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Bush Vetoes S-CHIP, Sets Stage for Showdown with Congress Core Elements
of MTM Released for Public Comment House Members Form Community Pharmacy
Coalition Movement Urged on PSO Legislation RWJF Announces Grants to Support National
Health Data Aggregation AHRQ Seeks Health Care Innovations October is National Breast Cancer
Awareness Month New Guide Helps Consumers and Employers Understand Health
Insurance NQF Looking to Endorse Practices for Culturally Competent
Care President Bush made good on his threat to veto the State Children’s
Health Insurance Program reauthorization bill by refusing to sign into
law compromise legislation that was delivered to him before the reauthorization
deadline. Instead, the President signed into law an extension bill that
keeps S-CHIP funds flowing until mid-November. Congressional leaders are now scrambling for the two-thirds majority
needed to override this veto. “The President does not appear likely
to budge from his policy position. If Congress is unable to override
the veto, it will need to enact more extensions or develop a compromise
measure to send to the President,” explained David Schulke, Executive
Vice President of the American Health Quality Association (AHQA). In recent weeks lobby groups stepped up efforts to urge the President’s
support for S-CHIP legislation. AHQA recently joined more than 320 national,
state and local organizations in sending a letter to the President urging
his support for S-CHIP. Because Congressional leaders have delayed a
veto override vote, supporters of the vetoed measure now plan to intensely
lobby the opposition. A recent survey conducted by the polling firm Fabrizio McLaughlin & Associates,
found that Republican voters supported a bill that would strengthen and
extend S-CHIP by a 2-to-1 margin. Republican voters also said they were
less likely to reelect a Member of Congress that opposed the legislation. EQRO Provisions The American Pharmacists Association (APhA) and the National Association
of Chain Drug Stores (NACDS) Foundation recently released a draft document
outlining core elements of a Medication Therapy Management program across
care settings. Comments on the document, “Medication Therapy Management
in Pharmacy Practice: Core Elements of an MTM Service (version 2.0) Draft,” will
be accepted until October 19, 2007. The draft document is the second version developed by the American Pharmacists
Association and the National Association of Chain Drug Stores Foundation
based on a July 2004 consensus definition of MTM. Version 1.0 provided
a model framework for implementing effective MTM services in a community
pharmacy setting; this version focuses on the provision of MTM services
across all pharmacy practice settings. The framework was developed with the input of an advisory panel of pharmacy
leaders representing diverse pharmacy practice settings including ambulatory
care, community, government technical support services, hospital, long-term
care, managed care health systems, managed care organization plan administration,
and outpatient clinics. The draft for public comment is available at www.pharmacist.com/mtm/DraftElements.
Comments can be submitted online at: A bipartisan Congressional Community Pharmacy Coalition was announced
in late September to “preserve patient access to community pharmacies
by restoring fairness and pragmatism to a health care system that devalues
these small business owners who often reside in underserved rural and
urban communities.” The Coalition includes 34 original members
and four co-chairs: Representatives Marion Berry (D-AR); Cathy McMorris
Rodgers (R-WA); Jerry Moran (R-KS); and Anthony D. Weiner (D-NY) Coalition members are advocating for the passage of: H.R.1474, the Fair
and Speedy Treatment of Medicare Prescription Drug Act; H.R.3140, the
Saving Our Community Pharmacies Act; and H.R.971, the Community Pharmacy
Fairness Act. “The deck is stacked against community pharmacies,” said
Rep. Weiner in a press release. “This Coalition wants to level
the playing field for our neighborhood pharmacists with the big chains
of the world by providing prompt payment under Medicare Part D, a fair
reimbursement rate under Medicaid and better negotiating rights for our
essential community pharmacies.” Other members of the Coalition are: Representatives Robert Aderholt
(R-AL); In recent letter to Health and Human Services Secretary Michael Leavitt,
six leading national health care associations urged prompt action on
legislation passed in 2005 that established Patient Safety Organizations
(PSOs). According to the Patient Safety and Quality Improvement Act of 2005,
HHS is tasked with writing regulations that would govern the PSO infrastructure.
Those regulations, said the letter writers, are now “languishing
in the review and clearance process” within the Department. “Improving patient safety is too important to allow this regulation
to be delayed further. We urge you to promptly publish a proposed rule,” the
letter said. Publication of a proposed rule would be followed by a public
comment period. HHS would then need additional time to consider those
comments and make amendments before a final rule could be published. The letter was signed by the American Hospital Association, the American
Medical Association, the American College of Physicians, the American
College of Surgeons, the American Dental Association, and The Joint Commission.
Read the letter at: http://www.aha.org/aha/letter/2007/070927-let-healthorgs-leavitt.pdf The Agency for Healthcare Research and Quality (AHRQ) serves as the
lead for implementation of the PSO Act. QIOs are eligible under the law
to be recognized as PSOs. The Iowa QIO was recently awarded a contract
to serve as the national Patient Safety Organization Privacy Protection
Center to help develop the data infrastructure for the program. At an event held Wednesday in Washington, DC, the Robert Wood Johnson
Foundation (RWJF) announced that it would provide nearly $16 million
in grants to develop and test a single national approach to aggregating
data from private health plans. The project is expected to be completed
by 2010. The Engelberg Center for Health Care Reform at the Brookings Institute
will receive $8.7 million and America’s Health Insurance Plans
(AHIP) Foundation will receive $4.2 million. The Engelberg Center is
directed by former Centers for Medicare & Medicaid administrator
Mark McClellan, MD, PhD, who will coordinate the project. Grants totaling
an additional $3 million will be made to other supporting organizations. As grantees, the Brookings Institute and America’s Health Insurance
Plans will work to bring consistency to the measurement and reporting
of information on the quality and cost of care that patients receive.
The project is intended to support the vision of the Quality Alliance
Steering Committee (QASC) to advance high-quality, cost-effective, patient-centered
health care by providing a national framework for implementing quality
and cost measures to improve care around the country. QASC will serve
an advisory role in the effort. “Our collective goal is to make better information about the quality
and cost of health care available, because better information is the
best way to drive improvements in care,” said Dr. McClellan, who
is also a co-chair of the QASC. The project will also identify and measure disparities in health care
so that providers and others can develop specific interventions to close
the gaps. “Our work will ensure that these new efforts to implement
quality and cost measures nationally will be done in ways that identify,
and ultimately help address, important racial and ethnic disparities,” said
Dr. McClellan. “It is our understanding that this effort will dovetail with federal
transparency efforts,” said Michele Johnson, AHQA Senior Director
of Government Affairs. “The data aggregation and transparency goals
of the program are similar to what we understand to be the objectives
of the Value Exchanges that are already in formative stages throughout
the country – many of which are supported by QIOs.” The Agency for Healthcare Research
and Quality (AHRQ) is seeking submissions for version 2.0 of the Health
Care Innovations Exchange Web (HCIE) Web site (http://www.innovations.ahrq.gov/index.aspx),
according to a September 28 Federal Register notice. Version 2.0 of the
Web site will be released in the Spring of 2008. Contributions to the Web site can be submitted at any time but individuals
submitting before January 15, 2008 will be able to “preview and
comment on version 2.0 of the Health Care Innovations Exchange Web site
via a secure mechanism,” the
notice said. Submissions can be emailed to info@innovations.ahrq.gov.
The subject line should include the words ‘‘Innovation Submission’’. The Centers for Medicare & Medicaid Services (CMS) is using National
Breast Cancer Awareness Month (NBCAM) as an opportunity to urge female
Medicare beneficiaries to take advantage of its preventive benefits,
namely screening mammograms and clinical breast exams. NBCAM provides many free resources to educate women about the importance
of early detection. Research shows that mammography screening is the
best available method to detect breast cancer and early detection can
lead to potentially less invasive treatment, improving chances of survival. Medicare provides coverage of an annual screening mammogram for all
female beneficiaries age 40 and older and one baseline mammogram for
female beneficiaries between the ages of 35 and 39. Information about
Medicare’s coverage of screening mammography and clinical breast
exams, including coverage, coding, billing, and reimbursement is available
at: http://www.cms.hhs.gov/Mammography/ More information about NBCAM is available at: www.nbcam.org AHRQ and America’s Health Insurance Plans recently released “Questions
and Answers about Health Insurance,” a new guide designed to help
consumers make important health insurance decisions. The guide explains
different types of health insurance, including network-based plans, non-network
based coverage, and consumer-directed health plans. It also provides
a glossary of health insurance terms as well as additional resources
to obtain more information. More information is available at: http://www.ahrq.gov/consumer/insuranceqa/ The National
Quality Forum (NQF) recently initiated Endorsing a Framework and Preferred
Practices for Measuring and Reporting Culturally Competent Care. The
project aims to endorse a comprehensive national framework for evaluating
cultural competency across all health care settings, endorse a minimum
set of preferred practices for cultural competency, and identify high
priority research areas to advance the evaluation of cultural competency
as a quality improvement tool. As part of this project, NQF is seeking
frameworks and practices that focus on all aspects of cultural competency
including: race and ethnicity, disabilities, sexual identity, spirituality,
and language preference. The Office of Minority Health is already moving
in this direction with the development of culturally and linguistically
appropriate services (CLAS) standards. But a consensus framework for
measuring and reporting the quality of culturally competent care is
needed to provide more patient-centered care that can improve health
outcomes, the NQF said. More information is available at: http://www.qualityforum.org/projects/ongoing/cultural-comp/  Home :: Inside AHQA :: For The Media :: Public Policy :: Advancing Quality :: Quality Connections :: SiteMap
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