News in brief - Oct 3, 2011

Lawmakers look to extend Medicare ESRD coverage

A House bill would continue coverage for end-stage renal disease patients who are cut off from treatment 36 months after a kidney transplant.

Reps. Michael Burgess, MD (R, Texas), and Ron Kind (D, Wis.) introduced the Immunosuppressive Drug Coverage for Kidney Transplant Patients Act on Sept. 20. Medicare has covered such treatment since 1972. There are no time limits for dialysis patients, but kidney transplant recipients lose coverage after three years.

Extending coverage beyond the limit would decrease the risk of organ failure, the sponsors said. "How incredibly cruel then, that the gravest threat to their newly acquired kidney is an incoherent federal policy that denies coverage for anti-rejection drugs after 36 months and a costlier return to patients and the Medicare system to dialysis," Dr. Burgess said.

The American Society of Transplantation and the National Kidney Foundation back the bill. Sens. Dick Durbin (D, Ill.), Thad Cochran (R, Miss.) and Scott Brown (R, Mass.) have introduced a companion bill.

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Collaborative formed to promote insurance options

Health care industry groups have formed a coalition called Enroll America to encourage the uninsured to participate in health plans.

Businesses, hospitals and organizations representing health professionals will aim to create an environment for optimal enrollment by 2014, which is when tens of millions of Americans will start being eligible for insurance subsidies under the health system reform law. The law also requires nearly everyone to obtain coverage starting in 2014 or pay a tax penalty.

Enroll America has outlined two goals: Promote ways to make enrollment easy, and organize campaigns to ensure that Americans know about insurance opportunities.

"Enroll America will play a critical role in ensuring health care access for millions of people who are one accident or diagnosis away from a medical crisis," said Rich Umbdenstock, president and CEO of the American Hospital Assn., one of the eight groups on the collaborative's board of directors.

Board members also include Blue Shield of California, Catholic Health Assn. of the United States, Families USA, Kaiser Permanente, Maryland Citizens' Health Initiative, National Assn. of Community Health Centers and Teva Pharmaceuticals USA.

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Connecticut doctors file to create nonprofit health plan

The Connecticut State Medical Society and its sister organization, CSMS-IPA, filed a notice of intent in mid-September with the U.S. Dept. of Health and Human Services to create a consumer-oriented, nonprofit health plan.

The plan would be offered alongside others in the state health insurance exchange, to open in 2014. The society decided to take advantage of this option in the health system reform law because the organization wanted to provide patients with another, more affordable health insurance plan that puts patient care first, said David S. Katz, MD, the society's immediate past president.

"We at CSMS know from our own involvement fighting rate hikes on behalf of our patients that they don't have access to insurance options that focus on quality of medical care and emphasize the patient-physician relationship," he said. CSMS-IPA has roughly 7,000 members.

HHS has about $3.8 billion available for start-up loans for such plans -- known as CO-OPs -- enough to fund at least one plan in each state. Full CO-OP applications are due on Oct. 17, and HHS expects to announce successful bids in January 2012.

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House extends GME funding at children's hospitals

The House on Sept. 20 approved by a voice vote a measure to reauthorize funding for graduate medical education in children's hospitals for five years.

The measure, the Children's Hospital GME Support Reauthorization Act of 2011, would cost $1.6 billion from fiscal 2012 to 2016, according to the Congressional Budget Office. The bill has 114 co-sponsors. The measure next heads to the Senate for approval.

American Academy of Pediatrics President O. Marion Burton, MD, encouraged the Senate to pass the bill quickly. Independent children's teaching hospitals represent less than 1% of all hospitals but train nearly 30% of all pediatricians and nearly half of all pediatric specialists, she said.

"The funding from the CHGME program helps to ensure that children have access to the trained pediatricians they need. Independent children's hospitals, with federal CHGME support, have played a key role in ensuring the continued growth of our nation's pediatric work force, including pediatric subspecialists in short supply," she said.

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