How Quest Diagnostics decides expansion to provide precision oncology services?

Quest Diagnostics is expanding its business line to give precision oncology services medicine diagnostics to aid oncologists in giving optimized cancer treatment and care for patients.

Madison, N.J.-based Quest is utilizing the acquisition of two lab businesses–Med Fusion and Clear Point–in Texas to form the basis for a precision oncology services center of excellence. The two labs give a complete range of diagnostic services to physicians and provider networks.

With the acquisitions, Quest will become a preferred provider of advanced oncology diagnostics for The US Oncology Network, which involves Texas Oncology. The US Oncology Network, which is supported by McKesson Specialty Health, a division of McKesson, contains more than 400 locations across the U.S. and more than 1,400 independent community-based physicians.

Quest targets to form a new precision oncology center of excellence that intends to give community oncologists with insights on tracing cancer in sufferers and managing their care.

Quest will give genomic and pathology testing, tumor sequencing and other advanced diagnostics to choose and monitor treatment and predict disease progression.

“Precision medicine is changing the way we treat cancer and offering new hope to people living with the disease, but too often, advanced diagnostics that facilitate the best possible care are out of reach of community oncologists and their sufferers,” claimed Steve Rusckowski, chairman, president and CEO, Quest Diagnostics. “By partnering with McKesson Specialty Health and The Network, we will make Quest’s state-of-the-art genomic analysis readily available to community oncologists everywhere.”

The transaction is anticipated to be completed in the third quarter of calendar year 2017, subject to the satisfaction of customary closing conditions, involving obtaining required regulatory approvals. Additional terms weren’t unveiled.

 

New Treatment to Be Introduced by Researches That Could Give Weeks of Glucose Control For Type 2 Diabetes Patients

To control their blood sugar levels, type 2 diabetes patients constantly require relying on medication, but it is a tricky condition to handle, specifically if you require daily insulin shots.
Researchers have been working on a latest method for delivering diabetes drugs to make them last longer in the body. Now a recent research using both mice and monkeys has indicated potential for treatments that would just need a couple of injections a month.
Few of the latest-generation type 2 diabetes drugs consist of a molecule called GLP1 (glucagon-like peptide-1), which stimulates insulin production in the body just when it requires more glucose.
That sounds ideal, but regrettably, GLP1 has a actually short half-life - it breaks down in the body quickly, making it an impractical long-term treatment on its own.
By combining it with other molecules, it is possible to extend the half-life of GLP1. But that method yet merely gets us to about 3-7 days.
Right now, sufferers in the US already have few options that can be injected weekly, but scientists are searching for a way to slow down the release of the drug itself.
Now a team from Duke University has managed to combine GLP1 with a biopolymer molecule that begins out as a liquid in colder temperatures, but thickens into a gel-like substance in reaction to body heat.
This means the solution can be managed with a simple injection, but once it gets into the body, the drug is released very slowly, so it can control blood glucose levels for longer with merely one dose.
To test how their new solution would work for actual diabetes treatment, the researchers tested the drug in both mice and in rhesus monkeys - 2 species with well-established diabetes models.
They got exciting outcomes in both: in mice, the new GLP1 solution controlled glucose levels for ten days after merely one injection; in monkeys, whose metabolism is slower, the effects lasted up to seventeen days.
More than 2 weeks for one injection is better than any diabetes drug presently on the market.
The team considers that because human metabolism is even slower than in monkeys, theoretically the drug could last longer in individuals, perhaps needing just one injection a month.
"Preclinical information presents compelling proof that this construct would need no more than 2 injections a month for humans, and possibly as few as one per month, particularly given the dose-stacking potential of this system," the researchers write in the paper.
The team considers their new approach to 'trapping' GLP1 in the gel-like substance could be applied to other types of medication, too.
Of course, it is significant to note that so far the method has only worked in animal studies, and scientists will require doing more research to see how the principles would translate to human use.
GLP1-based medications are presently not the first-line treatment for people with type 2 diabetes, but this sounds like an exciting step towards making diabetes management simpler for many.
The study was released in Nature Biomedical Engineering.

Prescription databases to play a vital role in decreasing opioid abuse

In the battles against rampant opioid abuse, physicians have a strong weapon in their arsenal—state prescription databases that detect all prescriptions written for these addictive drugs.

Nearly every state has executed Prescription Drug Monitoring Programs (PDMPs), which record opioid prescribing history of a patient. By leveraging these prescription databases, doctors can access information to make an informed decision about whether sufferers are opioid abusers.

PDMPs gather and share data on prescriptions for controlled substances to flag suspicious prescribing and utilization. Although, not all states need providers to access these kinds of prescription databases prior to writing or filling a prescription.

Researchers have discovered that “must access” PDMPs, which need physicians to consult them before writing prescriptions, primarily reduced opioid misuse in Medicare Part D, based on the review of 3.5 million patient records between the time period of 2007 and 2013. At the same time, their research demonstrated that PDMPs without such compulsory provisions have no effect on curbing opioid abuse.

Regrettably, when provider access isn’t mandatory, data indicates that only small numbers of providers create PDMP logins and actually request patient histories.

“A great instance is Kentucky, which passed a ‘must access’ requirement in the year of 2012 and saw the share of controlled substance prescribers who had developed a login rise from about a third to more than 95%,” claims Colleen Carey, assistant professor of policy analysis and management in the College of Human Ecology at Cornell University.

In accordance to Carey, a healthcare economist, one of the ways states can get providers to start using PDMPs is to pass laws that need physicians to check these databases for their sufferers’ previous prescriptions. She points out that New York has the nation’s toughest laws with those requirements.

“New York (is the) strictest state needing doctors to check the opioid history of ‘every patient, every time,’ which is stronger than any other state,” she claims.

Carey and Thomas Buchmueller, a professor in the Ross School of Business at the institute of University of Michigan, co-authored a paper detailing their findings which are to be released in an upcoming issue of the American Economic Journal: Economic Policy.

“Our results recommend that PDMPs that don’t require provider participation are not effective in decreasing questionable or unsuitable use of prescription opioids,” summarize Carey and Buchmueller. “We do find evidence that ‘must access’ PDMPs have the desired impact of curbing certain kinds of extreme utilization. Particularly, such policies decrease several measures of excessive quantity and shopping behavior. The strongest laws, which cover all ingredients and settings of care and don’t require providers to be suspicious, have larger effects on utilization than weaker laws, but even ‘limited’ and ‘discretionary’ laws lower rates of shopping behavior.”

Doctor shopping is explained as seeing multiple providers to procure prescription medications illicitly. In their research on “must access” PDMPs, Carey and Buchmueller found that Medicare opioid users who got prescriptions from 5 or more physicians—a common indication of doctor shopping—dropped by 8%, while the percentage of those who got opioids from 5 or more pharmacies was reduced by 16%.

Nevertheless, the researchers also analyze that the “passage of a ‘must access’ PDMP might prompt people to cross state lines in search of less-regulated prescribers and pharmacies.”

 

EHR information indicates reduction in opioids prescription by doctors

As the opioid issues reaches epidemic proportions, latest electronic heath record data show that physicians are giving opioids prescription to fewer sufferers, and they are also being stingy when it comes to prescribing drugs to treat opioid dependence.

Athenahealth, a cloud-based electronic health record (EHR) vendor, observed data from more than 2 million sufferer visits from the first quarter of 2014 to the first quarter of 2017 year.

While the misuse of opioids prescription has emerged as an urgent public health crisis, what researchers discovered is that opioids prescription have been steadily reducing over that time period.

“We have seen doctor prescribing patterns decreasing,” claims Josh Gray, vice president of athenaResearch. “It is been specifically notable, for instance, that orthopedic surgeons and primary care physicians have seen decline.”

Based on the EHR data, both orthopedic surgeons and primary care physicians are prescribing opioids to fewer patients.

At the similar time, Gray points out that more sufferers have opioid addictions but there has only been a slight increase in providers prescribing drugs to treat opioid dependence, which he observes as a troubling development.

“If you are a doctor and you are reducing the frequency with which you give patients opioids prescription, some of those sufferers might be dependent,” observes Gray. “You would like to think that at least the healthcare system would be giving medication-assisted treatment to patients that are addressing with dependence or active addiction.”

He adds that the proportion of doctors in athenaResearch’s dataset that prescribe buprenorphine, a medication that decreases or eliminates withdrawal symptoms linked with opioid dependence, has “barely nudged up” which Gray explains as a “terrible” trend.

“Doctors are being much more parsimonious in terms of opioids perscription, but the accessibility to medication-assisted treatment—such as buprenorphine and similar pharmaceutical compounds—is not increasing,” in accordance to Gray. “I am not a physician, but that might be one of the reasons we are seeing continued immensely high levels, if not increases, in overdose deaths. It is not that difficult to procure opioids illegally. So, sufferers who are dependent that cannot get medication to treat their dependence then go to other sources that are not medically supervised, which is highly dangerous.”

Since the year of 2000, more than 300,000 Americans have lost their lives to an overdose from either prescription or illicit opioids, in accordance to the Centers for Disease Control and Prevention. The CDC has been working to make better the opioid prescribing to reduce unessential exposure to opioids and stop addiction.

In the month of December 2016, President Obama signed the 21st Century Cures Act which provides $1 billion in new funding to combat the opioid crisis. Previous week, Health and Human Services Secretary Tom Price, MD, announced that HHS will soon give $485 million in grants to assist states and territories target opioid addiction—the first of two rounds provided for in the Cures Act.

HHS has prioritized 5 particular areas: strengthening public health surveillance, advancing the practice of pain management, making better access to treatment and recovery services, targeting availability and distribution of overdose-reversing drugs, and supporting cutting-edge research.

 

Umatilla County Human Services rolls out the expansion of drug, alcohol; treatment

Umatilla County Human Services rolled out an expansion of drug treatments and alcohol rehab programs at the start of February month. Department director Amy Ashton-Williams claimed that the moves are about offering more services to more individuals.

Ashton-Williams took the job in the year of July 2016 to head up a county division that lost its director and 2 alcohol and drug counselors the year before after an administrative investigation. She stated that the department’s staff was doing the best it could in the wake of the turmoil, but she needed to explore ways to better give intensive outpatient treatment for individuals with drug or alcohol issues.

“It took about 4 months of evaluating what new curriculum we required, what really were the requirements of our clients ... and getting a couple of clinicians trained in a specialized parenting program,” she said.

The expansion gives a “pretty comprehensive outpatient program,” she stated, that considered the needs in Pendleton, Hermiston and Milton-Freewater.

Milton-Freewater went from 3 drug and alcohol groups to five, involving two for Spanish speakers and an English-speaking group concentrated on how to stop addiction relapses. Ashton-Williams also said a third Spanish-speaking group is likely.

Hermiston and Pendleton added groups in the mornings and afternoons to better meet the requirements of swing and day shift workers. The Umatilla County Human Services also added a drop-in group at 8:30 a.m. in Hermiston and one at noon in Pendleton. She stated that these are good fits for those who’re not certain they have an issue or about treatment but want to check out the possibilities.

Hermiston and Pendleton also now have groups meeting twice a week for youth with addiction issues. Ashton-Williams claimed that there are 5 clients in Hermiston and 3 in Pendleton, and she is hopeful those will draw more youth in need.

“We know in our communities there are youth who’ve struggled hard with alcohol and drug use,” she stated, and these groups can assist break those cycles of addiction.

And 2 human services workers learned the community model of the Parenting Inside Out program, which the prison system utilizes to teach parenting skills to offenders. Ashton-Williams claimed that the community model is for parents with open cases in the Oregon Department of Human Services.

“We’ve many clients that come to us from DHS,” she asserted, and this program deals with parenting “from birth until they leave the home.”

Ashton-Williams applauded the clinicians with making the improvements while still giving stress and anger management and other services.

And starting in the month of March, she said her department is joining hands with county public health to have an alcohol and drug prevention worker take on suicide prevention.

Umatilla County Human Services, like other regional governments, is searching at a tight budget for the time period of 2016-17. Ashton-Williams said her staff knows that road well and know how to do more with less.

“We have seen a minor decrease in our budget from the state,” she said, “but not so much that we cannot continue the services that we are presently providing.”

 

Tabula Rasa HealthCare Initiates Part D Enhanced Medication Therapy Management Program To Make Better Medication Use

Tabula Rasa HealthCare, Inc., a healthcare technology company giving medication safety solutions for health plans and provider groups, victoriously launched, on the day of January 1, 2017, a pilot program to establish and deliver an Enhanced Medication Therapy Management (i.e., Enhanced MTM) program. The pilot involves 7 states included in Medicare Part D Region 25: Iowa, Minnesota, Nebraska, Montana, North Dakota, South Dakota, and Wyoming. The program deals the requirements of the Part D Enhanced MTM Model test proposed by the Centers for Medicare and Medicaid Innovation (CMMI), a division of the Centers for Medicare and Medicaid Services (CMS).

Tabula Rasa HealthCare has deployed its proprietary science and technology Medication Risk Mitigation products and services to conduct 360-degree reviews and safety assessments of complex medication regimens, giving an innovative, alternative approach to personalized pharmacotherapy. In this pilot, Tabula Rasa HealthCare has performed medication risk stratification of almost 240,000 members to recognize members at the highest risk for adverse drug events.  As a next step, TRHC is cooperating with members who recognize as high risk for an adverse drug event, and their prescribers, to more personalize their medication regimens thereby optimizing pharmacotherapy treatment.

“This EMTM compliance is a thrilling project – and new market – for us, as we’re tasked with optimizing medication use, hence decreasing medication-related hospitalizations, and making better coordination of care for tens of thousands of older Americans. This is the 1st application of our proprietary software outside of the Program for All-inclusive Care of the Elderly (PACE) market, and we consider we can drive similar improvements in outcomes as we do with our PACE partners, involving reductions in falls, emergency room visits, and hospitalizations,” claimed Calvin H. Knowlton, PhD, Chairman and CEO of Tabula Rasa HealthCare. “We consider TRHC’s approach to medication risk mitigation, which is deployed on the science of individual drug metabolism within a multi-drug regimen, fosters personalization of each medication regimen, which enables better member health outcomes and cost savings. Moreover, this is a great instance of the scalability and flexibility for our Medication Risk Mitigation Software Platform, MedWise Advisor®, as well as our personalized Medication Decision Support procedures.”

 

Good Shepherd Health seems to reduce prescription costs

Pharmacist Philip Baker launched the doors of Good Shepherd Health more than a year ago to offer free or at-cost prescriptions to uninsured people in the region of Memphis. Baker rapidly discovered that individuals covered by Medicare required the services of the nonprofit pharmacy. He founded that even individuals with insurance too often could not afford the high cost of drugs or prescription costs.

Now, he has set his sights on advancing the way self-insured employers pay for medicines of their employees. Good Shepherd plans to give its at-cost model for prescriptions to chop the drug costs of employers, competing with for-profit pharmacy benefit managers like Express Scripts Inc.

“I’ve a vision to entirely revolutionize the whole industry and that is by making PBMs, pharmacy benefit managers, obsolete,” Baker stated.

According to Baker, employers are paying the complete price for prescription costs and the mark-up on those drugs can be breathtaking.

Plavix, a drug utilized to stop blood clots and one of the most usually used, is his favorite instance.

Huge drug companies get a worse rap, and they should, for pricing brand-name drugs too high, he stated. Although, the major majority of drugs on the market are generic and he claimed for-profit pharmacies and pharmacy benefit managers are marking those up.

By eliminating the profit and giving its medication management service for employers for a fee, Baker stated “merely initial numbers we are looking at we can decrease the company’s drug costs by thirty or forty percent right off the top.”

Good Shepherd has not sold the idea yet, but is in talks with various companies, stated Baker, 40, a University of Tennessee Health Science Center College of Pharmacy graduate and former rehabilitation hospital director of pharmacy.

With a half dozen workers and headquartered in the Hickory Ridge Towne Center mall, Good Shepherd has offer $1.3 million worth of free medicines and served over 1,000 since opening in the year of September 2015, Baker claimed.

Despite nationwide attempts to assist uninsured individuals with the prescription costs drugs, charity pharmacies like Good Shepherd have sprung up to help meet the requirement in the last decade, stated Chris Palombo, chief executive of Dispensary of Hope in Nashville.

Dispensary of Hope is basically a nonprofit drug distributor that gets donated drugs from manufacturers and physician practices and supplies them to free and federally qualified clinics across the country, involving Good Shepherd, Palombo stated.

With estimates of more than thirty million uninsured persons nationwide, the requirement is massive and uninsured and low-income indivudals also suffer more chronic sicknesses, he claimed.

Help with prescriptions is falling short for millions, in spite of the Affordable Care Act, a separate federal program called as “340B” that gives steeply discounted drugs to several hospitals and federally qualified health centers, and drug manufacturers’ patient assistance programs.

Baker is crucial of the federal programs and said Good Shepherd does not participate in Medicare or any insurance program.

Huge deductibles that must be met before insurance pays under coverage available through Affordable Care Act leaves few sufferers unable to afford their drugs, he stated. And he called the 340B program “corrupted,” utilized as a profit-center for hospitals and health centers that need to treat it as one.

By giving free prescriptions to those with incomes that are eligible, at-cost drugs and tapping in to manufacturers’ patient assistance plans, Baker said Good Shepherd stitches together policies for both the uninsured and the insured. Sufferers with chronic conditions have become the major niche of agency.

Good Shepherd’s vision for providing services to employers and revolutionizing the industry also will assist to subsidize its charitable work and other ventures and will try to reduce the prescription costs.

 

OVERCOMING PAIN WITHOUT THE NEED OF DRUGS

Pain impacts more Americans than the heart disease, diabetes and cancer combined. It is the most usual cause of long-term disability, and it mostly leads to the depression and painkiller addiction. But what if there was a solution to heal the pain or overcoming pain without the need of drugs or meds? Martie salt indicates us how one famous hospital is providing an alternative access that is covered by insurance.

Horse shoeer Chris Wightman has lived a life of pain and adventure.

He claimed, "My lifestyle is a wanna-be cowboy!"

He had compressed discs, knee surgery, sciatica, torn rotator cuffs, arthritis, pinched nerves and tennis elbow. To make situation worst, Chris has a blood vessel and liver condition that makes using pain meds risky.

Chris stated, "I did not have much at my disposal. I was very depressed, and i was self-medicating with alcohol."

But today, pain of Chris is under control thanks to a unique program provided at the Cleveland Clinic. All credit goes to Cleveland Clinic for helping people in overcoming
pain without the need of drugs.
It combines alternative approaches such as yoga, hypnotherapy, massage, acupuncture, chiropractic care, Chinese herbal medicine and emotional health training, all in 1 place.

Josie Znidarsic, DO, staff physician from the Cleveland Clinic, stated, "We utilize everything that we’ve here to offer them as many choices as we can."

An in-depth analysis of twenty-nine researches involving almost 18,000 people discovered acupuncture led to a 50% reduction in pain. A research in the annals of internal medicine indicated patients with neck pain who utilized a chiropractor or exercised were more than twice as likely to be pain-free after twelve weeks as those who took meds.

It is been over one year since Chris has utilized alcohol or drugs for pain-relief.

He claimed, "I am high on life. It totally changed my life."

Doctors considered the Cleveland Clinic's drug-free pain management program is the mere one of its kind in the country for overcoming pain without the need of drugs or meds. They presently have a waiting list of almost 100 sufferers who need to participate, and they are putting together a research report to share their processes and techniques with other hospitals.

 

DoD inspector asks whether EHR decline of agency will be met

The Defense Department’s policies to implement a new electronic health record (EHR) system by the month of December may not be realistic, in according to a new audit from the DoD Office of the Inspector General.

In July 2015, the Pentagon granted a $4.3 billion contract award to a Leidos-Cerner team to modernize DoD’s EHR system. Called the Defense Healthcare Management System Modernization (DHMSM), the integrated system is designed to replace legacy military health systems and promote greater efficiencies by leveraging commercial-off-the-shelf Cerner Millennium solution.

An initial deployment is slated for December, when the EHR will be rolled out to DoD locations in the Pacific Northwest. But the OIG is concerned that the DHMSM program schedule might not meet initial operational capability needs by the end of this year.

“While the DHMSM program office has recognized the threats and mitigation strategies, it is still at risk for obtaining an EHR system by the December 2016 initial operational capability date due to the risks and potential delays involved in developing and testing the interfaces required to interact with legacy systems, ensuring the system is secure against cyber attacks, and ensuring the fielded system works correctly and that users are properly trained,” concluded the OIG report, which was released on Tuesday.

However, speaking that similar day at the ONC Annual Meeting in Washington, DC, Stacy Cummings, program executive officer for the Defense Healthcare Management Systems program, gave no indication that the EHR implementation schedule might be at risk because of potential delays with interfaces and inadequate training.

“We are going to be doing testing both prior to and during the deployment to make sure that our interfaces are working, to ensure that the workflows are working, as well as to make sure that it’s operationally suitable for our needs in the Department of Defense,” said Cummings, who oversees DoD’s EHR modernization, including the operational, infprmation exchange and interoperability initiatives.

She added that DHMSM is contributing in training, change management and coaches to aid the deployment of the new EHR. “As we deploy to a location, we are not just training people how to use the system,” stated Cummings. “We’re actually teaching them how to take advantage of the business processes and the decision support that is inherent in the commercial tool.”

Nonetheless, the OIG suggested that Cummings, as the program executive officer for Defense Healthcare Management Systems conduct a schedule analysis to determine whether the December 2016 initial operational capability deadline is achievable and remain to monitor DHMSM program threats and report to Congress quarterly on the progress of the program.

FDA proposes instructions on utilizing EHR data in clinical trials

New draft instructions from the Food and Drug Administration (FDA)) cover deciding whether and how to utilize EHRs as an information source in the clinical trials.

While the new instruction offers general guidance on EHR abilities, the new draft doesn’t involve provisions under which the FDA would assess agreement of records systems.

The agency’s draft covers utilizing EHRs that interoperate with electronic networks supporting trials, and explains ensuring the quality and integrity of information accumulated and used. FDA will agree to the comment on draft recommendations for sixty days before establishing final guidance.

The FDA’s lead in this place is significant because facilitating the correlation between EHRs and clinical trials would offer important benefits in speeding and cutting the prices of clinical trials, as well as streamlining the procedure of finding sufferers for research.

FDA initially released the separate guidance on electronic source information in clinical investigations, which appreciated that data can come from several sources and be entered into the trial sponsor’s Case Report Form (CRF), which is a paper or electronic questionnaire. This could involve information from EHRs—this latest proposed instruction concentrates on such data.

The agency doesn’t intend to actively assess agreement of EHRs used in trials with its rules. “Although, FDA’s acceptance of data from clinical investigations for decision-making purposes relies on FDA’s capability to verify the quality and integrity of data during FDA on-site inspections and audits,” in accordance to the guidance. Consequently, the agency is clarifying few hopes when EHRs are utilized as a source of data.

For example, FDA points out that interoperability of EHRs and a trial sponsor’s electronic data capture system (EDC) can simplify information collection by getting correct source data when a patient gets care. Such interoperability also can decrease the transcription errors and ease interpretation of data.

“FDA motivates the sponsors and clinical investigators to work with the entities that control the EHRs, like healthcare agencies, to use EHRs and EDC systems that are interoperable,” the draft guidance claims.

Another best practice for utilizing the EHR data in clinical trials is making sure the data is attributable, legible, contemporaneous, original and accurate. Further, FDA suggests utilization of ONC-certified EHRs and other health IT due to clear differences in interoperability and keeping data confidential.

Non-certified EHRs may be utilized, but should be assessed to determine if adequate controls are in place to make certain the data confidentiality, integrity and reliability. The assessment should involve limited access to electronic networks; identification of authors of records; audit trails to track changes to information; and availability and retention of records required for FDA inspection.

Moreover, trial sponsors should outline data flow between the EHR and the electronic data capture system, in accordance to FDA.

Other highlights of the instructions involve:

• When healthcare experts not part of the investigation modify or accurate EHR data that will be utilized in a trial, ensure modifications don’t obscure previous entries.


• Audit trail documentation of HER information should be retained at least as long as the time period needed for the subject’s electronic records, and should be present for FDA to review and copy.


• Informed consent must involve the extent to which subject confidentiality will be maintained and recognize entire entities who might have access to the subject information.


• Sponsors should consider safeguards to secure information from subjects who participate, decide to discontinue involvement or are discontinued from involvement by the clinical investigator.

How Opioid Abuse Invests To Rising Healthcare Prices

As the opioid epidemic in the USA sustains taking lives across the nation, it is also investing to rising healthcare prices for taxpayers.

Released in the May issue of the journal Health Affairs, a latest retrospective cohort research disclosed that hospitalizations regarded to opioid abuse/dependence rose importantly from 301,707 in the year 2002 to 520,275 in the year 2012, an increase of 72 percent. Overall hospitalizations during the similar time period sustained highly consistent: moderately growing from 36.52 million to 36.48 million.

Through email, study author Dr. Matthew Ronan, a hospitalist at the VA Boston Healthcare System’s West Roxbury Medical Center and a proposed instructor at the institute of Harvard Medical School, stated that injection opioid abuse leads to several difficulties, one of the most famous is critical infection.

Opioid-regarded hospitalizations with crucial infection jumped 91 percent to 6,535. Observing trends arranged within individual kinds of infection, the investigators discovered similar progress in the various cases of endocarditis (1.5-fold increase), septic arthritis (2.7- fold), osteomyelitis (2.2-fold), and epidural abscess (2.6-fold).

“Our research features the sobering effect of these infections on healthcare systems, but also on the sufferers themselves who are suffering from the immense addiction," he asserted. "Up to 5% of sufferers presenting to the hospital with an infection regarded to their opioid abuse will die during the process of hospitalization. Out of those that survive and live to hospital discharge, more than the rate of quarter will be too much functionally damaged to  go back home instantly and will require spending time in a rehab or qualified nursing facility and service. These are the proposed sobering statistics in a sufferer population with an average age of forty-three years.”

Dr. Shoshana Herzig, a hospitalist and impressive director of Hospital Medicine Research at Beth Israel Deaconess Medical Center and an assistant professor of medicine at the institution of the Harvard Medical School claimed the conclusions of research disclose the requirement for clinicians to prescribe the abusive narcotics more judiciously than they have been ever.

The fed's latest 'war on drugs': Obama suggests $1.1 billion to extend care for opioid addicts

Amid a proposed prescription opioid abuse and heroin use epidemic highly fueled by over prescribing among the doctors, President Obama has recommended giving $1.1 billion to extend affected people individuals’ approach to care— a suggestion that has garnered bipartisan support. However few professionals question whether throwing money at the problem will be enough, several consider that, if utilized properly, the funding has the possibility to save lives.

In accordance to the Centers for Disease Control and Prevention (CDC), almost half a million Americans lost their lives from drug overdoses between the years of 2000 and 2014. Opioid overdose deaths, involving those from heroin, hit record highs in the year 2014 and observed a 14% increase in only 1 year.

Baltimore City Health Commissioner Dr. Leana Wen, who has served as an emergency room doctor in 1 of the nation’s opioid addiction hotspots, claimed the proposal offers a shift in views about addiction as an individual’s issue best controlled with law imposition, to a chronic medical condition such as diabetes or heart disease that can be stopped and treated.

“That science has been around for many decades, and society’s view point has grabbed up.”

“A pill for every pain”

In the year 2014, 259 million opioids— or sufficient for every American adult— were prescribed, in accordance to the CDC. The most usual prescribed opioid pain relievers were natural or semi-synthetic opioids such as oxycodone and hydrocodone, which are included in the most overdose deadly deaths among opioids. The CDC observed 813 more deaths, a 9% increase, from these kinds of opioids in the year 2014 than 2013.

Over the previous decades, the deaths resulting from the extreme opioid abuse and abuse of illegal narcotics such as heroin have reached on peaks.

A study issued in the month of November 2015 issue of the journal Proceedings of the National Academy of Sciences recommended overdoses from drugs such as opioids is believed to be one of the primary reasons why deaths of middle-age white Americans are rising while the overall death amount in USA has fallen.

Drug-Dispensing Physicians Charge More Than Pharmacies

August 21, 2012 — Physicians who dispense pain medications and other commonly used drugs to workers' compensation (WC) patients charge up to 3 times more than pharmacies in some states, according to a recent study from the not-for-profit Workers Compensation Research Institute (WCRI).

That kind of mark-up could explain why physician dispensing for WC patients has grown at a rapid clip in recent years, and why some states now limit how much clinicians can charge. However, a desire for profit may not be the only reason why physicians charge more than pharmacies. Another factor may be wholesale prices that physicians pay to obtain the drugs that they sell.

The WCRI study, published in July, compares 23 states, including 3 (Massachusetts, New York, and Texas) in which physician dispensing in general is prohibited. Author Dongchun Wang, a senior researcher at WCRI, examined WC claims for work-related injuries that were submitted and paid during 2 periods: from 2007 to 2008 and from 2010 to 2011. WC claims typically are processed by private insurers.

Illinois stood out as the epicenter for physician dispensing for WC patients. From 2007-2008 to 2010-2011, the percentage of all prescription drugs for WC patients that were dispensed by physicians rose from 26% to 43%, the fastest growth of any state in the study. More significantly, physician dispensing represented 63% of total spending on WC prescriptions in 2010-2011 compared with just 22% in 2007-2008.

In a trend repeated in other states, Illinois physicians raised prices for the drugs they dispensed — most of them generic versions — during this period, even as pharmacies were lowering theirs. For example, Illinois physicians in 2007-2008 charged 87 cents on average for a hydrocodone/acetaminophen (Vicodin, Abbott) pill compared with 54 cents charged by pharmacies.

By 2010-2010, the physician price for the analgesic had jumped 66%, to $1.44 per pill, whereas the pharmacy price had dropped to 53 cents. (Hydrocodone/acetaminophen was the most commonly dispensed drug that physicians and pharmacies alike dispensed to WC patients in 2010-2011, followed by ibuprofen, meloxicam, tramadol, and cyclobenzaprine).

Physicians also jacked up the price of over-the-counter drugs they handed to WC patients, charging as much as 15 times more than pharmacies.

In Florida, Georgia, Illinois, and Maryland, for example, WC patients paid physicians on average $4 to $7 for a pill of ranitidine (Zantac, Boehringer Ingelheim) when they could have bought it at Walgreens for from 33 to 42 cents, depending on the strength and quantity.

California Law Had Only Small Effect on Physician Dispensing

A number of states during the last 5 years have closed the gap between what pharmacies and physicians charge WC patients for medications, the WCRI study reports. These states generally limit physician reimbursement to the average wholesale price (AWP) that drug makers charge their customers, including pharmacies. In some states, physicians are allowed to tack on a dispensing fee.

Supporters of physician dispensing, writes Wang, have argued that reducing what physicians can charge will discourage them from dispensing, which in turn could hurt patient care. After all, one clinical rationale for physician dispensing is that it increases patient compliance with medication regimens, as patients given a prescription may not necessarily bother to fill it at a pharmacy. In addition, treatment starts much sooner.

Wang, however, did not find a major downturn in physician dispensing for WC patients when she analyzed the effects of a California regulation that equalized what physicians and pharmacies could charge, beginning in March 2007. In the first quarter of 2007, physicians dispensed 55% of medications ordered for WC patients (that percentage had topped 65% 12 months earlier). In the 2010-2011 claim period, dispensing physicians accounted for 53% of WC prescriptions, which is just a tad short of the mark set in early 2007.

The biggest change in California since 2007, writes Wang, was the location at which physicians obtained the drugs they dispensed. In early 2007, they bought them mostly from so-called repackagers, who buy them in bulk from manufacturers and repackage them in smaller, prescription-sized quantities. Repackaging companies, writes Wang, often sell their drugs at a much higher AWP than drug manufacturers. By 2010-2011, dispensing physicians had largely switched to buying generally less expensive non-repackaged drugs in bulk. Wang's study did not provide details on the difference in wholesale prices between repackaged drugs and bulk drugs and how that might affect what dispensing physicians charge.

The WCRI study undercuts another argument against limiting what physicians can charge — that if physician dispensing decreases or disappears, patients will pay higher prices at the pharmacy. The reasoning here is that physicians invariably dispense generic drugs, whereas pharmacies dispense both generic drugs and more costly brand-name versions.

However, Wang found that for the drugs most commonly dispensed by physicians, the generic version was almost always dispensed by physicians and pharmacies alike, meaning that patients did not face the prospect of paying for a brand-name drug at the pharmacy. Moreover, physicians invariably charged more than pharmacies for the generic drugs they handed to patients.

Medicare Mailing eRx Pay-Cut Letters to Physicians

October 18, 2011 — Physicians participating in Medicare should read their mail carefully over the next few weeks. There could be a letter warning them about a possible 1% pay cut next year because of their failure to meet the program’s e-prescribing requirements, the Centers for Medicare and Medicaid Services (CMS) announced today.

Anyone who opens such a letter may have enough time to beat a November 1 deadline to apply for a hardship exemption from the penalty, dubbed a "payment adjustment" by CMS.

Companies who process and pay Medicare claims on behalf of CMS began mailing out the letters Monday, said Michael Rapp, MD, JD, director of the Quality Measurement and Health Assessment Group in the CMS Office of Clinical Standards and Quality, during a conference call with providers today. The agency had intended to inform physicians about the e-prescribing penalty through a so-called Payment Adjustment Feedback Report that they could access at the CMS Web site, but the reports will not be ready to post until late November or early December. So CMS resorted to snail mail to get the word out, said Dr. Rapp.

The mailing should be completed by October 25, just days before the November 1 deadline to apply for an exemption from the penalty.

In addition, in the coming weeks Medicare help-desk personnel will telephone physicians who unsuccessfully attempted to comply with the eRx requirements to give them a head’s up about the penalty.

CMS will inform physicians only about the possibility of a penalty because the warning is based on a preliminary as opposed to a final analysis of claims data, said Molly MacHarris, a policy analyst in Dr. Rapp’s department at CMS, during the conference call.

Penalties Increase Over Time

In 2009, Medicare began paying bonuses to physicians and other clinicians who qualified as "successful" e-prescribers — that is, they reported electronically transmitting a certain number of prescriptions from their computer to a pharmacy computer. In 2011 and 2012, the bonus equals 1% of a clinician’s fee-for-service (FFS) charges. It drops to 0.5% in 2013, the last year of the incentive program.

Meanwhile, physicians who have not satisfied the complicated rules for e-prescribing this year face a 1% reduction in their FFS charges in 2012. The penalty increases to 1.5% in 2013 and 2% in 2014.

Not every physician is subject to the eRx penalty next year. Someone who was not licensed as of June 30, 2011, for example, need not do anything. Physicians who are subject to the penalty can apply for 1 of 6 exemptions, which cover situations such as practicing in a rural area that lacks high-speed Internet access. They can submit their exemption application at a CMS Web site called the Quality Reporting Communication Support Page. Medical groups participating in Medicare's Physician Quality Reporting System under the Group Practice Reporting Option must apply for a hardship exemption in writing. Either way, the deadline is November 1.

More information on the e-prescribing incentive program, and how to obtain an exemption, is available on the CMS Web site.

CMS Proposes More Loopholes for E-Prescribing Penalty

July 19, 2011 — The federal government will begin to penalize some physicians next year for not electronically transmitting their Medicare patients' prescriptions to pharmacies. At the same time, the government wants to help physicians avoid paying those penalties.

In proposed policies for the 2012 Medicare Physician Fee Schedule (PFS) released earlier this month, the Centers for Medicare and Medicaid Services (CMS) unveils a plan to lower the bar for complying with its e-prescribing imperative, as well as giving physicians more time to do what it takes to avoid the penalty, euphemistically called a "payment adjustment." That adjustment for "unsuccessful" e-prescribers is 1% of PFS charges in 2012, 1.5% in 2013, and 2% in 2014.

The penalties come alongside bonuses for successful electronic prescribers in Medicare: 2% of PFS charges in 2009 and 2010, 1% in 2011 and 2012, and 0.5% in 2013. In its new policy recommendations, CMS states that the criteria for incurring the penalty need not be identical to the criteria for earning the bonus.

"In general, we believe that an incentive should be broadly available to encourage the widest possible adoption of electronic prescribing, even for low volume prescribers," CMS states. "On the other hand, we believe that a payment adjustment should be applied primarily to assure that those who have a large volume of prescribing do so electronically, without penalizing those for whom the adoption and use of an electronic prescribing system may be impractical given the low volume of prescribing."

In addition, CMS said that physicians and other prescribers who qualify for the bonus "have sufficiently demonstrated their adoption and use of electronic prescribing technology and thus should not be subject to the payment adjustment in a future year."

Less Work Needed to Avoid Penalty Than to Earn Bonus

As with its incentive program for electronic health records (EHRs), CMS is waving financial carrots and sticks to encourage clinicians to e-prescribe for the sake of patient safety and cost control. Both the federal government and the healthcare industry define electronic prescribing as transmitting a script from a clinician's computer to a pharmacy's, as opposed to writing a script with software and either faxing it or printing it out for hand delivery.

To receive the bonus for 2011, clinicians must generate at least 25 e-prescriptions on separate visits throughout the year, in conjunction with 56 particular billing codes for medical services, mostly having to do with evaluation and management. These codes must account for at least 10% of the clinician's Medicare allowed charges. In addition, clinicians must use a qualified e-prescribing software program.

It takes less work to avoid the penalty than to earn the bonus. Physicians will see their Medicare reimbursement shrink by 1% in 2012, the first year for payment adjustments, if they failed to generate at least 10 e-prescriptions through the first half of 2011. The penalty will not apply to physicians who lack at least 100 claims involving the 56 billing codes through the first half of the year, lack prescribing privileges, or were not licensed practitioners as of June 30, 2011. In addition, physicians also can claim a hardship exemption if they practice in a rural area without sufficient high-speed Internet access, or where pharmacies do not receive electronic prescriptions.

The penalty in 2013 currently depends on one's prescribing performance in 2011. If clinicians qualify for an incentive payment this year, they avoid the payment adjustment 2 years later.

In May, CMS proposed 4 other hardship exemptions for the 2012 penalty and a longer deadline for claiming one. One new exemption widely praised by physicians involves the federal incentive program for EHRs, which requires participants to e-prescribe. Under the May proposals, clinicians who register for the EHR incentive program and adopt certified EHR technology would be exempt from the e-prescribing penalty in 2012. The comment period on these recommendations ends July 25.

The CMS proposals released on July 1 would give clinicians a second chance to avoid penalties in 2013 and 2014. In case they failed to earn an e-prescribing bonus in 2011, clinicians also could escape the 1.5% reduction in 2013 if they report submitting at least 10 electronic prescriptions in the first half of 2012. In addition, these 10 prescriptions could be associated with any PFS billing code, not just the 56 codes required to earn the incentive.

The same rules would govern the 2014 payment adjustment: The adjustment would not hit clinicians who earn a bonus in 2012 or report at least 10 electronic prescriptions in the first half of 2013, regardless of the services rendered during those visits.

Proposals Fail to Lower Bar Enough, Says AAFP Official

The July proposals also apply 2 of the 4 new hardship exemptions from the 2012 penalty to 2013 and 2014; namely, the inability to e-prescribe because of local, state, or federal restrictions, and prescribing fewer than 100 scripts during a 6-month reporting period for payment adjustments. CMS did not recommend extending the exemption for clinicians who register in the EHR incentive program to 2013 and 2014, which was a decision that disappointed Steven Waldren, MD, director of the Center for Health Information Technology at the American Academy of Family Physicians.

Preserving the exemption based on participation in the EHR incentive program "would definitely lower the bar" for clinicians seeking to avoid the e-prescribing penalty, Dr. Waldren told Medscape Medical News. He also said that CMS should have addressed the issue of physicians finding it difficult to verify with the agency that they are complying with e-prescribing requirements.

As they stand, the proposed changes to the e-prescribing incentive program "lower the bar some," but nevertheless amount to "small potatoes," according to Dr. Waldren.

The comment period for the July 1 proposal, posted on the Federal Register, ends on August 30. The draft regulations explain several ways to submit comments.

More information on the e-prescribing incentive program, and on how to apply for an exemption, is available on the CMS Web site.

E-Prescriptions Just as Error-Prone as Paper Scripts

July 1, 2011 — Government and the healthcare industry have placed big bets on digital technology, and electronic prescribing in particular, for the sake of patient safety, but a new study reports that the error rate with computer-generated prescriptions in physician offices roughly matches that for paper scripts: about 1 in 10.

However, results from the study, published online June 29 in the Journal of the American Medical Informatics Association, are not as damning as they may initially appear. Error rates varied widely depending on the type of e-prescribing software used, with some programs outperforming pen and paper. In addition, software improvements could eliminate more than 80% of the mistakes, most of them involving omitted information.

In 2010, an estimated 190,000 physicians were electronically prescribing, the technical term for transmitting scripts directly to a pharmacy computer, according to a pharmacy industry group called Surescripts. That number does not include physicians who create a prescription with computer software and then either fax it to the pharmacy or give patients a printout.

Since 2009, the federal government has been paying hundreds of millions of dollars in Medicare bonuses to physicians and other clinicians who electronically prescribe. The government operates an even pricier incentive program for electronic health records, and e-prescribing is one of the prerequisites for earning a 6-figure bonus.

The new study study examined nearly 3900 computer-generated prescriptions received by a pharmacy chain in 2008 in Florida, Massachusetts, and Arizona, regardless of whether they were faxed or electronically transmitted to pharmacies or were printed out. Of those prescriptions, 11.7% contained at least 1 error. Researchers did not ascertain whether errors were corrected by the pharmacy chain or whether they led to an actual adverse drug event. Lead author Karen Nanji, MD, MPH, writes that the 11.7% figure is "consistent with the literature on manual handwritten prescription error rates."

Roughly one third of the errors represented potential adverse drug events, none of them life-threatening.

Software Improvements Must Be Physician-Friendly

Omitted information such as drug dose, duration, and frequency accounted for almost 61% of the errors detected by the authors. The rest of the errors stemmed from unclear, conflicting, or clinically incorrect information.

Software improvements, Dr. Nanji and coauthors write, could eliminate the vast majority of these mistakes. E-prescribing programs can incorporate so-called forcing functions that would prevent physicians from completing a prescription unless they enter required information, including complete drug names and proper abbreviations. Likewise, decision-support tools can issue alerts about a wrong drug dose or frequency. However, the authors note, physicians may rebel against e-prescribing software if antierror safeguards make it too slow or annoying to use.

Some e-prescribing programs included in the study appeared to give users a technological edge. The error rate associated with one such program was only 5.1% compared with a whopping 37.5% for another. However, the study did not assess whether the root cause was system design or how well or poorly the systems were implemented in physician offices. Training physicians and staff on new software systems, the authors note, is often given short shrift.

The study was supported by the federal Agency for Healthcare Research and Quality and the Harvard Risk Management Foundation. The authors have disclosed no relevant financial relationships.

J Am Med Inf Assn. Published online June 29, 2011. Abstract

Aspirin sharply reduces cancer risk: study

A small, daily dose of aspirin significantly diminishes the risk of death from a wide range of cancers, according to a landmark study released Tuesday. 

Earlier work by the same team of scientists showed that the century-old remedy for aches and pains, long a staple of family pharmacies, can help ward off colon cancer.

The new study, published in the British medical journal The Lancet, reveals for the first time that aspirin also helps protect against prostate, lung, brain, and throat cancers, among others.

"These findings provide the first proof in man that aspirin reduces deaths due to several common cancers," said Peter Rothwell, a professor at the University of Oxford and lead author of the study.

Rothwell and colleagues reviewed eight previous clinical trials involving a total of more than 25,500 patients. In each, some subjects took aspirin and others look-alike placebos.

None of the studies were originally designed to measure the impact of the drug on the incidence of cancer.

During the trials, which lasted four-to-eight years, doses of aspirin as low as 75 milligrams -- a fraction the normal dose for a headache -- cut cancer deaths overall by 21 percent.

Risk was especially reduced after five years of treatment with the drug, by 30 to 40 percent depending on the type of cancer.

Three of the eight trials ran long enough to examine the impact of aspirin over a period of two decades.

The 20-year risk dropped on average by a fifth: 10 percent for prostate cancer, 30 percent for lung cancer, 40 percent for colon cancer, and 60 percent for oesophageal cancer.

For cancer of the lung and throat, the protective effect was confined to adenocarcinomas, the type typically seen in non-smokers.

"Perhaps the most important finding for the longer term is the proof of principle that cancers can be prevented by simple compounds like aspirin, and that 'chemo-prevention' is therefore a realistic goal," Rothwell said.

The length of time before the benefits of taking aspirin kicked in also varied: five years for throat, pancreatic, brain and lung cancer, about 10 years for stomach and colorectal cancer, and 15 years for prostate cancer.

The reductions in stomach and brain cancers, however, were more difficult to quantify because of the smaller number of deaths recorded.

"These promising results build on a large body of evidence suggesting that aspirin could reduce the risk of developing or dying from many different types of cancer," said Ed Yong of Cancer Research UK in commenting on the study.

"This tells us that even small doses reduce the risk of dying from cancer provided it is taken for at least five years."

Many doctors recommend regular use of aspirin to lower the risk of heart attack, clot-related strokes and other blood flow problems.

But daily use of the drug, available without prescription, may cause stomach problems, including stomach bleeding. Alcohol use can aggravate these symptoms.

"We encourage anyone interested in taking aspirin on a regular basis to talk to their doctor first," Yong said.

Aspirin is believed to have a preventive effect because it inhibits an enzyme called COX-2, which promotes cell proliferation in cancer tumours.
In rich nations, the lifetime risk of developing cancer is about 40 percent, with rates in the developing world increasing.

Rule OKs E-Scripts for Controlled Rx

The Drug Enforcement Administration in the Department of Justice has published a long-delayed interim final rule, with a comment period, to permit electronic prescriptions for controlled substances.

The rule is available at the Federal Register's public inspection site at federalregister.gov/inspection.aspx, and will be officially published on March 31, effective 60 days later. The DEA will accept public comments during the 60-day interval.

Controlled substances are drugs that have the potential for abuse or dependence, including opiates, stimulants, depressants, hallucinogens and anabolic steroids. These drugs account for up to 20 percent of all prescriptions, according to various studies, which has forced providers that have adopted electronic prescribing to still maintain paper processes.

The rule will permit pharmacies to receive, dispense and archive electronic prescriptions for controlled substances. The regulations, according to DEA, are an addition to, not a replacement of, existing rules governing controlled substances.

"The regulations provide pharmacies, hospitals and practitioners with the ability to use modern technology for controlled substance prescriptions while maintaining the closed system of controls on controlled substances dispensing; additionally, the regulations will reduce paperwork for DEA registrants who dispense controlled substances and have the potential to reduce prescription forgery," according to the interim final rule. "The regulations will also have the potential to reduce the number of prescription errors caused by illegible handwriting and misunderstood oral prescriptions. Moreover, they will help both pharmacies and hospitals to integrate prescription records into other medical records more directly, which may increase efficiency, and potentially reduce the amount of time patients spend waiting to have their prescriptions filled."

It's these expected benefits that industry stakeholders, and a growing number of members of Congress, have been trying to convince DEA to appreciate for nearly a decade. The agency has considered such a rule since at least May 2001 when it issued an advanced notice of proposed rulemaking on the topic. But it wasn't until four years later than the DEA began to examine how to revise its rules to permit electronic prescriptions.

In December 2007, a 50-member coalition of stakeholders sent President Bush a letter asking for movement on the issue. "The country can no longer afford to have a two-tiered prescribing system," the letter stated. Nineteen U.S. Senators soon followed with their own letter. The agency finally published a proposed rule in June 2008, and 11 senators sent another letter in May 2009 asking for the final rule.

--Joseph Goedert

HHS and CMS to Provide Additional Support to North Carolina Health Insurance Assistance Program to Help People Formerly in Fox Prescription Drug Plan

Officials from the U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services and the Administration on Aging announced today that they were providing $120,000 in additional funds to the Senior's Health Insurance Information Program (SHIIP) in North Carolina, to support beneficiaries affected by Medicare's termination of the Fox Insurance Company's prescription drug plan.  The Centers for Medicare and Medicaid Services (CMS) ended its contract with the plan on Tuesday, March 9, after determining the plan's significant deficiencies jeopardized the health and safety of Fox enrollees.

"Protecting the health and safety of our Medicare beneficiaries is our primary mission at CMS and we felt that the risk to our beneficiaries' health was too high if they stayed in the Fox Prescription Drug plan.  We set up an alternate system to ensure that the former Fox Insurance plan members will be able to continue to get the medications they need," said Marilyn Tavenner, CMS principal deputy administrator.  "To make sure that we can quickly and clearly communicate this change to those beneficiaries who were in the Fox Plan, Secretary Sebelius authorized and allocated extra funds to help us support the staff and volunteers at the state health insurance assistance programs who will be on the front line addressing any concerns and reassuring beneficiaries that they will continue to get their drug coverage.

"Secretary Sebelius also directed CMS to work closely with the Administration on Aging, the other HHS operating divisions and our counterparts in North Carolina to help get out the word about this change quickly while ensuring there are people on the ground to help beneficiaries understand how they will get medicines now," said Tavenner.

"The SHIPs and the Administration on Aging's national network of community based organizations will work together and tirelessly to meet the needs of these Medicare beneficiaries. These resources will help them target the needs of those affected by Fox in North Carolina and seamlessly transition them into the best plan that meets their needs," said Assistant Secretary for Aging Kathy Greenlee.

Former Fox enrollees will be able to choose a new Medicare prescription drug plan through May 1, 2010. Those enrollees who do not choose a plan will be enrolled into a new plan by Medicare effective May, 2010.  With the additional funding, the North Carolina SHIIP offices will be available to help former Fox enrollees choose a new plan that best fits their individual needs.  Medicare beneficiaries affected by the termination of the plan can contact the SHIIP by calling its toll-free line at (800) 443-9354.
"We know that many Medicare beneficiaries across North Carolina rely on the information and support provided by the SHIIP during Medicare's annual enrollment periods," said Tavenner.  "By providing these additional funds, we expect that the SHIIP will be available to help ensure a smooth transition for the former Fox enrollees."
North Carolina residents who were part of the Fox Plan are encouraged to get work with the SHIIP to get more information about what to do next. The SHIIP toll-free number is (800) 443-9354 and contact information is available at the SHIIP's website, www.ncshiip.com. Medicare beneficiaries can also get additional information at 1-800-MEDICARE (800-633-4227) or www.medicare.gov.

Information is also available in Spanish and other languages.

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HHS and CMS to Provide Additional Support to Florida Health Insurance Assistance Program to Help People Formerly in Fox Prescription Drug Plan

Officials from the U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services and the Administration on Aging announced today that they were providing $274,000 in additional funds to Florida's health insurance assistance program, Serving Health Insurance Needs of Elders (SHINE), to support beneficiaries affected by Medicare's termination of the Fox Insurance Company's prescription drug plan.  The Centers for Medicare and Medicaid Services (CMS) ended its contract with the plan on Tuesday, March 9, after determining the plan's significant deficiencies jeopardized the health and safety of Fox enrollees.

"Protecting the health and safety of our Medicare beneficiaries is our primary mission at CMS and we felt that the risk to our beneficiaries' health was too high if they stayed in the Fox Prescription Drug plan.  We set up an alternate system to ensure that the former Fox Insurance plan members will be able to continue to get the medications they need," said Marilyn Tavenner, CMS principal deputy administrator.  "To make sure that we can quickly and clearly communicate this change to those beneficiaries who were in the Fox Plan, Secretary Sebelius authorized and allocated extra funds to help us support the staff and volunteers at the state health insurance assistance programs who will be on the front line addressing any concerns and reassuring beneficiaries that they will continue to get their drug coverage.

"Secretary Sebelius also directed CMS to work closely with the Administration on Aging, the other HHS operating divisions and our counterparts in Florida to help get out the word about this change quickly while ensuring there are people on the ground to help beneficiaries understand how they will get medicines now," said Tavenner.
"The SHIPs and the Administration on Aging's national network of community based organizations will work together and tirelessly to meet the needs of these Medicare beneficiaries. These resources will help them target the needs of those affected by Fox in Florida and seamlessly transition them into the best plan that meets their needs," said Assistant Secretary for Aging Kathy Greenlee.

Secretary Sebelius is making additional funds available to health insurance assistance programs in Florida and North Carolina, the two states with the largest number of Medicare enrollees who were previously in the Fox prescription drug plan.  Nationally, about 123,000 beneficiaries were enrolled in the plan; nearly 55,000 were enrolled in Florida and approximately 24,000 were enrolled across North Carolina.  All former Fox members are currently obtaining their drugs through LI-NET, a program run by Medicare and administered by Humana, ensuring that beneficiaries receive their Medicare prescription drugs.

 Former Fox enrollees will be able to choose a new Medicare prescription drug plan through May 1, 2010. Those enrollees who do not choose a plan will be enrolled into a new plan by Medicare effective May, 2010.  With the additional funding, the Florida SHINE offices will be available to help former Fox enrollees choose a new plan that best fits their individual needs.  Medicare beneficiaries affected by the termination of the plan can contact the SHINE by calling its toll-free line at (800) 963-5337.

"We know that many Medicare beneficiaries across Florida rely on the information and support provided by the SHINE during Medicare's annual enrollment periods," said Tavenner.  "By providing these additional funds, we expect that the SHINE will be available to help ensure a smooth transition for the former Fox enrollees."
Florida residents who were part of the Fox Plan are encouraged to get work with the SHINE to get more information about what to do next. The SHINE toll-free number is (800) 963-5337 and contact information is available at the SHINE's website, www.floridaSHINE.org. Medicare beneficiaries can also get additional information at 1-800-MEDICARE (800-633-4227) or www.medicare.gov.

Information is also available in Spanish and other languages.

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