According to a new report published by the Agency for Healthcare Research and Quality (AHRQ), the U.S. spent an estimated $333.3 billion on health care for people 65 and over in 2006, $106 billion more than in 1996. That’s an average increase of $2,091 per senior who used health services. About 20% of seniors had emergency room expenses in 2006, up from 13% in 1996. The portion spent on inpatient care decreased over the 10-year period to 37% from 43%, while the portion spent on outpatient care increased to 29% from 23%. The portion spent on prescription medicines rose to 22% from 13%, while the portion spent on home health care decreased to 7% from 15%. The spending estimates include payments from all sources to health care providers for services reported in the household component of the federal Medical Expenditure Panel Survey.

http://www.meps.ahrq.gov/mepsweb/data_files/publications/st256/stat256.pdf

he Department of Health and Human Services (HHS) has released an interim final rule implementing the Information Technology for Economic and Clinical Health (HITEC) Acts breach notification requirements. The Act requires hospitals and other HIPAA-covered entities and their business associates to notify individuals when the privacy of their “unsecured” personal health information is breached. The notice obligations are effective for breaches occurring on or after September 24th.

The interim final rule is available at http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/breachnotificationifr.html

The Centers for Disease Control and Prevention (CDC) has issued an H1N1 flu vaccination Q&A that answers questions related to vaccine distribution and administration. According to the CDC, if vaccine shipment begins in mid-October, planners should expect to receive about 120 million doses over four weeks, followed by shipments of roughly 20 million doses per week. Vaccine will be shipped to clinics, offices, health departments and others who receive CDC Public Health Emergency Preparedness grants. Although clinical trials are being conducted to determine appropriate dosing, planners should assume that two doses would be administered 21 to 28 days apart, with single-dose syringes provided for young children and pregnant women. 

The Q&A can be found at http://www.cdc.gov/h1n1flu/vaccination/statelocal/qa.htm

On August 7, Health and Human Services Secretary Kathleen Sebelius announced that the U.S. Senate has unanimously confirmed Francis Collins, M.D., as director of the National Institutes of Health (NIH). Collins has served as director of the NIH’s National Human Genome Research Institute from 1993-2008, and previously was on the faculty of the University of Michigan and an investigator for the Howard Hughes Medical Institute.

The press release is available at http://www.nih.gov/news/health/aug2009/hhs-07.htm.

On August 6, the Centers for Medicare & Medicaid Services (CMS) released the 2010 proposed rule for home health agencies. According to the proposal, there would be a 2.2 % home health market basket update to the home health prospective payment system (HH PPS) rates for 2010. In addition, CMS is proposing modifications to its outlier policy. 

The rule was published Federal Register with comments accepted through September 28. It is available at http://www.access.gpo.gov/su_docs/fedreg/a090806c.html.

The Centers for Medicare & Medicaid Services (CMS) has announced the 60-day supplier bidding period that will begin in late October for the Round One Rebid of the Medicare Competitive Bidding Program for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS). The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) required CMS to rebid the contracts awarded in the first round of the program. The rebid will occur in the same U.S. regions as the initial bidding, excluding Puerto Rico, and will pertain to most of the same types of equipment and supplies.

For additional information about the Medicare DMEPOS Competitive Bidding program, visit the http://www.cms.hhs.gov/DMEPOSCompetitiveBid/.

On July 31, 2009 the Centers for Medicare & Medicaid Services (CMS) issued the annual updates and payment rules for the Hospital Inpatient Prospective Payment System (HIPPS) for fiscal year (FY) 2010. In FY 2010, acute care hospitals will receive an inflation update of 2.1 percent, rather than the 0.2 percent that was proposed.

In the final rule, CMS is finalizing the expansion of hospital quality measurement by expanding the number of measures that hospitals must report in 2010 to receive a full market basket update in 2011. For FY 2010, CMS added 15 new measures to the Reporting Hospital Quality Data Annual Payment Update (RHQDAPU) program and retired one. This results in an expansion of the program to 44 measures, which consists of 26 chart-abstracted process measures, 6 claims-based measures, 9 AHRQ claims-based patient safety/inpatient quality indicator measures, 1 claims-based nursing sensitive measure, 1 structural measure that assesses participation in a systematic database for cardiac surgery and the HCAHPS patient experience of care surgery.

In addition, CMS will continue to apply the capital indirect medical education (IME) adjustment to payment rates for teaching hospitals. It had previously been proposed to be reduced by 50% and eliminated in 2010.

Several changes are being made to the disproportionate share hospital (DSH) adjustment policies, which are:

• Exclusion of observation beds and patient days from the calculation
• Calculation of inpatient days in the Medicaid fraction
• Inclusion of labor and delivery patient days

The final rule was released on July31 and will take effect on October 1. The display copy can be found at http://federalregister.gov/OFRUpload/OFRData/2009-18663_PI.pdf