THIS WEEK IN REVIEW: Monday, Sept. 23rd – Friday, Sept. 27th

September 27, 2019 by B. Cameron Webb, MD, JD

THIS WEEK IN REVIEW: Monday, September 23rd – Friday, September 27th

Happy Fall, y’all!

If you hate paperwork and love patients then this news story might be for you – on Thursday the Centers for Medicare & Medicaid Services (CMS) detailed a new rule that will save providers an estimated 4.4 million annual work hours and save $8 billion over 10 years by reducing regulations. Programs that attempt to hold health organizations to best practices will now be shareable across hospitals and systems allowing smaller and rural organizations to utilize the resources of larger ones. The new rule will also electronically streamline x-ray requests, halve the frequency of policy reviews and program evaluations for rural clinics and federally qualified health centers, and reduce data-submission regulations for transplant programs.

CMS also released new rules on discharge planning between acute and post-acute care (PAC). Hospitals will now be required to provide their patients detailed information on options following discharge, as well as ensure that health records follow the patient. Information required will include performance measures of PAC providers, and focus discharge planning based on patient goals and preferences.

Kaiser Health News (KHN) also wants to help the American health system cut out waste, this time by suing the government. They argue that CMS is illegally retaining audit documents for Medicare Advantage plans that would show billions of dollars of overpayments. The suit contends that CMS is violating the Freedom of Information Act by failing to disclose such reports. KHN has reason to be concerned – in 2014 a separate suit forced CMS to release audit reports showing an average of $1,000 overpayment per Medicare Advantage patient over three years– a total of $30 billion. 

On the topic of Medicare Advantage Plans, the White House says that President Trump is planning to call for the strengthening of these plans and the potential importing of prescription drugs from other countries in an executive order in the coming weeks. This is in an effort to present a plan in distinction from Democratic proposals on health care in the election sphere and in Congress.

While, on the whole, the administration’s attention has been diverted… elsewhere this week, President Trump and his colleagues have found the time to address health policy in a few ways. At the United Nations General Assembly on Monday, Department of Health and Human Services (HHS) Secretary Alex Azar asked for world leaders to refrain from mentioning terms such as sexual and reproductive health rights in UN policy documents. Secretary Azar claimed that these terms were “ambiguous” and promote practices like abortion that hold “no ideological consensus” among the nations of the world. His statements were made on behalf of the United States as well as a few other countries, some of which have abortion bans or restrictions.

Governor of California Gavin Newsom received a letter from Environmental Protection Agency Administrator Andrew Wheeler on Thursday, questioning whether California was doing enough to enforce the Clean Water Act. This came in the wake of President Trump attributing state water pollution on waste from camps of homeless persons, a complaint which Wheeler’s letter reiterated. A spokesperson for Gov. Newsom claimed the criticism came not from actual concern about pollution, but solely from “political retribution against California”.

While Trump may be focusing on the homeless, Democrats have come together to pass a bill regarding the health of a different population: migrants in the custody of Customs and Border Protection (CBP). The Democrat majority House passed The U.S. Border Patrol Medical Screening and Standards Act would require the Department of Homeland Security (DHS) to establish an electronic health records system for those in CBP custody. Currently, border patrol agents must keep health records on paper, and these documents do not always have successful transfers when the corresponding person is moved between facilities. This would also require DHS to provide a report to Congress within 30 days outlining potential recommendations to improve health screenings. The bill faces fierce opposition from the GOP as they disagree with the focus of the bill and view the timeline as unrealistic. The Hill is sure to be busy in the next few weeks with votes on this as well as a rollback on insurance plan waivers and drug pricing reform. Oh, and the whole budget thing so the government doesn’t shut down again

States are also busy with vaping legislation. This week Massachusetts became the third state to place a temporary ban on the sale of vape products as the number of vaping-related deaths rises to 10. The CEO of Juul stepped down and was replaced by an executive from Altria, a major tobacco company. Juul promised to not lobby the Trump administration and halt all advertising immediately. Many lawmakers have pointed fingers at The Food and Drug Administration’s (FDA) reluctance to regulate e-cigarettes, but Vitamin E oil may be the culprit. Illicit and legal cannabis products use Vitamin E Oil as a thickening agent to dilute THC oil, the active psychedelic ingredient. While Vitamin E is safe to be ingested or applied to skin, health officials have warned that it could be dangerous when inhaled. Additionally, counterfeit products from China are being sold on the black market under American labels, adding to the confusion.

And to finish off this week, we give you an unexpected tragic love story. You may have heard of “broken heart syndrome” – the common name for Takotsubo cardiomyopathy which occurs when the lower left ventricle balloons during contractions, typically following a sudden high-stress event. Well, a 60-year old Isreali woman can say she had the first ever reported wasabi-induced case of broken heart syndrome after mistaking the green substance for avocado. Don’t worry – doctors were able to treat her and she’s doing just fine.

 


This Week’s Viewpoints Writing Team:
Carina Clawson, Jo McClain, Steven Moore and Nana Owusu