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Legislation on Lupus

New legislation aims to strengthen federal efforts to identify the causes of and a cure for lupus. The Lupus Research, Education, Awareness, Communication, and Healthcare Amendments of 2005 (S. 756) would instruct the director of the National Institutes of Health to coordinate lupus research activities within the institutes. The bill also calls for clinical research into the development and evaluation of new treatments, research to validate lupus biomarkers, and research to develop improved diagnostic tests. The bill would also authorize a national epidemiologic study to determine the prevalence and incidence of lupus in the United States. “It has been nearly 40 years since the U.S. Food and Drug Administration approved a new medication specifically for lupus,” Sandra C. Raymond, president and CEO of the Lupus Foundation of America, said in a statement. “Ultimately, this legislation will stimulate additional investment in research that will lead to the development of safer and more effective therapies.” Sen. Robert Bennett (R.-Utah) introduced the legislation, which was referred to the Senate Health, Education, Labor, and Pensions committee.

Arthritis Patients Lack Insurance

Nearly 12% of nonelderly adults in the United States who report having arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia are uninsured, according to government statistics. And 59% of uninsured adults with arthritis-related conditions have unmet need for either medical care or prescription drugs, according to the Robert Wood Johnson Foundation, which analyzed data from the Centers for Disease Control and Prevention's National Center for Health Statistics. The analysis showed that uninsured adults with arthritis were 4.5 times as likely as insured adults with the same condition to have unmet need for medical care or prescription drugs.

Campaign For Psoriasis Funding

The National Psoriasis Foundation has launched a letter-writing campaign to lobby Congress for increased federal funding for research into psoriasis and psoriatic arthritis. The Foundation added an online advocacy tool to its Web site—

www.psoriasis.org

E-Prescribing Standards

Medicare should adopt a program-wide system of uniform national electronic prescribing standards for its new prescription drug benefit, according to the Pharmaceutical Care Management Association (PCMA). A uniform national standard is key to maximizing the participation of private plans in the Part D benefit and in helping to reduce regional variations in health care delivery and outcomes, PCMA said in comments to the Centers for Medicare and Medicaid Services on its proposed rule for Medicare e-prescribing standards. “PCMA believes that Medicare e-prescribing holds the potential to transform the health care delivery system,” PCMA President Mark Merritt said in a statement. “Regrettably, a 50-state patchwork approach would increase costs, decrease efficiency, and severely undermine the promise of e-prescribing.” The organization also urged CMS officials to preempt duplicative and conflicting state laws that could increase costs.

CMS: Pay for Performance Works

Preliminary data indicate that pay-for-performance is improving quality of care in hospitals. A 3-year demonstration project sponsored by the CMS is tracking hospital performance on a set of 34 measures of processes and outcomes of care for five common clinical conditions. Reports from more than 270 participating hospitals on their experiences during the project's first year show that median quality scores improved in all of the clinical areas. For example, scores increased from 90% to 93% for patients with acute myocardial infarction; from 64% to 76% for patients with heart failure; and from 70% to 80% for patients with pneumonia. These early returns demonstrate that using financial incentives works to deliver better patient care and to avoid costly complications for patients, said CMS Administrator Mark B. McClellan, M.D.

New Medicare Wheelchair Policy

Ability to function is the primary criterion in the CMs' new national coverage policy for power wheelchairs and scooters. The criteria look at how well the beneficiary can accomplish activities of daily living such as toileting, grooming, and eating with and without using a wheelchair or other mobility device. The criteria are “part of our efforts to ensure that seniors who need mobility help will get it promptly, and that we are paying appropriately for mobility assistive equipment,” Dr. McClellan said in a statement. The coverage policy is one element in Medicare's year-old effort to improve the coverage, payment, and quality of suppliers for wheelchairs and scooters. That effort was launched after Medicare spending on mobility equipment rose to $1.2 billion annually.

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