’s no waste or fraud, and the law does what it’s designed to do. And I mean it: we have to get this right… because we have to continue to build confidence in the American people that their government can function for them and deliver.” [Full story with “where the money goes” sidebar here.]

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What Happens to Nursing Home Workers Who Missed COVID-19 Vaccinations?

by Susan Jaffe | AARP | March 26, 2021

COVID-19 has rampaged through nursing homes and other long-term-care facilities, leaving a death toll near 180,000 and counting. So when the first coronavirus vaccines became available at the end of last year, nursing home residents and staff were first in line, given top priority along with emergency responders and health care providers.

The federal government paid CVS and Walgreens to offer three vaccination clinics for residents and staff at nearly every nursing home in the U.S. That effort, called the Pharmacy Partnership for Long-Term Care Program, wraps up this month.  So how do new nursing home residents and workers who missed the onsite clinics get vaccinated now? For residents, plans are in the works to make sure they get the shots. But so far, many of those plans don’t include the staff members who care for them. [Continued here.]…

New leadership at the US CDC

Volume 397, Issue 10270
16 January 2021

 

WORLD REPORT Rochelle Walensky, an infectious diseases expert, promises to provide transparency, accountability, and restored trust at the embattled organisation. Susan Jaffe reports from Washington, DC.  [Full story here.]

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Rochelle Walensky: New Director of the US CDC

Volume 397, Issue 10271 
14 January 2021
PROFILE  Rochelle Walensky 

A highly respected researcher, Walensky has published nearly 300 papers, many focused on the cost-effectiveness of HIV interventions and aimed at improving patients’ care. “I call the research that I do policy motivating”, Walensky says. One example is a 2006 landmark study showed that advances in HIV treatment in the USA added nearly 3 million years to patients’ lives.[Full story here.]…

Nursing Homes Fined for COVID Infection Control Lapses

By Susan Jaffe  | Contributing Writer | MedPageToday  | November 25, 2020

During the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) has fined 218 nursing homes more than $17.6 million for the most serious infection control violations that put residents in “immediate jeopardy,” conditions CMS believes are likely to seriously injure or kill them.

More than 91,000 residents and staff of long-term care facilities have died after contracting COVID-19 — about 40% of the total deaths in the U.S., according to a Kaiser Family Foundation analysis. …Frustrated by repeated violations of infection control requirements during the pandemic, CMS raised the penalty amounts and announced a crackdown on egregious offenders in August. But the hard-line approach doesn’t seem to have produced the intended results. (Click here for a list of nursing homes that were fined.)  [Continued here.]

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US election 2020: the future of the Affordable Care Act

Volume 396, Number 10260     31 October 2020 

WORLD REPORT   President Donald Trump pledges to replace the Affordable Care Act while his Democratic opponent Joe Biden offers detailed proposals to improve it. Susan Jaffe reports from Washington, DC.

Since winning the presidency in 2016 in large part by promising to eliminate Obamacare, otherwise known as the Affordable Care Act (ACA), Donald Trump has promised more than a dozen times that his replacement plan would be ready soon. The plan would be released in 2 weeks, a White House spokeswoman said 2 months ago.

“We’re going to have a health-care plan that will be second to none”, Trump said in 2017. “It’s going to be great and the people will see that.” And at last week’s final presidential debate, he vowed “to terminate Obamacare, [and] come up with a brand new beautiful health care”.

A decade after the ACA—President Barack Obama’s signature achievement—became law, repealing and replacing Obamacare is again central to Trump’s re-election. And improving and expanding the law is a crucial part of the campaign of his challenger, former Vice President Joe Biden. [Continued here.]     

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US election 2020: research and health institutions

Volume 396, Number 10259

24 October 2020

 

WORLD REPORT   How will the NIH, CDC, and FDA change if President Donald Trump wins a second term or if his Democratic challenger, Joe Biden, defeats him? Susan Jaffe reports from Washington, DC. 

Whoever wins the presidency needs to “restore the CDC and improve it by letting [scientists] know that they will have an opportunity to do the best science and make the best recommendations…” says James Curran, dean of the Rollins School of Public Health at Emory University in Atlanta. [Continued here.]…

US election 2020: public health

Volume 396, Number 10256

3 October 2020

 

WORLD REPORT   In the race for the White House, where do US President Donald Trump and his Democratic challenger, former Vice President Joe Biden, stand on public health? Susan Jaffe reports from Washington, DC. 

Analyzing the candidates’ plans to address the opioid epidemic, gun violence, women’s health, global health and COVID-19.

Unlike more conventional presidential candidates, Trump does not intend to issue formal policy proposals or position papers. With less than 5 weeks remaining before the election, his campaign says he will share “details about his plans through policy-focused speeches on the campaign trail”. …Joe Biden’s campaign has released a total of 51 policy proposals outlining how he will accomplish his goals if he wins in November. [Continued here.]…

Media reports reveal political interference at the US CDC

Volume 396, Number 10255

26 September 2020

 

WORLD REPORT  News accounts say that Trump administration officials wanted to edit and approve COVID-19 studies and publish guidance without the usual scientific review. Susan Jaffe reports.

After news stories about attempts by members of the Trump administration to manipulate COVID-19 reports published by the US Centers for Disease Control and Prevention (CDC) and over-rule its scientists, one top official is taking a sudden leave of absence for health reasons. Another’s government contract has abruptly ended. The 2-month absence of Michael Caputo, chief spokesman for the US Department of Health and Human Services (HHS), comes after he claimed that a CDC “resistance unit” seeks to undermine Trump. He and an adviser reportedly demanded the right to revise and approve COVID-19 studies published in the CDC’s highly respected Morbidity and Mortality Weekly Report journal.  [Continued here.]…

House Committee Approves Bill to Ease Medicare Part B Enrollment

Seniors would be notified about eligibility to avoid late fees, coverage gap

By Susan Jaffe  | Contributing Writer | MedPageToday  | July 15, 2020

A House committee unanimously approved legislation Wednesday that would make changes for the first time in 50 years to the complex rules for enrolling in Medicare’s Part B, which covers doctor visits and other outpatient care.

Currently, seniors who don’t get Part B when they first become eligible for Medicare pay permanent, recurring late enrollment penalties and can only sign up during the first 3 months of the year for coverage that begins July 1, unless they qualify for an exception. To make matters worse, they cannot buy other health insurance during their months-long wait. [Continued here.]

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US Supreme Court upholds abortion rights, for now

Volume 396, Number 10244

11 July 2020

 

WORLD REPORT The court’s decision means that Louisiana’s three abortion clinics will remain open. Susan Jaffe reports.

The US Supreme Court delivered the Trump administration’s third defeat in as many weeks when it overturned a Louisiana law requiring physicians who provide abortions to have local hospital-admitting privileges.

In an opinion written by Justice Stephen Breyer, the court declared on June 29 that “enforcing the admitting privileges requirement would drastically reduce the number and geographic distribution of abortion providers, making it impossible for many women to obtain a safe, legal abortion in the State and imposing substantial obstacles on those who could”.  [Continued here.]…

LGBTQ discrimination in US health care under scrutiny

Volume 395    Number 10242     
27 June 2020                          
WORLD REPORT  A US Supreme Court ruling could undermine the Trump Administration’s plan to roll back some protections against sex discrimination. Susan Jaffe reports. 

The Trump administration suffered a major defeat last week a major defeat last week in the US Supreme Court, which could undermine its attempt to scrap protections under the Affordable Care Act (ACA) against sex discrimination. In a landmark decision on June 15, the court ruled that the Civil Rights Act protects gay and transgender workers from discrimination by their employers. But days later, Trump Administration officials at the Department of Health and Human Services (HHS) finalised a more permissive standard for discrimination in health care. [Continued here.]  

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Whether By Luck Or Safety Protocols, Some Nursing Homes Remain COVID-19 Free

BY SUSAN JAFFE  |  CONNECTICUT HEALTH INVESTIGATIVE TEAM   |  JUNE 15,2020           

The coronavirus has decimated many of the nation’s nursing homes, and elderly, chronically ill residents of these facilities account for 64% of the state’s 4,201 death toll. They are roughly 100 times more likely to die of the virus than other people in the state.

So, the fact that some 41 of Connecticut’s 214 nursing homes have managed to keep out the virus, according to an analysis by C-HIT, is both remarkable and mystifying. Did they just get lucky?

This article also ran on Connecticut Public Radio.

Administrators at several COVID-19-free facilities use the word “fortunate” to describe a situation they acknowledge could change at any time. [Continued here, with map and table of COVID-19 free nursing homes.]

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Hundreds Died of COVID at NYC Nursing Homes With Spotless Infection Inspections

By Susan Jaffe   |    THE CITY    |    May 27, 2020     

More than 600 residents have died from COVID-19 at 25 New York City nursing homes that received clean bills of health for controlling the spread of infections, state Department of Health inspection reports obtained by THE CITY show.

Those facilities include homes with some of the highest coronavirus death tolls in the nation — including the Sapphire Center for Rehabilitation and Nursing in Flushing, which reports 54 residents died of confirmed or presumed COVID….

At the Franklin Center for Rehabilitation and Nursing, also in Flushing, 60 residents — nearly one in five — succumbed to the virus. Its May 4 inspection report found no problems.

Also passing its May 11 infection-control inspection was New York State Veterans Home in St. Albans, Queens. Staff there previously told THE CITY that the state Health Department-run home failed to separate COVID-positive and uninfected residents, something that was a violation at other facilities….

“It’s very shocking that at the apex of this pandemic, our inspectors went in and reported that that there’s nothing out of the ordinary when it’s clear that the infection rate had spread,” said Assemblymember Ron Kim (D-Queens), whose district includes Sapphire and the Franklin Center.   [continued here].

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As Congress Weighs COVID Liability Protections, States Shield Health Providers

By Susan Jaffe  | Kaiser Health News | May 14, 2020 | This story also ran on 

Coronavirus patients and their families who believe a doctor, nurse, hospital or other provider made serious mistakes during their care may face a new hurdle if they try to file medical malpractice lawsuits.

Under pressure from health provider organizations, governors in Connecticut, Maryland, Illinois and several other states have ordered that most providers be shielded from civil ― and, in some cases, criminal— lawsuits over medical treatment during the C OVID-19 health emergency. In New York and New Jersey, immunity is now part of state law….

Some legal experts and seniors’ advocates worry that the state immunity guarantees go too far, leaving patients with no way to hold providers accountable. Supporters argue that health care providers and facilities deserve protection from lawsuits as they battle a deadly virus during an unprecedented public health emergency.  [Continued at Kaiser Health News and Daily Beast. ]  

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Nursing Home Watchdogs Scarce At NYC Facilities As Hundreds Die Within

CLOSED  DOORS    |    THE CITY    |    April 23, 2020     

By Susan Jaffe 

Eyes and ears usually trained on New York’s nursing homes and adult care facilities have been nearly locked out as the coronavirus has claimed the lives of more than 3,500 residents statewide.

Almost entirely out of the picture are nursing home inspectors,employed by the state Department of Health and

 coordinated by the federal government, who are responsible for ensuring that the facilities comply with federal health and safety requirements.

“Nursing facilities are essentially free of public scrutiny right now, at a time when scrutiny is more important than ever,” said Susan Dooha, executive director of the Center for Independence of the Disabled in New York [continued here].

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Federal Regulators split on antimalarials for COVID-19

Volume 395    Number 10231     
11 April 2020                          
WORLD REPORT   US and French authorities have authorised the use of chloroquine and hydroxychloroquine, but the EU regulator and WHO say the science doesn’t support the decision. Susan Jaffe reports. 
With no “adequate, approved and available” alternative, the US Food and Drug Administration (FDA) is allowing the use of the antimalarial drugs hydroxychloroquine and chloroquine to treat coronavirus disease 2019 (COVID-19).

The FDA’s emergency use authorisation (EUA) issued last week gives physicians the option to prescribe the drugs, which President Donald Trump has recommended. However, both drugs are unproven and untested for COVID-19, and have rare but potentially deadly side-effects.  The decision bypassed the usual drug approval process including doubleblind, placebo-controlled clinical trials, stoking a worldwide debate about whether the drugs are appropriate for treating the disease.

“I think it was resorted to more out of a sense of desperation”, said Joseph Masci, an infectious disease specialist and director of global health at Elmhurst Hospital in Queens, a borough of New York City, which is at the centre of the epidemic in the USA. “It is just an indication of how sudden and massive this outbreak has been.” [Continued here.]  

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Federal Judge Rules Medicare Patients Can Challenge ‘Observation Care’ Status

By Susan Jaffe  | Kaiser Health News | March 30, 2020| This story also appeared in  

Hundreds of thousands of Medicare beneficiaries who have been denied coverage for nursing home stays because their time in the hospital was changed from “inpatiKHN logo for widget.JPGent” to “observation care” can now appeal to Medicare for reimbursement, a federal judge in Hartford, Connecticut, ruled last week.

If the government does not challenge the decision and patients win their appeals, Medicare could pay them millions of dollars for staggeringly high nursing home bills….

“If I had gone home, I would have died,” said Ervin Kanefsky, 94, a plaintiff [in a class action lawsuit against Medicare] from suburban Philadelphia. He was admitted to the hospital as an inpatient after fracturing his shoulder in a fall. When he was about to leave after five days to recuperate at a nursing home, a hospital official told him his status had changed to observation. With one arm in a sling, stitches in the other and unable to hold onto his walker, he learned Medicare wouldn’t pay for the nursing home.  [Continued at Kaiser Health News or The Philadelphia Inquirer.]  

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State Says Hospitals Must Allow Support Person at Births

FAMILIES    |    THE CITY    |    March 28, 2020     
The state Department of Health has toughened up its message to hospitals that have been telling pregnant women they can’t bring a partner or other support person into the delivery room because of coronavirus concerns. The new visitation policy’s boldface wording, issued late Friday, appears to leave little open to interpretation.
It “requires hospitals to allow one support person in labor and delivery settings if the patient so desires and two designated support persons in pediatric settings, provided that only one is present at a time.”
…The update reverses visitor bans announced earlier this week by New York-Presbyterian and Mount Sinai Health System in response to the coronavirus crisis. Other hospital systems had been expected to adopt similar procedures. [continued here]
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Coronavirus Stresses Nursing Home Infection-Control Practices

I-TEAM IN-DEPTH   |    CONNECTICUT HEALTH INVESTIGATIVE TEAM   |  MARCH 12,2020

As coronavirus cases increase, posing heightened risks to the elderly, nursing homes will face growing scrutiny from state health inspectors.

In Connecticut and nationally, complying with federal infection-control requirements is a challenge for some nursing homes. Between 2017 and 2019, 145 of Connecticut’s 217 nursing homes – or about 67 percent – were cited for infection-control violations, according to a Conn. Health I-Team analysis of data from the Centers for Medicare & Medicaid Services (CMS). [Continued here, with list of nursing home infection violations.]

 

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Medicare for All scrutinised in Democratic primaries

Volume 395       Number 10225     29 February 2020                          
WORLD REPORT  On March 3, 14 states will pick their nominees for the US presidential election. The feasability of a single payer insurance plan is a key issue. Susan Jaffe reports from Washington, DC.
Anxiety about rising health-care costs— the top issue for Democratic voters, according to recent polls—propelled Bernie Sanders to the head of the pack in last week’s Democratic primary contest in Nevada. Of the six leading candidates vying for the party’s presidential nomination, Sanders, a Vermont senator and self-described democratic socialist, has proposed the most radical solution for lowering medical bills and reaching universal coverage. His signature policy initiative, the Medicare for All single-payer programme, would eliminate private health insurance, including employment-based plans that cover about half of the US population. [Article compares Medicare for All and the public option proposal favoured by former Vice President Joe Biden; continued here]
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Decisions to be made on US gun violence research funds

Volume 395       Number 10222     8 February 2020   
WORLD REPORT  The National Institutes of Health and the Centers for Disease Control and Prevention will decide how to spend new federal funds later this year. Susan Jaffe reports from Washington, DC.
After a hiatus of more than two decades, Congress and President Donald Trump agreed to add funding for gun violence research to the federal budget in December. With grants expected to be awarded in September, the priorities for research and its potential impact are crucial for halting the US’s record-breaking gun-related death toll. [Continued here.]   
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Congress Considers Bill to Address Medicare Late Penalties, Coverage Gap

Current enrollment rules can leave late enrollees liable for doc visits Medicare usually covers

By Susan Jaffe  | Contributing Writer | MedPageToday  | January 20, 2020

Some 10,000 Americans turn 65 every day and become eligible for Medicare, but enrollment mistakes can subject them to a lifetime of late penalties, as well as a months-long coverage gap.

Legislation that would fix these problems was one of the bills discussed at a hearing held by the House Energy & Commerce Health Subcommittee…. Although the panel focused on how the bipartisan Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act impacts Medicare patients, it also affects their physicians. [Continued here and PDF here]

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