Washington, DC, United States (KaiserHealth) – Medicaid will stop paying for about two dozen “never events” in hospitals, such as operations on the wrong body part and certain surgical-site infections, federal officials said today.

Currently, about 21 states have such a nonpayment policy. The 2010 federal health law, in effect, expands the ban nationwide. The rule published today gives states until July 2012 to implement it.

Medicaid is a joint state-federal program for the poor and disabled. Under the rule, Medicaid funds can’t be used to pay doctors and hospitals for services that “result from certain preventable health care-acquired illnesses or injuries,” the officials said.

A similar regulation has been in place for Medicare, the federal health program for the elderly, since 2008.

“These steps will encourage health professionals and hospitals to reduce preventable infections, and eliminate serious medical errors,” said Donald Berwick, administrator of the Centers for Medicare and Medicaid Services. “As we reduce the frequency of these conditions, we will improve care for patients and bring down costs at the same time.”

Some physician groups have concerns about the new policy. “Simply not paying for complications or conditions, that, while extremely regrettable, are not entirely preventable, is a blunt approach that is not effective or wise for patients or the Medicare or Medicaid program,” Dr. Michael Maves, CEO of the American Medical Association, said in written comments to CMS in March.

He said the medical association has “grave concerns” about states extending the non-payment policy beyond the conditions considered by Medicare. The American Hospital Association expressed similar reservations.

Cindy Mann, deputy director of CMS and director of Medicaid, said the rule gives states the option to expand the nonpayment policy to health care settings besides hospitals and to add other types of “never events.”

She said the policy would help improve patient care and drive down costs in the $364 billion program. “All (health care) payers are looking to gain better value for the dollars they spend and Medicaid is no different,” she said.

But the costs savings from the change is relatively modest. According to the proposed rule, Medicaid would save about $35 million over the next five years from stopping pay for such medical mistakes. Medicare has saved about $20 million a year under its policy.

“It’s a welcome first step into the national debate on quality,” said Matt Salo, executive director of the National Association of Medicaid Directors. “Clearly many states have already moved ahead, although that should never be taken as rationale for forcing the rest of them to do … well, anything. But improving quality in a coordinated fashion between Medicare and Medicaid is important.”

This is list of preventable conditions that Medicaid will no longer pay for:

• Foreign Object Retained After Surgery
• Air Embolism
• Blood Incompatibility
• Stage III and IV Pressure Ulcers
• Falls and Trauma
• Fractures
• Dislocations
• Intracranial Injuries
• Crushing Injuries
• Burns
• Electric Shock
• Catheter-Associated Urinary Tract Infection (UTI)
• Vascular Catheter-Associated Infection
• Manifestations of Poor Glycemic Control
  • Diabetic Ketoacidosis
  • Nonketotic Hyperosmolar Coma
  • Hypoglycemic Coma
  • Secondary Diabetes with Ketoacidosis
  • Secondary Diabetes with Hyperosmolarity
• Surgical Site Infection Following:
  • Coronary Artery Bypass Graft (CABG) – Mediastinitis
  • Bariatric Surgery
  • Laparoscopic Gastric Bypass
  • Gastroenterostomy
  • Laparoscopic Gastric Restrictive Surgery
• Orthopedic Procedures
  • Spine
  • Neck
  • Shoulder
  • Elbow
• Deep Vein Thrombosis (DVT)/Pulmonary Embolism (PE) Following Total Knee Replacement or Hip Replacement – with pediatric and obstetric exceptions
• Surgery on the wrong patient,
• wrong surgery on a patient, and
• wrong site surgery

Source: CMS

pgalewitz@kff.org

– Provided by Kaiser Health News.

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Washington, DC, United States (KaiserHealth) – Trying to spur enrollment in a key new benefit of the 2010 health law, the Obama administration announced today it is slashing premiums for new high-risk insurance plans and no longer requiring applicants to submit a rejection letter from private insurers.

Since the plans were introduced in most states last summer, enrollment has fallen far short of expectations; only about 18,000 people have signed up. The Congressional Budget Office had estimated that as many as 4 million uninsured Americans would be eligible and that 200,000 would be enrolled by 2013. The government set aside $5 billion to fund the plans.

Citing the low enrollment, some Republicans including Rep. Fred Upton, R-Mich, have criticized the administration’s handling of the program. Twenty-seven states run their own plans; the federal government operates them in 23 states and the District of Columbia. The changes, which occur July 1, affect only federally run plans. The plans are intended to serve as a bridge to help people with medical conditions until insurance market reforms required by the law are implemented in 2014. At that time, insurers will no longer be able to deny coverage or charge higher rates for people with pre-existing conditions, a major benefit of the law.

To be eligible for the plans, applicants have to be uninsured for at least six months and have a pre-existing condition.

In the states where the plans are run by the federal government, applicants will no longer have to prove they were denied coverage by an insurance company. Instead, they can provide a doctor’s letter stating that they have a medical condition. At least a dozen state-run plans do not ask for a denial letter from an insurer. The premiums will drop as much as 40 percent in 17 states plus the District where the federally administered plans operates, the administration estimates. These decreases will help bring premiums closer to the rates in each state’s individual insurance market. In the six states where high-risk plan premiums were already similar to what healthy people pay for individual plans, premiums will remain the same. States that will see a 40 percent drop in premiums are Alabama, Arizona, Delaware, Florida, Kentucky and Virginia. In other states, premium reductions range from 2.1 percent in Mississippi to 38.3 percent in Minnesota.

In Florida, where 770 people have enrolled, a person 55 and over who subscribes to the so-called standard plan will see his or her monthly premium for the standard plan fall by $150 to $376.

To further generate interest in the plans, HHS this fall will begin paying insurance agents and brokers for signing up people.

“These changes will decrease costs and help insure more Americans,” said Health and Human Services Secretary Kathleen Sebelius. The administration released a chart showing changes to premiums in states with federally administered plans.

pgalewitz@kff.org

– Provided by Kaiser Health News.

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Washington, DC, United States (AHN) – The U.S. State Department on Tuesday barred seven firms from trading with the U.S. because they supplied oil to Iran in violation of 1996 sanctions against the Islamic country.

Sanctioned were Venezuela’s state oil company, Petróleos de Venezuela, Ofer Brothers Group of Israel, Petrochemical Commercial Company International (PCCI) of the United Kingdom, Royal Oyster Group and Speedy Ship of the United Arab Emirates, Tanker Pacific of Singapore and Associated Shipbroking of Monaco.

Petroleos was found to have delivered $50 million worth of petroleum products to Iran between December 2010 and March this year.

Under the sanctions, the firms cannot bid for government contracts, obtain export licenses, and obtain export-import financing.

The department also sanctioned more than 15 people and companies in China, Iran, North Korea, Syria and elsewhere for illicitly trading in missile technology and weapons of mass destruction. They were banned from vying for U.S. government contracts and from buying and selling U.S. defense articles.

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Washington, DC, United States (AHN) – President Barack Obama’s proposal for a resolution to the stalemate in Israel was rejected by Israeli Prime Minister Benjamin Netanyahu and Hamas, while being welcomed by Europe and receiving a mixed response in the Middle East.

Israel immediately rejected Obama’s suggestion that Israel return to its 1967 borders as an outline for peace negotiations with Palestinians. Obama further suggested that any land swaps deviating from those borders be mutually agreed upon by both Israel and the Palestinians.

Although international law does not allow a nation to keep or occupy territory it seizes in war, Israel does not recognize international law on this point. And Israel maintains it has a right to occupy, build upon and keep the territories of the West Bank and Gaza that it seized from Palestinians in the 1967 war.

Ahead of a planned meeting with Netanyahu, Obama said in a speech Thursday that Palestinians needed to know the basic shape of their territory and that Israel needed to know it was secure.

But Netanyahu rejected the proposal to return to its internationally recognized 1967 borders, saying that giving up territory seized in war would render its borders indefensible.

Hamas officials also rejected the plan. Hamas is the militant political party elected to govern the Gaza Strip. However, many nations, including the U.S. and Israel, classify Hamas as a terrorist organization.

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Washington, DC, United States (AHN) – President Barack Obama has added a stop at the American Israel Public Affairs Committee’s (AIPAC) annual conference during a week that will address his administration’s goals for the region. On Thursday, Obama will deliver a major speech on the “Arab spring” and how the White House is supporting democracy in the Middle East.

Obama “will discuss, among several topics, the dramatic change we’ve seen in the Middle East and North Africa this year,” White House Press Secretary Jay Carney told reporters. “He will also discuss the Middle East peace process and the need for that process to continue and succeed.”

Indeed, there is a lot for the United States to address. Sectarian violence has erupted in Egypt after toppling a decades-long leader. American troops are still fighting in Afghanistan and Iraq, while other troops launch air strikes on targets in Libya. There is escalating violence in Syria and Yemen, with ongoing unrest in Bahrain and Tunisia.

The White House has been under public pressure to denounce the violence in Syria. The situation became more complicated when Palestinian refugees living in Syria staged protests in the Golan Heights, an area occupied by Israeli troops.

Now, as violence and protests spill over to the Israeli border, Jerusalem is looking to the White House for stability. Obama will meet with Israeli Prime Minister Benjamin Netanyahu on Friday, then address the AIPAC’s conference in Washington on Sunday. Topics will likely include a discussion on who will replace U.S. special Middle East envoy George Mitchell, who resigned after peace talks with Palestinians stalled. Obama and Netanyahu will also discuss the outcome of a unity government in the works between Hamas in Gaza and Fatah in the West Bank.

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Washington, DC, United States (AHN) – The Federal Reserve’s policy panel decided Wednesday to keep buying $600 billion in long-term U.S. bonds until June as planned, citing a moderate economic recovery and inflation as reasons to continue the program.

The Federal Open Market Committee was unanimous for the third consecutive time in letting the program expire during a meeting in Washington.

The bond-buying scheme set in November is the second round of quantitative easing designed to keep short-term interest rates near zero and encourage businesses to loan. The economic stimulus was the government’s response to the financial crisis that hit the country in 2008.

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Washington, DC, United States (AHN) – The U.S. Consumer Product Safety Commission and Health Canada, in cooperation with the firm named below, today announced a voluntary recall of the following consumer product. Consumers should stop using recalled products immediately unless otherwise instructed. It is illegal to resell or attempt to resell a recalled consumer product.

Name of Product: Disney Princess Plastic Racing Trikes

Units: About 9,000 in the U.S. and 700 in Canada

Manufacturer: Kiddieland Toys Limited, of Scituate, Mass.

Hazard: The plastic castle display and the princess figures protruding from the top of the handle bar pose a laceration hazard if a child falls on it.

Incidents/Injuries: CPSC and Kiddieland have received three reports of children suffering facial lacerations.

Description: This recall involves the Disney Princess Plastic Racing Trikes. The trikes are pink and fuchsia with a purple seat and wheels. On top of the handlebar, there is a rotating castle display surrounded by three princess figures. “Disney Princess” is printed on the label in front of the trike just below the handlebar.

Sold at: Target, JCPenney, Meijer and H.E.B. stores nationwide and on the Web at www.target.com from January 2009 through April 2011 for about $50.

Manufactured in: China

Remedy: Consumers should immediately take the trikes away from children and contact Kiddieland for a free replacement handlebar with an enclosed rotating display.

Consumer Contact: For additional information, contact Kiddieland at (800) 430-5307 anytime, or visit the firm’s website at www.kiddieland.com.hk

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Washington, DC, United States (KaiserHealth) – On a near party-line vote delayed a half dozen times by protesters in the packed galleries, the Republican-controlled House passed a budget plan for the next decade that would dramatically shrink the role of the federal government. The controversial spending and tax blue print, designed by House Budget Committee Chairman Paul Ryan, was approved 235 to’3, with no Democratic support and four Republicans voting against it.

U.S. House Majority Leader Rep. Eric Cantor (R-VA) (C) speaks as (L-R) Rep. Dave Camp (R-MI), Rep. Diane Black (R-TN), Rep. Paul Ryan (R-WI), and Rep. Jeb Hensarling (R-TX) listen during a news conference Wednesday on Capitol Hill. (Photo by Alex Wong/Getty Images)

As the contentious day-long debate neared its conclusion, House Speaker John Boehner, R-Ohio, threw down the gauntlet to President Obama for the upcoming negotiations over raising the $14.3 trillion debt ceiling, which will become necessary sometime in the next several months. “The president wants a clean bill,” Boehner said, but “there will be no debt limit increase unless it is accompanied by spending cuts and real budget reforms.”

Though the House-backed plan stands no chance of passage in the Senate, much less being signed by the president, as a starting point for negotiations it sets a stake in the ground as far to the right as any political party has attempted since Barry Goldwater ran for president in’64. It calls for far-reaching changes to government programs – more extensive than what was proposed in the’94 GOP “Contract with America” — that affect about a fifth of the U.S. economy.

The fiscal 2012 budget resolution:

Cuts spending on domestic programs by over $100 billion next year and continues to add cuts to the environment, housing and education for the next decade, lowering domestic spending as a share of the economy to levels not seen since the first half of the 20th century.

Shrinks Medicare by giving seniors who turn 65 after 2023 a voucher that would cover about one-third of the cost of insurance-industry provided plans.

Turns Medicaid back to the states and cuts the federal contribution by $700 billion over the next decade.

Holds defense spending at levels that remain 20 percent above the last peak during the’80s.

Overhauls the tax code to lower taxes on wealthier Americans and some corporations.

The House-passed budget would cut all programs by $6.2 trillion over the next decade. By contrast, President Obama’s budget plan released this week would cut approximately $3 trillion over the next decade and nearly $4 trillion over 12 years. The Republican blueprint uses most of its budget savings to reduce tax collections by $4.2 trillion. The GOP plan would lower top tax rates on individuals and corporations and not allow the Bush-era tax cuts to expire.

Ryan, R-Wis., the plan’s architect, said of the House action today: “This is our defining moment.”

Four Republicans, who joined the 189 Democrats in the chamber, voted against the budget plan. The four were David McKinley, a freshmen from Wheeling, West Virginia who won election last November with 50 percent of the vote; Walter Jones, a nine-term member from Greenville, N.C.; Denny Rehberg, the sole representative from Montana whose two Senators and governor are Democrats; and Ron Paul, a libertarian gadfly from Texas who favors cuts in defense and reduced American commitments abroad.

Rep. Chris Van Hollen of Maryland, the ranking Democrat on the Budget Committee, led the Democratic opposition to the bill. In a preview of what is certain to be a top issue in campaigns across the country in the next election, he and House Minority Leader Nancy Pelosi, D-Calif., repeatedly homed in on the dramatic changes to Medicare contained in the Republican approach to reducing deficits.

“The Republican plan disconnects the amount we give seniors from rising health care costs,” Van Hollen said. “That’s why seniors wind up paying more and more and more.” Democrats repeatedly referred to a Congressional Budget Office analysis released last week that showed seniors who turn 65 after 2023 will pick up 68 percent of their health care costs compared to 20 to 25 percent today.

“Do you realize your Republican leadership is asking you to cast a vote today that abolishes Medicare as we know it?” Pelosi asked in her final comments on the bill. Responded Ryan: “The biggest threat to Medicare is the status quo. … What we say is that in the future people who are wealthy do not need as much subsidy. People who are sick and who are poor get more.

The House-backed plan now goes to the Senate, where it stands no chance of passage since it is controlled by Democrats. A bipartisan group of six Senators, including several who served on the president’s fiscal commission, have been meeting for weeks to craft an alternative.

Their efforts were largely overshadowed this week when President Obama shifted sharply to the right by endorsing much of what was contained in his deficit commission’s plan released last November. The president proposed cutting deficits by $4 trillion over the next dozen years by cutting both domestic and defense spending, and raising taxes on well-off Americans through tax reform and ending the Bush-era tax cuts for those earning over $250,000 a year.

The Republicans who rose in support of the bill repeatedly castigated the president for proposing higher taxes in what is likely to be one of their major election-year themes. “The debt and deficit problem we have today is not because we have taxed too little, but because we have spent too much,” said second-term Rep. Tom Graves, R-Ga.

But Democrats continually linked their tax increases to the cuts in Medicare. “The question is not whether to reduce the deficit, but how,” said Rep. Xavier Becerra, D-Cal., who served on the deficit commission. “This plan gives $130,000 in tax cuts for millionaires while eliminating the guarantee for Medicare beneficiaries to choose doctors [and] adds $6,000 in health care costs. We don’t think Americans should get a coupon instead of a guarantee.”

– Provided by Kaiser Health News.

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Washington, DC, United States (AHN) – Inflation rose in March at its highest rate in more than a year fueled by high gas prices that hit consumers in the pocket, causing retail sales to stall.

According to Friday’s report from the Labor Department, the Consumer Price Index (CPI) rose 2.7 percent in March compared to the same period in 2010. Labor Department officials said that was the largest 12-month increase in the government’s chief measure of inflation since December 2009.

However, the core CPI, which is a measure of prices except volatile energy and food prices, rose only 1.2 percent from a year ago. Analysts consider the core CPI a better tool to predict long-term inflation.

Nevertheless, consumers dealing with higher fuel and food prices might not be comforted by the lower inflation readings of the core CPI. Gasoline prices rose by 5.6 percent in March and are up 27.5 percent from a year ago. Meantime, food prices rose 0.8 percent in March. That represents the largest increase in prices in a one-month period since July 2008. In addition, food prices were 2.9 percent higher than a year ago.

Those higher prices apparently caused retail sales to slow.

Although analysts expected U.S. retail sales to rise by 0.5 percent from February to March, in reality sales only increased by 0.4 percent to $389.6 billion in March, according to the U.S. Department of Commerce. However, that represented a 7.1 percent increase from the same period a year ago.

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Washington, DC, United States (AHN) – After two years of investigating, a U.S. Senate committee has charged that Goldman Sachs knew the mortgage-backed securities it was selling to investors would fail.

The Senate Permanent Subcommittee on Investigations looked at the behavior of Wall Street banks during the credit crisis and found Goldman Sachs knowingly misled investors.

In a report issued Wednesday, the committee said that Goldman failed to tell banks and other investors that four sets of complex mortgage securities were risky. Moreover, Goldman was betting the investment’s value would fall and did not mention to investors that it did not believe in backing the investments it was selling.

Goldman marketed billions of dollars worth of poor quality mortgage securities that were parceled out to bundles of securities called collateralized debt obligations.

But Goldman didn’t invest much in the collateralized securities. On the risk, or long side, Goldman only invested $6 million, and then Goldman secretly invested $2 billion in bets against the securities, which was the opposite or short position. Goldman did not tell investors about the bank’s bets against the securities it was selling them.

In addition, the committee found that Goldman CEO Lloyd Blankfein’s testimony to Congress in 2010 was misleading. It has asked the Justice Department to investigate Blankfein’s testimony.

However, Goldman Sachs has disputed the findings of the report. The bank also says all its executives gave truthful and accurate testimony to Congress in 2010.

Other banks were investigated along with Goldman.

The Senate committee made similar charges against Deutsche Bank and also found that Washington Mutual ignored warnings from its chief credit officer to knowingly underwrite poor quality mortgages.

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