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Health reform heads for legal showdown
The Supreme Court, starting March 26, will hold three days of oral arguments on legal challenges to the Patient Protection and Affordable Care Act, a defining moment for the 2-year-old statute and a major factor in determining whether it will survive. In November 2011, the high court agreed to take up health reform lawsuits brought by a coalition of states and a prominent small-business association, a widely expected move that likely sets up a June decision by the court in the middle of the presidential election campaign. Justices could decide that the law is constitutional, invalidate part or all of it on constitutional grounds, or effectively postpone a final determination by stating that the plaintiffs cannot challenge the law until it takes full effect in 2014. The justices will hear from the Obama administration and a multi-state coalition led by Florida on whether the Anti-Injunction Act renders moot the central challenge posed to the reform law by the states. The act in [Read more]
Enforcement of 5010 standards delayed until July 1
Federal officials have extended by an additional 90 days the enforcement deadline for physicians, health plans and claims processors to comply with the 5010 electronic transaction standards under the Health Insurance Portability and Accountability Act. The decision to delay again the full implementation of the electronic transaction standards used to bill services throughout the health system comes as physician practices continue to report problems with claims processing, creating millions of dollars in unpaid claims. A number of outstanding issues led the Centers for Medicare & Medicaid Services to make the decision to hold off on enforcing the standards through June 30, the agency said in a March 15 statement. In late 2011, CMS had decided to move the enforcement date from Jan. 1 to April 1. The latest postponement means that electronic submissions using the old 4010 HIPAA transaction format, or using the new 5010 standard but with formatting errors, will continue to be process [Read more]
Men more likely to reapply to medical schools, study finds
Tough competition means that many prospective medical students aren’t accepted the first time they apply to medical school, but several factors affect whether an individual decides to apply a second time. Among them are age, gender, educational debts, scores on the Medical College Admissions Test, socioeconomic status and other career opportunities, says an Academic Medicine study published online Feb. 22. To help medical school admissions officials and pre health advisers better understand applicants’ motivations, Assn. of American Medical Colleges researchers analyzed data on 3,326 people who reapplied to medical school in 2010 after being rejected as first-time applicants in 2009. “The study was prompted by a broader goal of better understanding factors that might be associated with a medical school aspirant transitioning to an applicant,” said Douglas Grbic, PhD, lead study author and AAMC senior research analyst. Fifty-three percent of 38,402 U.S. citizens or perm [Read more]
Shared decision-making key in treating advanced heart failure
Patients with advanced heart failure often prefer to receive treatment from the doctors who know them best — their primary care physicians, said the lead author of a scientific statement on managing the chronic condition. But too often, doctors delay critical conversations about a patient’s preferences and expectations until emergency situations, when the individual’s decision-making might be impaired, said Larry A. Allen, MD, MHS, lead author of the American Heart Assn. statement, which was published online March 5 in Circulation. Part of the problem is that physicians often have insufficient time during office visits to thoroughly discuss with patients the unpredictable nature of the disease and the benefits and downfalls of the complex treatments available, Dr. Allen said. Doctors often have limited training in shared decision-making, which is required for appropriate care of patients with advanced heart failure, he added. The American Heart Assn. statement urges phys [Read more]
Hospitals find success in slashing health disparities
A coalition of health care organizations is highlighting how collecting patients' demographic data, expanding cultural competency training and diversifying health leadership can help reduce care disparities. For example, New York-Presbyterian Hospital started an initiative to improve care for patients in the largely Hispanic neighborhoods of Washington Heights and Inwood in New York City. The effort included a four-hour training program for health professionals to help address patients' cultural, language and literacy needs. "The cultural competency training provides background information in terms of the various ethnicities and religions and groups that we see predominantly," said J. Emilio Carrillo, MD, MPH, vice president for community health at New York-Presbyterian. "However, we are making it very clear that we ascribe to a patient-centered, cross-cultural approach." Whatever ethnic or racial background a patient is from, "people are trained to respond to them as an indiv [Read more]
Guidelines focus on newly diagnosed HIV patients
Worried that too few people with HIV receive the care they need, infectious diseases experts have issued guidelines calling on physicians to ensure that newly diagnosed patients start treatment and adhere to life-long drug regimens. The recommendations were developed by a panel of 31 HIV experts on behalf of the International Assn. of Physicians in AIDS Care. They were published online March 5 in Annals of Internal Medicine. The guidelines urge health professionals to monitor the entry of patients they diagnose with HIV into treatment programs. After the initial visit for such programs, nurses or other staff members periodically should call patients to ensure that they are properly taking their medications. Adherence also can be monitored through systems that alert physicians when a patient does not pick up his or her prescriptions, said Larry W. Chang, MD, MPH, co-author of the guidelines and an assistant professor of Medicine at Johns Hopkins University School of Medicine in [Read more]
Medicare overhauls patient claims statements
Medicare has redesigned the claims and benefits statements that are sent to enrollees on a quarterly basis, with the goal of clarifying a document that has been criticized as impenetrable to many patients. Some of the changes to the Medicare summary notices include descriptions of medical services that are deemed more consumer-friendly, larger fonts and definitions of all the terms that Medicare uses on the forms. The notice also is reformatted around a snapshot of the beneficiary's current deductible status, a list of health professionals they saw during the quarter, and information about whether their claims were approved or denied. Critics of the Medicare claims system have complained that beneficiaries often don't realize that claims for their services have been rejected, making the process of appealing those decisions more difficult. The Centers for Medicare & Medicaid Services said the clearer forms will make it easier for patients to launch appeals if they think the denial [Read more]
Medical students show gains in empathy are short-lived after training
The actor wore goggles smeared with petroleum jelly to simulate poor vision and earplugs to replicate hearing loss. He portrayed an elderly patient being admitted to a long-term, assisted-care facility and fired questions at another actor playing the facility's assistant manager. The two had trouble communicating. While the patient wanted to know about the center's schedule, food service and what to do in an emergency, the assistant manager wanted to focus on rules. It was a brief, 10-minute performance, but it had a strong impact on the 370 first-year medical and pharmacy students who saw it. The students showed increased signs of empathy after watching and discussing the skit, but the results were not sustained, said a study in the Feb. 10 American Journal of Pharmaceutical Education. Still, the results are encouraging, said Mohammadreza Hojat, PhD, study co-author and research professor of psychiatry and human behavior at Thomas Jefferson University Jefferson Medical Col [Read more]
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