Medicare Expands Stent Coverage
The Centers for Medicare and Medicaid Services (CMS) has expanded Medicare coverage of percutaneous transluminal angioplasty of the carotid artery concurrent with stent placement. Previously, CMS only covered carotid artery stenting in clinical trials being conducted prior to Food and Drug Administration approval and, more recently, in postapproval studies. The new policy expands coverage to include high-risk patients with symptomatic narrowing of the carotid artery of 70% or more.
'Migraine Calculator' Debuts
Employers will be able to calculate how much employees' migraines are costing their businesses, thanks to a new “migraine calculator” from the Pharmaceutical Research and Manufacturers of America (PhRMA). The calculator, developed by consulting firm HSM Group of Scottsdale, Ariz., estimates both the incidence of migraine and its financial impact based on the company's size, type of industry, location, and age and gender of employees. It also projects the potential net savings the company can expect if employees obtain treatment, taking the cost of treatment into account. The calculator “is an important tool that allows employers to see the whole picture on the economics and value of getting patients with migraines needed treatment,” said HSM Group president Sheryl Bronkesh. It is available at
http://www.migrainecalculator.com/Welcome.asp
Physicians Prefer Paper
When it comes to recording patient health information, most doctors and hospitals still prefer paper to the computer, the Centers for Disease Control and Prevention reported. Ambulatory medical care surveys conducted from 2001 to 2003 revealed that only 17% of physicians' offices had electronic medical records to support patient care. Less than a third of hospital facilities (31% of hospital emergency departments and 29% of outpatient departments) had electronic records. Physicians under age 50 years were twice as likely as those over that age to use computerized physician order entry systems, the CDC reported.
Chiropractic Coverage Demo
On April 1, CMS began covering an expanded array of chiropractic services provided to Medicare beneficiaries in Maine, New Mexico, and parts of Illinois, Iowa, and Virginia. Under the 2-year demonstration project, newly covered services include extraspinal manipulation, x-rays, EMG and nerve conduction studies, clinical lab tests, electrotherapy, ultrasound therapy, and evaluation and management services. Chiropractors also will be allowed to order MRIs, CT scans, and clinical lab services and to make referrals for physical therapy. Currently, Medicare chiropractic coverage is limited to manual spinal manipulation and therapy to treat neuromusculoskeletal conditions. “By expanding chiropractic coverage in this demonstration, we are reducing out-of-pocket costs for seniors who visit chiropractors, and we will learn whether paying chiropractors for delivering these additional services can help improve health outcomes and keep Medicare costs down,” said CMS Administrator Mark B. McClellan, M.D.
Bill on Livestock Antibiotics
Sen. Edward M. Kennedy (D-Mass.) and Sen. Olympia Snowe (R-Maine) have introduced a bill to cut down on the amount of antibiotics used in livestock, citing evidence that increased antibiotic use in animals leads to reduced effectiveness in humans. “Antibiotics are among the greatest miracles of modern medicine, yet we are destroying them faster than the pharmaceutical industry can create replacements,” Sen. Kennedy said in a statement. “If doctors lose these critical remedies, the most vulnerable among us will suffer the most—children, the elderly, and persons with HIV/AIDS, who are most in danger of resistant infections.” The measure would require the Food and Drug Administration to withdraw approval for nontherapeutic use of eight classes of antibiotics in food-producing animals after 2 years if the use has not been proven harmless during that time. It also requires manufacturers of animal drugs or drug-containing feed to make their sales records available to government regulators for tracking emerging antimicrobial resistance.
How Now, Mad Cow?
The Department of Agriculture appears to be considering returning “downer cattle” to the food supply. USDA is performing a surveillance program to see whether the ill cattle are infected with bovine spongiform encephalopathy (BSE). In testing 314,000 animals in the last year “we have not found another case of BSE,” Agriculture Secretary Mike Johanns told the Food and Agriculture Policy Conference.