Monday, February 11, 2013


Hey all – here’s the latest Federal Fridays and I think there’s a lot of good stuff in this edition including reference to a Unicorn . . . yes, Unicorns.  The ongoing budget battles, state of the Union, sequestration and several items pertaining to telemedicine/telehealth are part of this edition so enjoy a cup of coffee and have a quick read.  And for those interested in health reform implementation items, be sure to scroll to the bottom for recent updates. 

State of the Union.  Next week President Obama gives his state of the Union and it sounds like he’s in combat mode about the sequester and the GOP controlled House of Representatives.  Note that if nothing is done, automatic spending cuts begin March 1 – a year of cuts crammed into a 6 month time frame.  Efforts are underway by the Administration to propose a smaller package of cuts to buy more time for a ‘big solution’ and Congress is preparing a ‘continuing resolution’ to keep government open while it continues to try and hammer out a solution.

Deficit is shrinking, but . . .  You remember Harry S Truman’s desire for a one handed economist right?  Well, the CBO reports that the deficit is shrinking however there are mixed results when looking deeper into the longer-term situation.  (And if you don’t know about the one handed economist reference, Google it!)

20,000 jobs threatened.  That’s according to a study by United for Medical Research, suggesting that if automatic spending cuts take place beginning March 1, 2013, 20,000 research related jobs could be lost.  In Illinois they stand to lose approximately $62 million in NIH research funds. 

Director’s Blog, Star-date 2013.  (okay, really lousy effort at humor).  NIH Director Frances Collins has begun publishing his own blog.  You can check it out here and also sign up to receive via email.  In his blog yesterday he has a chart showing the number of clinical studies being held in all 50 states ranging from 283 in Wyoming to over 18,000 in California.

Health Reform 2.0.  Former GOP Senator Dave Durenberger penned an op-ed in Politico highlighting the need for additional reforms to the system including the Medicare payment system, addressing the high cost of prescription drugs, and creating competition in the increasingly un-competitive private market.

Office of Wireless Health.  California Rep. Mike Honda has introduced a bill to create this office within the FDA.  The office would be tasked with regulating the growing number of mobile, wireless health gadgets and applications.

Comprehensive Telehealth Scan.  Thanks to Stewart Ferry from California for sending along a link to this comprehensive scan of the 50 states and DC by the Center for Connected Health Policy summarizing where each jurisdiction is on virtually everything telehealth/telemedicine as it relates to access, reimbursement, licensure, etc.  The Commonwealth Fund published a summary of successes among early adopters of telehealth.

Senator ‘Unicorn’?  Lawmakers Let Their Hair Down.  Even with all the budget chaos and political divisions in the country, members of the House and Senate recently spent some quality time ‘ribbing’ each other at the Washington Press Club dinner.  See some of the zingers here.

Low Vision Issues?  NIH’s National Eye Institute has produced a 20 page large print booklet “Living with Low Vision” that includes information on seeking help for low vision as well as tips to maximize remaining eyesight.  2.9 million Americans live with low vision with an expected 73% increase by 2030.

Veteran’s health care.  Vet’s groups are lining up to urge Congress and the Administration to make good on longstanding health care commitments to them and their families.

A billion here, a billion there . . .   Yes, soon it adds up to real money.  A recent audit found that the VA overpaid disabled vets by nearly $1 billion between 1993 and 2009 and if the agency doesn’t correct the problem, they will overpay another $1.1 billion by 2016.

Snow Drought.  For our friends in the Northeast this will be of no comfort, but the DC area has a ‘snow drought’ which comes with side-effects.  The area has gone 744 days without two inches of snow.
FMLA turns 20.  This week President Clinton was at the U.S. Department of Labor celebrating 20 years since he signed the Family and Medical Leave Act into law.  It was a significant advancement in worker’s rights however one analysis suggests that the U.S. seriously lags the rest of the other high income nations when it comes to leave.  Lag is apparently an understatement though, we’re dead last. 

‘Activated Patients’ fare better.  A recent study showed that patients who participated in treatment decisions and took part in managing their own care―had significantly lower costs than those who were the least activated.

Health Reform Implementation News:

  • Projecting the ACA’s impact:  New projections by the Congressional Budget Office suggest fewer of the currently un-insured will gain coverage, at least in the first few years.  Their most recent projections suggest approximately 27 million are likely to gain coverage by 2017, a full five million less than projected a year ago.

  • New Q and A on Medicaid and the ACA:  HHS issued a five page Q and A updating and clarifying some pretty complex Medicaid topics.  Fortunately, ACA guru and Washington & Lee Law Professor Tim Jost blogged about it so regular folks have a better shot at actually understanding it.

  • Let the Sun Shine In!  Part of the Affordable Care Act was designed to allow anyone to look up which doctors are getting how much from which companies.  But regulators have had so much on their hands, that the so-called ‘Sunshine Act’ was put on the back-burner for a while.  New regulations issued this week were welcomed as one of the ACA’s more important transparency measures.   The law firm Holland & Knight posted this analysis.

  • HHS Rejects Mississippi’s Exchange Proposal:  The Administration’s rejection of the state’s bid to run its own exchange means it will have to run a Federally-facilitated exchange instead.

  • Tracking Medicaid Expansion Decisions:  Check out the chart in  the National Academy for State Health Policy’s most recent e-news.    
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