Welcome
to Federal Health Update. This newsletter, produced by
Kate Connelly Theroux in collaboration with the Institute of Federal
Health Care, is a compilation of the latest news in the federal health
care sector.
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Executive and Congressional
News
- During
a Veterans Affairs Committee budget hearing on the proposed budget for
fiscal year 2013, Chairman Jeff Miller accused the White House
on Wednesday of leaving veterans "twisting in the wind" by refusing
to declare the Department of Veterans Affairs exempt from automatic
cuts to reduce the deficit, reports
The Washington Post.
Miller said the Congressional Research
Service and the Government Accountability Office have given the committee
legal opinions that under current law, VA should be ruled exempt. But
the White House's Office of Management and Budget has not yet given
a legal opinion.
Democrats dispute this characterization,
noting the proposed VA budget includes a 10.5 percent overall increase.
Miller acknowledged that the increases
are "certainly positive" given the tight fiscal climate. But he
added that "veterans don't care about numbers, they want their claims
decided faster, their health care taken care of and their aging facilities
upgraded."
In testimony before the panel, VA
Secretary Eric K. Shinseki said the budget request "continues the
momentum" for the department's three top priorities: improving veterans'
access to care and benefits, eliminating the huge disability claims
backlog and ending veterans' homelessness by 2015.
Military Health Care
News
- On Feb.
13, 2012, President Barack Obama sent to Congress a proposed defense
budget of $613.9 billion for fiscal 2013.
The request for the Department of
Defense (DoD) includes $525.4 billion in discretionary budget authority
to fund base defense programs and $88.5 billion to support Overseas
Contingency Operations (OCO), primarily in Afghanistan. This is a 1
percent decrease from the fiscal year 2012 budget request
The Military Health System is "fully
funded" at $48.7 billion. An additional $8.5 billion is slotted
for family support programs, $200 million for the Yellow Ribbon program,
and $100 million for transition assistance.
The Administration's budget calls
for continued increases in TRICARE enrollment fees and new Standard/Extra
and TRICARE-for-Life enrollment fees. Under the president's
budget, retail pharmacy copays would increase to encourage greater use
of the mail order pharmacy benefit. None of these fees would apply
to those still on active duty, survivors of service members who died
while on active duty, or those who retired due to disability.
The budget calls for a markedly smaller
military. The Army will lose 72,000 troops; the Marine Corps will
lose 20,000; the Navy will lose 6,200; and the Air Force will lose 4,200.
Smaller reductions will also occur within the Reserves and National
Guard. The Administration estimates that this will save about
$50 billion in the next several years.
DoD is also asking for two new rounds
of base closures, in 2013 and again in 2015.
Veterans Affairs
News
- The Department
of Veterans Affairs is expanding its efforts to prevent suicide through
several new initiatives that increase the availability of services for
veterans, service members and their families.
The new initiatives include a new,
free, confidential text-messaging service in the existing Veterans Crisis
Line, the introduction of toll-free access from Europe, and collaboration
with Vets Prevail and Vets4Warriors.
Since its founding July 2007, VA's
Veterans Crisis Line and the later Chat Service have received 500,000
calls and engaged in 31,000 chats resulting in over 18,000 rescues of
Veterans in immediate crisis.
Now, in addition to the Veterans
Crisis Line (1-800-273-8255 and Press 1) and online chat (www.VeteransCrisisLine.net), veterans and service members in crisis—and
their friends and families—may text free of charge to 83-8255 to receive
confidential, personal and immediate support. The text service is available,
like the Veterans Crisis Line and online chat, 24 hours a day, seven
days a week, 365 days a year and connects a user with a specially trained
VA professional -- many who are veterans themselves.
As a part of the effort to extend
VA's reach, veterans and members of the military community in Europe
may now receive free, confidential support from the European Military
Crisis Line, a new initiative recently launched by VA. Callers in Europe
may dial 0800-1273-8255 or DSN 118 to receive confidential support from
responders at the Veterans Crisis Line in the U.S.
VA's Veterans Crisis Line continues
to add external resources to provide veterans with additional support.
Two of these organizations include Vets Prevail (www.VetsPrevail.org) and Vets4Warriors (www.Vets4Warriors.com).
In December, Vets Prevail launched
a chat service that connects veterans to caring responders who provide
information on a wide variety of resources. If the Veteran is in crisis
or needs mental health support, the conversation is then seamlessly
transferred to a VA Veterans Crisis Line responder.
Vets4Warriors has helped thousands
of their peers connect with confidential assistance through a free hotline
(1-855-838-8255/1-855-VET-TALK) and online chat (www.Vets4Warriors.com). If a veteran is in need of professional crisis
or mental health support, Vets4Warriors' responders will transfer
the Veteran to a responder at the Veterans Crisis Line.
- President
Barack Obama has proposed a $140.3 billion budget for the Department
of Veterans Affairs for the fiscal year beginning Oct. 1.
The proposed budget would fund services
for newly discharged veterans, continue the drive to end homelessness
among veterans, improve access to benefits and services, reduce the
disability claims backlog, improve the Department's collaboration
with the Defense Department and strengthen its information-technology
program that is vital for delivering services to Veterans.
The budget request includes $64 billion
in discretionary funds, mostly for medical care, and $76 billion for
mandatory funds, mostly for disability compensation and pensions.
If approved by Congress, the new
spending levels would support a health care system with 8.8 million
enrollees and growing benefits programs serving nearly 12 million service
members, veterans, family members and survivors, including the eighth
largest life insurance program in the nation; education benefits for
more than 1 million Americans; home loan guarantees for more than 1.5
million veterans and survivors; plus the largest national cemetery system
in the country.
Highlights from the President's
2013 budget request for VA, include
- The President's proposed
budget seeks $52.7 billion for medical care, a 4.1 percent increase
over the $50.6 billion approved by Congress for the current fiscal year,
and a net increase of $165 million above the advance appropriations
level already enacted for FY 2013.
- For the next fiscal year,
VA estimates 6.33 million patients will use VA for health care. About
610,000 of those patients will be Veterans of the conflicts in Iraq
and Afghanistan. The budget request also would provide:
- $403 million for the gender-specific
health care needs of women Veterans, improving their access to services
and treatment facilities;
- $6.2 billion for mental health,
a 5.3 percent increase in funding over the current level, making possible
increased outreach and screenings, expansion of innovative technologies
for self-assessment and symptom management of post-traumatic stress
disorder, and enhancements to programs that reduce the stigmas of mental
health;
- $7.2 billion for long-term
care, meeting VA's commitment to provide long-term care in the least
restrictive and most clinically appropriate settings, such as non-institutional
programs that serve a daily population of about 120,000 people;
- $583 million in direct appropriations
for medical research, which receives another $1.3 billion from other
sources, with emphasis on research for traumatic brain injury, suicide
prevention, PTSD and genomic medicine;
- $792 million to support the
activation of health care facilities, including new hospitals in New
Orleans, Las Vegas, Denver and Orlando, Fla.
- Funding in VA's major construction
account of $396.6 million is provided to continue construction of new
medical facilities at Seattle, Dallas, St. Louis and Palo Alto, Calif.
Since enactment of the Veterans Health
Care Budget Reform and Transparency Act in 2009, VA includes an advance
appropriations request for medical care in the Budget submission. Included
in today's spending request is $54.5 billion for FY 2014, which begins
Oct. 1, 2013. This request for advance appropriations will support nearly
6.38 million unique patients and fulfill our commitment to Veterans
to provide timely and accessible high-quality medical services. The
Administration will review the initial advance appropriations request
in the FY 2014 budget cycle.
The 2013 budget proposal includes
$3.3 billion for information technology, a $216 million increase over
the current budget. VA operates one of the largest consolidated IT organizations
in the world, supporting over 300,000 VA employees and about 10 million
veterans and family members who use VA programs. About 80 percent of
the IT budget supports the direct delivery of health care and benefits
to veterans and their families.
- The Department
of Veterans Affairs signed a formal agreement with the National Association
of State Directors of Veterans Affairs (NASDVA) to enhance their relationship
on Feb. 13, 2012.
The agreement pledges the two groups
to maintain "effective communications, an exchange of ideas and information,
identification of emerging needs, and continuous reevaluation of existing
programs."
NASDVA represents the state departments
of veterans affairs in dealings with VA and with veterans residing in
their respective states. The states fund about $5 billion in benefits
and services for Veterans.
The involvement of state governments
in veterans affairs goes back to the American Revolution, with the federal
government becoming involved after the Civil War. In 1946, NASDVA was
created to coordinate programs between VA and the states, territories
and the District of Columbia.
- Nine employees
of the Department of Veterans Affairs are among the top 100 leaders
in the IT industry, according to the
"Federal 100" created by Federal Computer Week.
This year's top federal IT leaders
were selected for their "pivotal roles in the federal government IT
community . . . affecting change, progress and efficiency in determining
how the federal government acquires, develops and manages IT," according
to a statement from Federal Computer Week.
- Deputy Secretary W. Scott
Gould;
- Charles J. De Sanno, executive
director of VA Enterprise Infrastructure Engineering;
- Lisa Doyle, chancellor of
VA's Acquisition Academy;
- Charles Hume, deputy chief
of the Office of Health Information;
- Peter L. Levin, senior advisor
to the Secretary on IT;
- Wendy J. McCutcheon, associate
executive director of VA's New Jersey Health Care System;
- Jeff Shyshka, VA's deputy
chief information officer;
- Maurice C. Stewart, associate
deputy assistant secretary for Acquisition & Logistics Programs
& Policy; and
- Stephen Warren, principal
deputy assistant secretary for the Office of Information and Technology.
Federal Computer Week will
honor the "Federal 100" March 28 in a gala at Washington's Grand
Hyatt Hotel.
General Health Care
News
- The National
Health Service Corps (NHSC) awarded $9.1 million in funding to medical
students in 30 States and the District of Columbia who will serve as
primary care doctors and help strengthen the health care workforce.
The National Health Service Corps'
Students to Service Loan Repayment Program provides financial support
to fourth year medical students who are committed to a career in primary
care in exchange for their service in communities with limited access
to care.
Administered by HHS' Health Resources
and Services Administration (HRSA), Students to Service is a pilot program
that provides loan repayment assistance of up to $120,000 to medical
students (MDs and DOs) in their last year of education. In return, they
commit to serve in a health professional shortage area upon completion
of a primary care residency program.
These newest NHSC providers must
serve three years of full-time service or six years of half-time service
in rural and urban areas of greatest need.
The NHSC provides financial, professional,
and educational resources to medical, dental, and mental and behavioral
health care providers who bring their skills to areas of the United
States with limited access to health care. The NHSC was established
in 1972 and has connected over 41,000 primary health care practitioners
to communities all over America.
- Attorney
General Eric Holder and Department of Health and Human Services (HHS)
Secretary Kathleen Sebelius released a new report showing that the government's
health care fraud prevention and enforcement efforts recovered nearly
$4.1 billion in taxpayer dollars in Fiscal Year (FY) 2011.
This is the highest annual amount
ever recovered from individuals and companies who attempted to defraud
seniors and taxpayers or who sought payments to which they were not
entitled.
The annual Health Care Fraud and Abuse
Control Program (HCFAC) report
found that approximately $4.1 billion stolen or otherwise improperly
obtained from federal health care programs was recovered and returned
to the Medicare Trust Funds, the Treasury and others in FY 2011. This
is an unprecedented achievement for HCFAC, a joint effort of the two
departments to coordinate federal, state and local law enforcement activities
to fight health care fraud and abuse.
The recently-enacted Affordable Care
Act provides additional tools and resources to help fight fraud that
will help boost these efforts, including an additional $350 million
for HCFAC activities. The administration is already using tools authorized
by the Affordable Care Act, including enhanced screenings and enrollment
requirements, increased data sharing across government, expanded overpayment
recovery efforts and greater oversight of private insurance abuses.
- Health
and Human Services Secretary Kathleen Sebelius announced that the Affordable
Care Act provided approximately 54 million Americans with
at least one new free preventive service in 2011 through their private
health insurance plans.
Secretary Sebelius also announced
that an estimated 32.5 million people with Medicare received at least
one free preventive benefit in 2011, including the new Annual Wellness
Visit, since the health reform law was enacted.
Together, this means an estimated
86 million Americans were helped by health reform's prevention coverage
improvements. The new data were released in two new reports from HHS.
The Affordable Care Act requires
many insurance plans to provide coverage without cost sharing to enrollees
for a variety of preventive health services, such as colonoscopy screening
for colon cancer, Pap smears and mammograms for women, well-child visits,
and flu shots for all children and adults. The law also makes proven
preventive services free for most people on Medicare.
The report on private health insurance coverage also examined
the expansion of free preventive services in minority populations. The
results showed that an estimated 6.1 million Latinos, 5.5 million Blacks,
2.7 million Asian Americans and 300,000 Native Americans with private
insurance received expanded preventive benefits coverage in 2011 as
a result of the new health care law.
The report discussing Medicare preventive
services found that more than 25.7 million Americans in traditional
Medicare received free preventive services in 2011. The report also
looked at Medicare Advantage plans and found that 9.3 million Americans
– 97 percent of those in individual Medicare Advantage plans – were
enrolled in a plan that offered free preventive services. Assuming that
people in Medicare Advantage plans utilized preventive services at the
same rate as those with traditional Medicare, an estimated 32.5 million
people benefited from Medicare's coverage of prevention with no cost
sharing.
- Physician
practices, hospitals, and other healthcare employers should "strongly
consider" mandating that their employees receive influenza vaccinations
if they fall short of a 90 percent immunization rate on a voluntary
basis, a federal advisory committee has recommended.
The National Vaccine Advisory Committee
(NVAC), which advises the US Department of Health and Human Services
(HHS), adopted its position this week. It also said healthcare employers
should be free to exempt employees from a vaccination requirement based
on their medical condition or religious convictions.
The Healthy People 2020 initiative
of HHS set a target of 90 percent of healthcare personnel getting immunized.
While the actual rate has been rising in recent years, it still is a
long way off from the HHS goal. During the 2010-2011 influenza season,
for example, just 63.5
percent of healthcare workers
received the seasonal vaccine, according to the US Centers for Disease
Control and Prevention.
Proponents of mandatory influenza
vaccination for healthcare workers argue that this safety precaution
not only prevents virus transmission to patients, but also reduces the
risk for infection among healthcare workers, thus preserving an adequate
workforce during influenza outbreaks. Vaccination also contributes to
overall herd immunity.
However, mandatory vaccination has
not always gone over well with unionized hospital employees. New York
State ordered its healthcare workers to get vaccinated during the H1N1
influenza pandemic of 2009-2010 only to rescind the order several months
later after blowback from a large healthcare union.
- The Office
of the National Coordinator for Health IT will test its standards and
services for electronic and distributed population health queries in
New York.
The Primary Care Information Project
(PCIP) in the New York City Department of Health and Mental Hygiene
will test the standards and a reference model for the Query Health project with the New York State Department of Public
Health in a pilot to expand population health monitoring, according
to Rich Elmore, ONC coordinator for the Query Health initiative.
PCIP, which supports the adoption
of health IT among primary care providers who tend to the city's underserved
populations, will use the Query Health standards and reference implementation
to expand its population health monitoring network to encompass citywide
health information exchange coverage of inpatient and outpatient encounters.
Currently, when health researchers
develop questions about a population, they generally manually submit
them to provider organizations, which then employ technical teams to
produce reports.
With Query Health, the question can
be delivered in a format that will be interpreted automatically by an
electronic health record or other health IT system, which will generate
a report with the answer.
In September, ONC launched Query
Health based on the contributions of 100 organizations to identify
standards and services to enable providers to send information requests
and questions about population health to a variety of places where it
is held, primarily certified EHRs.
Providers will distribute their requests
through network data partners, who will then deliver the query through
a standard clinical information model and then securely return the results
to the requester.
Questions can be sent to different
types of data sources, such as providers' EHRs, payers' clinical
records, personal health records and health information exchanges. The
aggregated results do not share patient-level data.
Guard/Reserve
- As of Feb.
7, 2012, the total number of Guard and Reserve currently on active duty
has increased by 432 to
74,911. The
totals for each service are Army National Guard and 54,854; Navy Reserve,
4,584; Air National Guard and Air Force Reserve, 9,498; Marine Corps
Reserve, 5,214, and the Coast Guard Reserve, 761. www.defenselink.mil
.
Reports/Policies
- The Congressional
Budget Office published "The Veterans Health Administration's Treatment
of PTSD and Traumatic Brain Injury Among Recent Combat Veterans,"
on Feb. 13, 2012. In this report,
CBO found that VHA spent about $2 billion in fiscal year 2010
to provide medical care to all recent combat veterans. For more
details, visit: http://www.cbo.gov/doc.cfm?index=12711
Hill Hearings
- The Senate Armed Services
Committee will hold a hearing on Feb. 28, 2012, to examine the
Department of the Navy in review of the Defense Authorization request
for fiscal year 2013 and the Future Years Defense Program.
- The House and Senate Committees
on Veterans' Affairs
will hold a joint hearing on Feb. 28, 2012, to receive legislative
presentation of the Disabled American Veterans (DAV).
- The House and Senate Committees
on Veterans' Affairs
will hold a joint hearing on March 7, 2012, to receive legislative
presentation from the Veterans of Foreign Wars (VFW).
- The Senate Armed Services
Committee will hold a hearing on March 8, 2012, to examine the
Department of the Army in review of the Defense Authorization request
for fiscal year 2013 and the Future Years Defense Program.
- The House and Senate Committees
on Veterans' Affairs
will hold a joint hearing on March 21, 2012,to receive legislative
presentations of the Military Order of the Purple Heart, Iraq and Afghanistan
Veterans of America (IAVA), Non Commissioned Officers Association, American
Ex-Prisoners of War, Vietnam Veterans of America, Wounded Warrior Project,
National Association of State Directors of Veterans Affairs, and The
Retired Enlisted Association.
- The House and Senate Committees
on Veterans' Affairs
will hold a joint hearing on March 22, 2012, to receive legislative
presentations of the Paralyzed Veterans of America, Air Force Sergeants
Association, Blinded Veterans Association, American Veterans (AMVETS),
Gold Star Wives, Fleet Reserve Association, Military Officers Association
of America, and the Jewish War Veterans.
Legislation
- H.R.4023 (introduced
Feb. 14, 2012): the Veterans' Telehealth and Telemedicine Improvement
Act was referred to the House Committee on Veterans' Affairs.
Sponsor: Representative Kathleen C. Hochul [NY-26]
- H.R.4031 (introduced
Feb. 14, 2012): To provide that claims presented to an Indian Health
Service contracting officer pursuant to the Indian Self-Determination
and Education Assistance Act on or before October 31, 2005, involving
claims that accrued after October 1, 1995 and on or before September
30, 1999, shall be deemed timely presented was referred to the House
Committee on Natural Resources.
Sponsor: Representative Don Young [AK]
- H.R.4042 (introduced
Feb. 15, 2012): the Veterans Access to Care Act was referred
to the House Committee on Energy and Commerce
Sponsor: Representative Bruce L. Braley [IA-1]
- H.R.4046 (introduced
Feb. 15, 2012): the Schoolchildren's Health Protection Act was
referred to the House Committee on Education and the Workforce
Sponsor: Representative Doug Lamborn [CO-5]
- S.2113 (introduced
Feb. 15, 2012): A bill to empower the Food and Drug Administration to
ensure a clear and effective pathway that will encourage innovative
products to benefit patients and improve public health was referred
to the Committee on Health, Education, Labor, and Pensions.
Sponsor: Senator Kay Hagan [NC].
Meetings
- Annual HIMSS Conference &
Exhibition will be held Feb. 20-24, 2012, in Las Vegas, Nev. http://www.himssconference.org/?src=hwnav
- The International Conference
on Emerging Infectious Diseases 2012 (ICEID) will be held on March
11-14, 2012, in Atlanta, Ga. http://www.cdc.gov/eid/content/16/11/e1.htm
- Behavioral Risk Factor Surveillance
System (BRFSS) 29th Annual Conference will be held on March 24-28,
2012, in Atlanta, Ga. http://www.brfss2011conference.com/
- Warrior Resilience Conference
IV will be held March 29-30, 2012, in Washington DC http://www.dcoe.health.mil/Default_Error.aspx?aspxerrorpath=/content.aspx
- 9th Annual World Healthcare
Congress will be held April 16-18, 2012, in Washington DC http://www.worldcongress.com/events/HR12000/index.cfm?confCode=HR12000
- Freedom & Recovery—Integrated
Mental Health and Addiction Treatment for Veterans will be held April
23-26, 2012, in San Diego, Calif. http://www.foundationsrecoverynetwork.com/events/freedom-and-recovery-2012/FRN-Freedom-and-Recovery-Ad.pdf
- Armed Forces Public Health
Conference will be held June 1-8, 2012, in San Diego, Calif. http://usaphcapps.amedd.army.mil/afphc/
- Armed Forces Public Health
Conference "Partners in Prevention" Core Conference will be
held on June 4-8,2012, in San Diego, Calif. http://www.pdhealth.mil/education/afphc.asp
- The 15th International Congress
on Infectious Diseases (ICID) will be held on June 13-16, 2012,
in Bangkok, Thailand. http://www.isid.org/15th_ICID/
- The 2012 National Conference
on Health Statistics will be held August 6-8, 2012, in Washington
DC 2012 http://service.govdelivery.com/service/view.html?code=USCDC_43
If you need further
information on any of the items in the Federal Health Update, please contact Kate Theroux at (703) 447-3257
or by e-mail at dhakat@aol.com. |
