Tuesday, March 22, 2011

Tuesday Tidbits

OPM released yesterday a benefits administration letter about the upcoming Open Season for the Federal Long Term Care Insurance Program. The Open Season will run from April 4 through June 24, 2011. Here's a link to FAQs about this Open Season.

Also yesterday, the Department of Health and Human Services released to Congress and the public a national strategy to improve healthcare quality. National Underwriter notes that
Drafters mention the cost of care briefly in the new National Strategy for Quality Improvement in Health Care, a document that is supposed to shape U.S. quality improvement efforts. * * * To reduce costs, officials say, “the National Quality Strategy will foster care strategies that reduce redundant and harmful care, for example, by reducing health care-acquired conditions; establish common measures that will help assess the cost impact of new programs and payment systems."
The New York Times reports on Washington State's health technology assessment committee which determines which medical devices and procedures will be covered under the State's Medicaid and state employee health programs. The Times describes the committee "as a living laboratory of the complexities of applying evidence-based medicine, something that is becoming more common as a way to rein in health care costs." The Affordable Care Act created a Patient Centered Outcomes Research Institute to make similar decisions for the Medicare Program. This organization will be funded with per capita fees imposed on health plans beginning later this year (January 1, 2012, for the FEHB Program).

The AMA News reports that the Medicare Rights Center has convinced a federal judge in New York City to rule that the Medicare program must cover off label prescription drugs "when the treatment is medically necessary [according to peer reviewed literature even if] the use is not described in an official medical compendium [of approved off label uses]."  When the Food and Drug Administration ("FDA") approves a prescription drug for the market because testing has proved the drug to be effective and safe, the agency also approves a "label" for the drug. Under the FDA's rules, the manufacturer must market the drug strictly in accordance with the labelled uses, but with the exception of controlled substances, doctors can decide to prescribe the drug for so-called off label uses as the American Cancer Society explains.

The American Medical News also includes a helpful report on how to avoid data breaches.
Kaufman, Rossin & Co., an accounting firm in South Florida, issued a report in February that found practices and hospitals are more likely to experience a breach because of an employee losing a thumb drive, mobile device or stack of paper files than because they were targeted for a malicious hacking.
The firm analyzed 166 breaches affecting 500 or more patients that were reported to HHS' Office for Civil Rights from September 2009 to September 2010 and found that theft and loss were the leading causes.
"Humans truly are the biggest vulnerability within an organization with regard to security and privacy," said Rebecca Herold, a privacy and data security consultant based in Iowa.
Common sense truly is a wonderful trait.

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