Portable Health Plans
Patients can take their health insurance coverage with them when they change or lose a job, under the final regulations that implement the last piece of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). According to a statement by the Health and Human Services Department, it is important that American workers, who often change jobs several times in the course of their lives are able to respond to the modern workplace without having to fear for their health insurance. The regulations allow greater portability and availability of group health coverage during a time of job transition, setting limits on preexisting condition exclusions that could be imposed, and requiring group health plans and insurance issuers to offer “special enrollment” to certain patients who lose eligibility for other group health coverage or health insurance, or to otherwise eligible new dependents. The regulation goes into effect for plan years starting on or after July 1.
Computer Entries Lead to Errors
Automation isn't necessarily a foolproof way to improve patient safety and reduce medical errors, a report from the U.S. Pharmacopeia (USP) found. Computer entry errors were the fourth leading cause of medication errors according to MEDMARX, USP's national medication error reporting system. These errors have steadily increased and represent about 12% of all MEDMARX records from 1999 through 2003. Performance deficits—where an otherwise qualified physician makes a mistake—were the most frequently reported cause of errors. Distractions were the leading contributing factor, accounting for almost 57% of errors associated with computer entry. The report provided an analysis of 235,159 medication errors voluntarily reported by 570 hospitals and health care facilities nationwide.
Reduced Benefits for Retirees
Businesses are asking retirees to pay more for their health coverage as they struggle to control rising costs, the Kaiser Family Foundation reported. In the past year, 79% of firms increased their retirees' contributions for premiums, and 85% expect to do so in the coming year. In addition, 8% of employers surveyed eliminated subsidized health benefits for future retirees in 2004. For 2005, 11% said they are likely to terminate coverage for future retirees. However, 58% said they were likely to continue offering prescription drug benefits and accept the tax-free subsidy created by the new Medicare law. The survey included responses from 333 large private-sector firms that offer retiree health benefits.
Spending for Power Wheelchairs
Federal safeguards did not go far enough to curb Medicare's spending growth for power wheelchairs, the Government Accountability Office found. Medicare spending for the wheelchairs rose more than fourfold from 1999 to 2003, raising concerns that some of the payments may have been improper. Following the indictment of several power wheelchair suppliers in Texas who fraudulently billed Medicare, GAO was asked to examine earlier steps taken by the Centers for Medicare and Medicaid Services to respond to improper payments. CMs' contractors started informing the agency in 1997 about escalating spending for wheelchairs, and some started taking steps to respond to improper payments, yet the agency didn't assume an active role until 2003. Since then, CMS has worked to prevent fraudulent suppliers from entering the Medicare program, but it has not revised its form to collect better information for power wheelchair claims reviews, the GAO found.
Medicaid's Benefits to the States
An annual fiscal survey of the states failed to examine the benefit of Medicaid to the states' economies, according to Families USA. The report released by the National Governors Association (NGA) and the National Association of State Budget Officers indicated that state spending for Medicaid, including federal funds, has surpassed state spending on primary and secondary education. Yet, in examining state general fund expenditures, states spent more than twice as much on education than they did on Medicaid. “When analyzing the NGA survey's findings on Medicaid, it is important to count the economic benefit that Medicaid holds for states,” said Families USA Executive Director Ron Pollack. “A recent Families USA study found that on average every $1 million invested in Medicaid by states generates nearly 34 jobs, $1.2 million in wages, and $3.3 million in business activity,” he added. During fiscal 2005, Medicaid is estimated to grow as much as 12% due in part to expiring federal fiscal relief. Long-term growth is expected to be 8%–9%, well above expected state revenue growth, the NGA's report said.
Global Smallpox Stockpile
The United States has pledged 20 million doses of smallpox vaccine toward the global stockpile managed by the World Health Organization. The vaccine doses will physically remain in the U.S. Strategic National Stockpile, but will be available for use by the WHO in the event of an emergency. The global stockpile is designed to help those countries that have no smallpox vaccine and are not prepared to respond to an outbreak of the disease. The global stockpile will only be used if at least one case of smallpox is confirmed in the human population. U.S. government officials have been urging the creation of a WHO Smallpox Vaccine Bank, which would create a physical stockpile of vaccine in Geneva and a virtual global stockpile of pledged vaccine stocks around the world.