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CMS chief Dr. Berwick to step down Dec. 2
Washington -- President Obama on Nov. 23 nominated Marilyn B. Tavenner to be the next administrator of the Centers for Medicare & Medicaid Services. Donald M. Berwick, MD, the current CMS chief, will serve his last day on Dec. 2, according to a letter he sent to agency staff. He has been administrator since July 2010. "Our work has been challenging, and the journey is not complete, but we are now well on our way to achieving a whole new level of security and quality for health care in America," Dr. Berwick wrote. Dr. Berwick made a central goal at CMS his three-part aim of improving health care for individuals, improving population health and lowering health care costs. "He infused a deep commitment to patient-centered care into all the [CMS] innovations and was a tireless advocate for reforms that improve patient outcomes and patient experiences of care," said Debra L. Ness, president of the National Partnership for Women and Families, a health care advocacy organization. [Read more]
Many writers of diabetes, cholesterol guidelines have conflicts of interest
Half of experts who write clinical practice guidelines for diabetes and high cholesterol have financial conflicts of interest with the drug industry, a study says. One in nine panelists who said they had no conflicts actually had a conflict, said the study, published online Oct. 11 in the journal BMJ. "Our main concern is that there is a potential risk of industry influence on developing guideline recommendations," said lead study author Jennifer Neuman, MD, an instructor of preventive medicine at Mount Sinai School of Medicine in New York. "For practitioners and developers alike, it's important to be mindful of this issue." The study examined 14 guidelines published on diabetes and high cholesterol between 2000 and 2010 by national organizations in the United States and Canada. Those groups included the American Heart Assn. and the American Diabetes Assn. A financial conflict was defined as direct compensation to a guideline panelist by a manufacturer of a drug used to treat [Read more]
Lawsuit can be amended after deadline to include wrongful death
A Massachusetts plaintiff can amend a medical liability lawsuit to include wrongful death even though the time allowed under the law to make the claim has expired, the state Supreme Judicial Court ruled in October. However, the court set parameters on when a wrongful death claim may be substituted for a personal injury claim, ruling that: The trial must not have begun. The original complaint alleging malpractice must have been filed within the time frame that the law allows. The allegations of liability supporting the personal injury claim must be the same as those supporting the wrongful death claim. "I don't think [the ruling] will open the floodgates," said John P. Barylick, an attorney with Wistow & Barylick in Providence, R.I., who represented the patient's family. "It is really fairly limited circumstances." He noted that this is the first time the issue has come before the court in the more than 20 years since the Massachusetts Legislature enacted the l [Read more]
Medicare looks to ease physician revocation rules
Washington -- Physicians who are kicked out of Medicare because of a clerical or administrative error would be reinstated quickly under a rule change proposed by the Obama administration. The Centers for Medicare & Medicaid Services acknowledges that the consequences for missing Medicare enrollment deadlines are unnecessarily harsh and can jeopardize access to care for patients, according to an Oct. 18 proposed rule. The Medicare agency has proposed rolling back this policy along with a number of other regulations considered Draconian. "These rules reflect the [Obama] administration's ongoing commitment to reducing regulatory burdens as much as possible, while maintaining full protections for the doctors and patients in our system," Dept. of Health and Human Services Secretary Kathleen Sebelius said during a briefing on the rule changes. The American Medical Association and other physician associations support numerous changes to regulations and already have secured several re [Read more]
Hair professionals are potential front line for skin cancer detection
Physicians and patients could benefit from hair professionals being trained to help in the early detection of skin cancer on the scalp, neck and face, a study says. Nearly 60% of 203 hair professionals surveyed at 17 salons in the Houston area said they already had recommended at least once that a customer see a health professional for an abnormal mole, said a report in the October Archives of Dermatology. In addition, 37% looked at more than half of their customers' scalps for suspicious lesions during the previous month, 29% checked more than half of their customers' necks, and 30% looked at more than half of their customers' faces. Scalp and neck melanomas represent 6% of all melanomas, and they account for 10% of melanoma deaths in the United States. Hair professionals could help with earlier detection of these cancers, said Alan C. Geller, MPH, RN, a study author and senior lecturer at Harvard School of Public Health. "The scalp is a perfect example of a place for m [Read more]
California Medicaid tries to recover millions in fees
California's Medicaid agency plans to recoup millions of dollars in fees it paid in the past year for dental, chiropractic and podiatry services, but at least one group of affected health centers has said the move will put its facilities in a precarious financial position. California lawmakers cut these and other optional Medicaid services effective July 1, 2009, but the U.S. District Court for the Eastern District of California issued an injunction against the cuts in October 2010, saying the state did not go through the proper Medicaid plan amendment process. However, the Centers for Medicare & Medicaid Services in May 2011 approved a state plan amendment allowing the California Dept. of Health Care Services -- the state's Medicaid agency -- to reinstate the cuts. On Sept. 30, the state's Medicaid agency notified clinics and health centers that it will recover fees it paid for dental, podiatry and chiropractic services between October 2010 and May 2011, the period covered by th [Read more]
New ADHD guidelines lower age of diagnosis
New guidance from the American Academy of Pediatrics expands the age at which children can be diagnosed with attention-deficit/hyperactivity disorder. The recommendations also encourage physicians to partner with parents, teachers and mental health specialists when creating a treatment plan for these patients. The guidelines, published online Oct. 16 in Pediatrics, recommend that physicians evaluate children age 4 to 18 for ADHD if they have academic or behavioral problems and symptoms of inattention, hyperactivity or impulsivity. That marks a shift from AAP guidance issued in 2000 and 2001, which called for assessments for the neurobehavioral disorder in children age 6 to 12. "Treating children at a young age is important, because when we can identify them earlier and provide appropriate treatment, we can increase their chances of succeeding in school," said Mark Wolraich, MD, chair of the subcommittee that wrote the guidelines and professor of pediatrics at the University of Ok [Read more]
Medical liability concerns drive hospital admission decisions
Medical liability is a key reason physicians admit more emergency department patients and discharge them less, say two studies in the October Annals of Emergency Medicine. In one study, a survey of 849 emergency physicians and patients in two inner-city emergency departments found that 11% of physicians reported "medico-legal" concerns as a primary driver for admitting patients with potential acute coronary syndrome. In another study, researchers compared admission rates for congestive heart failure patients in 27 emergency departments in New Jersey and New York between 1996 and 2010. The percentage of such patients discharged from EDs dropped from 24% to 9%. Concerns about medical liability probably were the reason behind the decreased discharges, study authors said. The findings show that doctors consider factors other than patients' health when making admission choices, said co-author of the coronary study David Newman, MD, an emergency physician and director of clinical [Read more]
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