Adverse Event Reports Go Unused
The Food and Drug Administration's Center for Devices and Radiological Health fails to use adverse event reports in a systematic manner to detect and address medical device safety problems, a report from the HHS Office of the Inspector General found. Manufacturers and medical facilities are required to promptly submit reports to the FDA center following adverse events, which can include deaths, serious injuries, and device malfunctions. But the center has no documentation of following up on these events, and it fails to read most reports in a timely fashion, according to the report. Meanwhile, reports of problems with medical devices are increasing, the Inspector General's office found: The FDA center received about 73,000 adverse event reports in 2003 but more than 150,000 in 2007. The Inspector General recommended that the center develop better protocols for reviewing and tracking the reports.
Medicare's Improper Payments
The Centers for Medicare and Medicaid Services made approximately $24 billion in improper payments in fiscal year 2009, an error rate that was almost double the rate of the previous year. In fiscal year 2009, 7.8% of Medicare fee-for-service claims were paid in error, compared with 3.5% in fiscal year 2008, said the agency in a statement. The CMS said that the increase in the error rate resulted largely from a change in how it identified improper payments. “This year, we made the call to stop calculating our error rate in fee-for-service Medicare the way that the previous administration did and to start using a more rigorous method in calculating this rate in keeping with our mandate to root out errors and fraud,” Health and Human Services Secretary Kathleen Sebelius said in a statement. The CMS said that the higher improper payment rate is not necessarily an indicator of greater fraud. Rather, it was “a more complete accounting of errors,” according to Ms. Sebelius.
Employers Favor Family Plans
Employer contributions to health savings accounts, which are integral to “consumer-driven” health plans, are shifting to favor family-coverage plans, according to the Employee Benefit Research Institute. Workers with employee-only coverage have seen annual employer contributions to their health savings accounts decline, but those with family coverage saw increases in 2009, the institute said. About 4% of Americans have consumer-driven health plans, the report said, and about 63% of employers offering such plans make contributions to their workers' health savings accounts.
Electronic Tools Effective: AHRQ
Consumer health informatics—electronic tools and applications designed to provide tailored health advice to patients—could save money by eliminating the need for some health education activities now performed by clinicians, said a report from the Agency for Healthcare Research and Quality. Health informatics also could improve clinician-patient interactions dealing with a wide variety of diseases and health issues, the AHRQ said. The agency reviewed more than 100 studies of consumers getting health information via the Web, computer programs, and other electronic avenues such as texting and chat groups. The analysis found that the most effective health informatics applications tailor messages using a patients' own health information and provide feedback about the that person's progress as the intervention progresses.
Provider Fraud Most Common
By far, most health care fraud—80%—involves providers systematically overcharging public or private insurers, according to a report from researchers at George Washington University, Washington, and the National Academy for State Health Policy. The study found that these schemes disproportionately target demographic groups likely to be enrolled in Medicare and Medicaid. However, the researchers also found that fraud information concerning the public programs is frequently confused with payment-error data. The authors recommended stronger laws governing insurance marketing, enrollment, claims payments, and antifraud procedures.
DEA Effort Delays Pain Relief
Efforts by the Drug Enforcement Administration to prevent the theft of prescription narcotics are denying pain relief to many nursing home, hospice, and other long-term care patients, two senators said in a letter to Attorney General Eric Holder. Sen. Herb Kohl (D-Wis.), chairman of the Senate Special Committee on Aging, and Sen. Sheldon Whitehouse (D-R.I.) called on Holder to issue new directives to the DEA. The senators proposed legislation that they said could fix the problem. To deter diversion of prescription drugs, the agency stepped up enforcement of laws that require pharmacies to obtain hard copies of prescriptions with signatures from physicians, instead of routine medication orders, for controlled substances prescribed in residential-care settings. This has disrupted “well-established medication coordination protocols” and led to delays in providing those medications to sick patients, the two lawmakers said.