Mary Ellen Schneider

Alzheimer's Disease Affects 5 Million

About 5.1 million Americans are living with Alzheimer's disease, according to a recent report from the Alzheimer's Association. While the vast majority of affected people are over 65 years of age, between 200,000 and 500,000 people younger than 65 years old have early-onset Alzheimer's or other dementias. Without improvement in treatment, the group estimated that the prevalence of the disease could reach 7.7 million by 2030 and between 11 million and 16 million by 2050. The price tag for Alzheimer's disease is also significant, according to the report. The direct and indirect costs of Alzheimer's disease add up to more than $148 billion each year. For Medicare, the cost of caring for patients with Alzheimer's and other dementias is expected to climb from $91 billion in 2005 to more than $189 billion by 2015. But Harry Johns, president and CEO of the Alzheimer's Association, was hopeful. “There are currently nine drugs in phase III clinical trials for Alzheimer's, several of which show great promise to slow or stop the progression of the disease,” Mr. Johns said in a statement.

NIH Examines Parkinson's Therapy

Officials at the National Institutes of Health have launched a large-scale phase III clinical trial to assess whether the nutritional supplement creatine is effective in slowing the progression of Parkinson's disease. Creatine has not been approved for the treatment of Parkinson's disease or any other condition. However, researchers have hypothesized that it could improve the function of mitochondria and by acting as an antioxidant prevent damage from compounds that harm brain cells. The study is placebo controlled and double blind and will include 1,720 individuals with early-stage Parkinson's disease. Half of the study participants will receive creatine and half will receive a placebo. Participants will be followed for 5–7 years. Both the supplement and the placebo will be provided by Avicena Group Inc. The study will be conducted at 51 medical centers in the United States and Canada.

Alzheimer's Treatment Delays

Race and ethnicity may play a role in delays in diagnosis and treatment of Alzheimer's disease, according to the results of a survey released by the Alzheimer's Foundation of America. The survey found that 70% of African American and 67% of Hispanic caregivers were likely to dismiss the symptoms of Alzheimer's as old age, compared with 53% of caregivers of other races. The survey highlighted similar trends in knowledge of the disease. About 67% of African American caregivers and 63% of Hispanic caregivers said they did not know enough about the disease to recognize symptoms, compared with 49% of caregivers from other races. And African American caregivers were also more likely to report that stigma of the diagnosis affected their decision to obtain a diagnosis for a family member. For example, 36% of African American caregivers cited concerns about stigma as delaying diagnosis, compared with 22% of Hispanic caregivers and 18% of caregivers of other races. The survey, conducted by Harris Interactive, included 655 adults who are currently caregivers for someone with Alzheimer's. The survey was sponsored by Forest Pharmaceuticals Inc.

NIH Launches Addiction Study

In response to the growing problem of prescription drug abuse, officials at the National Institutes of Health are launching the Prescription Opioid Addiction Treatment Study (POATS), a multisite study conducted under the direction of the National Institute on Drug Abuse. The researchers will examine the effectiveness of buprenorphine/naloxone (Suboxone) combined with either intensive or brief drug-counseling approaches. Investigators aim to enroll about 648 participants at 11 sites. “Opioid analgesics were designed to help people in pain and we want to be sure that those who require them for legitimate reasons can continue to effectively manage their pain,” said Dr. Nora D. Volkow, who is director of NIDA, in a statement. “However, we must also recognize the risk of addiction to pain medications and develop treatments for those who become addicted to them. This trial is an important first step.”

CMS Extends Form Deadline

The Centers for Medicare and Medicaid Services has postponed the deadline for filing Medicare claims using its new version of claims form CMS-1500, because of formatting errors on the revised form, CMS announced. The original deadline for switching to the new form, known as CMS-1500 (08–05) originally was April 2. But CMS said last month that contractors have been directed to continue to accept the old form until the agency notifies them to stop. In addition, the agency advised physicians who must use the form to use legacy provider numbers as the form cannot accommodate a National Provider Identifier (NPI) number.

Medical Debt Increasing

Families are turning to credit cards to pay for medical care as health care costs continue to rise faster than incomes, according to new research by public policy advocacy groups Demos and the Access Project. The groups found that 29% of low- and middle-income households with credit card debt reported that medical expenses contributed to their current balances, and within that group, 69% had a major medical expense in the previous 3 years. Low- and middle-income households with unpaid medical bills had, on average, 46% higher levels of credit card debt than did households without medical debt. In addition, the medically indebted were almost twice as likely to be called by bill collectors.

Alzheimer's Disease Affects 5 Million

About 5.1 million Americans are living with Alzheimer's disease, according to a recent report from the Alzheimer's Association. While the vast majority of affected people are over 65 years of age, between 200,000 and 500,000 people younger than 65 years old have early-onset Alzheimer's or other dementias. Without improvement in treatment, the group estimated that the prevalence of the disease could reach 7.7 million by 2030 and between 11 million and 16 million by 2050. The price tag for Alzheimer's disease is also significant, according to the report. The direct and indirect costs of Alzheimer's disease add up to more than $148 billion each year. For Medicare, the cost of caring for patients with Alzheimer's and other dementias is expected to climb from $91 billion in 2005 to more than $189 billion by 2015. But Harry Johns, president and CEO of the Alzheimer's Association, was hopeful. “There are currently nine drugs in phase III clinical trials for Alzheimer's, several of which show great promise to slow or stop the progression of the disease,” Mr. Johns said in a statement.

NIH Examines Parkinson's Therapy

Officials at the National Institutes of Health have launched a large-scale phase III clinical trial to assess whether the nutritional supplement creatine is effective in slowing the progression of Parkinson's disease. Creatine has not been approved for the treatment of Parkinson's disease or any other condition. However, researchers have hypothesized that it could improve the function of mitochondria and by acting as an antioxidant prevent damage from compounds that harm brain cells. The study is placebo controlled and double blind and will include 1,720 individuals with early-stage Parkinson's disease. Half of the study participants will receive creatine and half will receive a placebo. Participants will be followed for 5–7 years. Both the supplement and the placebo will be provided by Avicena Group Inc. The study will be conducted at 51 medical centers in the United States and Canada.

Alzheimer's Treatment Delays

Race and ethnicity may play a role in delays in diagnosis and treatment of Alzheimer's disease, according to the results of a survey released by the Alzheimer's Foundation of America. The survey found that 70% of African American and 67% of Hispanic caregivers were likely to dismiss the symptoms of Alzheimer's as old age, compared with 53% of caregivers of other races. The survey highlighted similar trends in knowledge of the disease. About 67% of African American caregivers and 63% of Hispanic caregivers said they did not know enough about the disease to recognize symptoms, compared with 49% of caregivers from other races. And African American caregivers were also more likely to report that stigma of the diagnosis affected their decision to obtain a diagnosis for a family member. For example, 36% of African American caregivers cited concerns about stigma as delaying diagnosis, compared with 22% of Hispanic caregivers and 18% of caregivers of other races. The survey, conducted by Harris Interactive, included 655 adults who are currently caregivers for someone with Alzheimer's. The survey was sponsored by Forest Pharmaceuticals Inc.

NIH Launches Addiction Study

In response to the growing problem of prescription drug abuse, officials at the National Institutes of Health are launching the Prescription Opioid Addiction Treatment Study (POATS), a multisite study conducted under the direction of the National Institute on Drug Abuse. The researchers will examine the effectiveness of buprenorphine/naloxone (Suboxone) combined with either intensive or brief drug-counseling approaches. Investigators aim to enroll about 648 participants at 11 sites. “Opioid analgesics were designed to help people in pain and we want to be sure that those who require them for legitimate reasons can continue to effectively manage their pain,” said Dr. Nora D. Volkow, who is director of NIDA, in a statement. “However, we must also recognize the risk of addiction to pain medications and develop treatments for those who become addicted to them. This trial is an important first step.”

CMS Extends Form Deadline

The Centers for Medicare and Medicaid Services has postponed the deadline for filing Medicare claims using its new version of claims form CMS-1500, because of formatting errors on the revised form, CMS announced. The original deadline for switching to the new form, known as CMS-1500 (08–05) originally was April 2. But CMS said last month that contractors have been directed to continue to accept the old form until the agency notifies them to stop. In addition, the agency advised physicians who must use the form to use legacy provider numbers as the form cannot accommodate a National Provider Identifier (NPI) number.

Medical Debt Increasing

Families are turning to credit cards to pay for medical care as health care costs continue to rise faster than incomes, according to new research by public policy advocacy groups Demos and the Access Project. The groups found that 29% of low- and middle-income households with credit card debt reported that medical expenses contributed to their current balances, and within that group, 69% had a major medical expense in the previous 3 years. Low- and middle-income households with unpaid medical bills had, on average, 46% higher levels of credit card debt than did households without medical debt. In addition, the medically indebted were almost twice as likely to be called by bill collectors.

Alzheimer's Disease Affects 5 Million

About 5.1 million Americans are living with Alzheimer's disease, according to a recent report from the Alzheimer's Association. While the vast majority of affected people are over 65 years of age, between 200,000 and 500,000 people younger than 65 years old have early-onset Alzheimer's or other dementias. Without improvement in treatment, the group estimated that the prevalence of the disease could reach 7.7 million by 2030 and between 11 million and 16 million by 2050. The price tag for Alzheimer's disease is also significant, according to the report. The direct and indirect costs of Alzheimer's disease add up to more than $148 billion each year. For Medicare, the cost of caring for patients with Alzheimer's and other dementias is expected to climb from $91 billion in 2005 to more than $189 billion by 2015. But Harry Johns, president and CEO of the Alzheimer's Association, was hopeful. “There are currently nine drugs in phase III clinical trials for Alzheimer's, several of which show great promise to slow or stop the progression of the disease,” Mr. Johns said in a statement.

NIH Examines Parkinson's Therapy

Officials at the National Institutes of Health have launched a large-scale phase III clinical trial to assess whether the nutritional supplement creatine is effective in slowing the progression of Parkinson's disease. Creatine has not been approved for the treatment of Parkinson's disease or any other condition. However, researchers have hypothesized that it could improve the function of mitochondria and by acting as an antioxidant prevent damage from compounds that harm brain cells. The study is placebo controlled and double blind and will include 1,720 individuals with early-stage Parkinson's disease. Half of the study participants will receive creatine and half will receive a placebo. Participants will be followed for 5–7 years. Both the supplement and the placebo will be provided by Avicena Group Inc. The study will be conducted at 51 medical centers in the United States and Canada.

Alzheimer's Treatment Delays

Race and ethnicity may play a role in delays in diagnosis and treatment of Alzheimer's disease, according to the results of a survey released by the Alzheimer's Foundation of America. The survey found that 70% of African American and 67% of Hispanic caregivers were likely to dismiss the symptoms of Alzheimer's as old age, compared with 53% of caregivers of other races. The survey highlighted similar trends in knowledge of the disease. About 67% of African American caregivers and 63% of Hispanic caregivers said they did not know enough about the disease to recognize symptoms, compared with 49% of caregivers from other races. And African American caregivers were also more likely to report that stigma of the diagnosis affected their decision to obtain a diagnosis for a family member. For example, 36% of African American caregivers cited concerns about stigma as delaying diagnosis, compared with 22% of Hispanic caregivers and 18% of caregivers of other races. The survey, conducted by Harris Interactive, included 655 adults who are currently caregivers for someone with Alzheimer's. The survey was sponsored by Forest Pharmaceuticals Inc.

NIH Launches Addiction Study

In response to the growing problem of prescription drug abuse, officials at the National Institutes of Health are launching the Prescription Opioid Addiction Treatment Study (POATS), a multisite study conducted under the direction of the National Institute on Drug Abuse. The researchers will examine the effectiveness of buprenorphine/naloxone (Suboxone) combined with either intensive or brief drug-counseling approaches. Investigators aim to enroll about 648 participants at 11 sites. “Opioid analgesics were designed to help people in pain and we want to be sure that those who require them for legitimate reasons can continue to effectively manage their pain,” said Dr. Nora D. Volkow, who is director of NIDA, in a statement. “However, we must also recognize the risk of addiction to pain medications and develop treatments for those who become addicted to them. This trial is an important first step.”

CMS Extends Form Deadline

The Centers for Medicare and Medicaid Services has postponed the deadline for filing Medicare claims using its new version of claims form CMS-1500, because of formatting errors on the revised form, CMS announced. The original deadline for switching to the new form, known as CMS-1500 (08–05) originally was April 2. But CMS said last month that contractors have been directed to continue to accept the old form until the agency notifies them to stop. In addition, the agency advised physicians who must use the form to use legacy provider numbers as the form cannot accommodate a National Provider Identifier (NPI) number.

Medical Debt Increasing

Families are turning to credit cards to pay for medical care as health care costs continue to rise faster than incomes, according to new research by public policy advocacy groups Demos and the Access Project. The groups found that 29% of low- and middle-income households with credit card debt reported that medical expenses contributed to their current balances, and within that group, 69% had a major medical expense in the previous 3 years. Low- and middle-income households with unpaid medical bills had, on average, 46% higher levels of credit card debt than did households without medical debt. In addition, the medically indebted were almost twice as likely to be called by bill collectors.

Arthritis Legislation Reintroduced

Advocates are applauding the reintroduction of the “Arthritis Prevention, Control, and Cure Act of 2007” (S. 626 and H.R. 1283), which would expand investments in prevention, diagnosis, and treatment research. The bill was introduced in the last Congress but remained stalled in committee. Sponsored by Sen. Edward Kennedy (D-Mass.) and Rep. Anna Eshoo (D-Calif.), the proposed legislation would increase research and surveillance activities related to juvenile arthritis, and would address the shortage of pediatric rheumatologists by increasing training grants and establishing a loan repayment program. The bill's scope reflects new statistics from the Centers for Disease Control and Prevention, according to Dave Zook, interim chief public policy officer at the Arthritis Foundation. The CDC estimates that arthritis and other rheumatic conditions cost the U.S. economy approximately $128 billion in 2003.

CMS Extends Form Deadline

The Centers for Medicare and Medicaid Services has extended the deadline for filing Medicare claims using its new version of claims form CMS-1500, because of formatting errors on the revised form, CMS announced. The original deadline for switching to the new form—known as CMS-1500 (08/05)—originally was April 2. But CMS said last month that contractors have been directed to continue to accept the old form until the agency notifies them to stop. Additionally, the agency advised physicians who must use the form to use legacy provider numbers, as the form cannot accommodate a National Provider Identifier (NPI) number.

New Imaging-Cut Moratorium

Several members of Congress introduced legislation last month to place a 2-year moratorium on cuts to Medicare payments for medical imaging that went into effect this year. The bill also requires a Government Accountability Office study of patient access to imaging. The bill (H.R. 1293) was introduced by Reps. Carolyn McCarthy (D-N.Y.), Gene Green (D-Tex.), and Joseph Pitts (R-Penn.), and had 49 cosponsors at press time. Rep. Pitts sponsored similar legislation in the last Congress; the cuts were mandated as part of the Deficit Reduction Act of 2005. A Senate companion bill is expected soon. Under the DRA, payments for the technical component of an imaging service are to be set at the hospital outpatient-department rate, if the payment under the Medicare physician fee schedule is higher. The Access to Medical Imaging Coalition said that a new report by the Moran Co. shows that the DRA mandate means physicians face reimbursement that's 18%–19% below that for outpatient departments. “The fact is, the DRA has decimated the imaging payments received by cardiologists, radiologists, and other providers,” said Tim Trysla, executive director of the coalition.

Damage Award in Vioxx Case

Merck & Co. was assessed $47.5 million in compensatory and punitive damages in the latest Vioxx-related court case. A New Jersey jury sided with the plaintiff and determined that Merck had failed to give an adequate warning to physicians about the increased risk of heart attacks from Vioxx prior to September 2001. The plaintiff, Frederick Humeston, alleged that he suffered a heart attack in 2001 as a result of using Vioxx. Merck plans to appeal the verdict. “We believe that the punitive damages assessed today by the jury are uncalled for because Merck acted appropriately in providing information to the medical, scientific, and regulatory communities in a responsible and appropriate manner,” Kenneth C. Frazier, Merck senior vice president and general counsel, said in a statement. Mr. Humeston originally lost his case against Merck; the setting aside of that verdict last year precipitated this latest court battle.

Bill Targets Psoriatic Arthritis

New legislation introduced in the U.S. House aims to expand research into psoriatic arthritis and psoriasis. The legislation (H.R. 1188), “The Psoriasis and Psoriatic Arthritis Research, Cure, and Care Act of 2007,” would widen the scope of research performed by the National Institutes of Health. The bill calls for establishing a national psoriatic arthritis and psoriasis patient registry under CDC direction. If passed, the legislation would also create a federal summit to discuss research opportunities in psoriasis and psoriatic arthritis and direct the Institute of Medicine to issue a report evaluating insurance coverage for psoriasis treatments. “This is the first time psoriasis will be recognized through legislation,” Sheila Rittenberg, director of advocacy for the National Psoriasis Foundation, said in a statement. “Psoriasis research is lagging and treatment options are improving but still often do not meet patients' needs. This bill lays out a plan which will pave the way to a cure.”

FDA to Study DTC Risk Data

Saying that it has become more concerned about how much risk information is disclosed to consumers in print ads, and that the information is not usually in a consumer-friendly format, the Food and Drug Administration announced that it will study how to better present those data. One study will look at whether giving consumers more context—instead of a list of risks, for instance—will aid their understanding of a product's potential downside. Another will look at the usefulness of several different formats for presenting the data. FDA is accepting comments on the proposed testing until mid-April.

Arthritis Legislation Reintroduced

Advocates are applauding the reintroduction of the “Arthritis Prevention, Control, and Cure Act of 2007” (S. 626 and H.R. 1283), which would expand investments in prevention, diagnosis, and treatment research. The bill was introduced in the last Congress but remained stalled in committee. Sponsored by Sen. Edward Kennedy (D-Mass.) and Rep. Anna Eshoo (D-Calif.), the proposed legislation would increase research and surveillance activities related to juvenile arthritis, and would address the shortage of pediatric rheumatologists by increasing training grants and establishing a loan repayment program. The bill's scope reflects new statistics from the Centers for Disease Control and Prevention, according to Dave Zook, interim chief public policy officer at the Arthritis Foundation. The CDC estimates that arthritis and other rheumatic conditions cost the U.S. economy approximately $128 billion in 2003.

CMS Extends Form Deadline

The Centers for Medicare and Medicaid Services has extended the deadline for filing Medicare claims using its new version of claims form CMS-1500, because of formatting errors on the revised form, CMS announced. The original deadline for switching to the new form—known as CMS-1500 (08/05)—originally was April 2. But CMS said last month that contractors have been directed to continue to accept the old form until the agency notifies them to stop. Additionally, the agency advised physicians who must use the form to use legacy provider numbers, as the form cannot accommodate a National Provider Identifier (NPI) number.

New Imaging-Cut Moratorium

Several members of Congress introduced legislation last month to place a 2-year moratorium on cuts to Medicare payments for medical imaging that went into effect this year. The bill also requires a Government Accountability Office study of patient access to imaging. The bill (H.R. 1293) was introduced by Reps. Carolyn McCarthy (D-N.Y.), Gene Green (D-Tex.), and Joseph Pitts (R-Penn.), and had 49 cosponsors at press time. Rep. Pitts sponsored similar legislation in the last Congress; the cuts were mandated as part of the Deficit Reduction Act of 2005. A Senate companion bill is expected soon. Under the DRA, payments for the technical component of an imaging service are to be set at the hospital outpatient-department rate, if the payment under the Medicare physician fee schedule is higher. The Access to Medical Imaging Coalition said that a new report by the Moran Co. shows that the DRA mandate means physicians face reimbursement that's 18%–19% below that for outpatient departments. “The fact is, the DRA has decimated the imaging payments received by cardiologists, radiologists, and other providers,” said Tim Trysla, executive director of the coalition.

Damage Award in Vioxx Case

Merck & Co. was assessed $47.5 million in compensatory and punitive damages in the latest Vioxx-related court case. A New Jersey jury sided with the plaintiff and determined that Merck had failed to give an adequate warning to physicians about the increased risk of heart attacks from Vioxx prior to September 2001. The plaintiff, Frederick Humeston, alleged that he suffered a heart attack in 2001 as a result of using Vioxx. Merck plans to appeal the verdict. “We believe that the punitive damages assessed today by the jury are uncalled for because Merck acted appropriately in providing information to the medical, scientific, and regulatory communities in a responsible and appropriate manner,” Kenneth C. Frazier, Merck senior vice president and general counsel, said in a statement. Mr. Humeston originally lost his case against Merck; the setting aside of that verdict last year precipitated this latest court battle.

Bill Targets Psoriatic Arthritis

New legislation introduced in the U.S. House aims to expand research into psoriatic arthritis and psoriasis. The legislation (H.R. 1188), “The Psoriasis and Psoriatic Arthritis Research, Cure, and Care Act of 2007,” would widen the scope of research performed by the National Institutes of Health. The bill calls for establishing a national psoriatic arthritis and psoriasis patient registry under CDC direction. If passed, the legislation would also create a federal summit to discuss research opportunities in psoriasis and psoriatic arthritis and direct the Institute of Medicine to issue a report evaluating insurance coverage for psoriasis treatments. “This is the first time psoriasis will be recognized through legislation,” Sheila Rittenberg, director of advocacy for the National Psoriasis Foundation, said in a statement. “Psoriasis research is lagging and treatment options are improving but still often do not meet patients' needs. This bill lays out a plan which will pave the way to a cure.”

FDA to Study DTC Risk Data

Saying that it has become more concerned about how much risk information is disclosed to consumers in print ads, and that the information is not usually in a consumer-friendly format, the Food and Drug Administration announced that it will study how to better present those data. One study will look at whether giving consumers more context—instead of a list of risks, for instance—will aid their understanding of a product's potential downside. Another will look at the usefulness of several different formats for presenting the data. FDA is accepting comments on the proposed testing until mid-April.

Arthritis Legislation Reintroduced

Advocates are applauding the reintroduction of the “Arthritis Prevention, Control, and Cure Act of 2007” (S. 626 and H.R. 1283), which would expand investments in prevention, diagnosis, and treatment research. The bill was introduced in the last Congress but remained stalled in committee. Sponsored by Sen. Edward Kennedy (D-Mass.) and Rep. Anna Eshoo (D-Calif.), the proposed legislation would increase research and surveillance activities related to juvenile arthritis, and would address the shortage of pediatric rheumatologists by increasing training grants and establishing a loan repayment program. The bill's scope reflects new statistics from the Centers for Disease Control and Prevention, according to Dave Zook, interim chief public policy officer at the Arthritis Foundation. The CDC estimates that arthritis and other rheumatic conditions cost the U.S. economy approximately $128 billion in 2003.

CMS Extends Form Deadline

The Centers for Medicare and Medicaid Services has extended the deadline for filing Medicare claims using its new version of claims form CMS-1500, because of formatting errors on the revised form, CMS announced. The original deadline for switching to the new form—known as CMS-1500 (08/05)—originally was April 2. But CMS said last month that contractors have been directed to continue to accept the old form until the agency notifies them to stop. Additionally, the agency advised physicians who must use the form to use legacy provider numbers, as the form cannot accommodate a National Provider Identifier (NPI) number.

New Imaging-Cut Moratorium

Several members of Congress introduced legislation last month to place a 2-year moratorium on cuts to Medicare payments for medical imaging that went into effect this year. The bill also requires a Government Accountability Office study of patient access to imaging. The bill (H.R. 1293) was introduced by Reps. Carolyn McCarthy (D-N.Y.), Gene Green (D-Tex.), and Joseph Pitts (R-Penn.), and had 49 cosponsors at press time. Rep. Pitts sponsored similar legislation in the last Congress; the cuts were mandated as part of the Deficit Reduction Act of 2005. A Senate companion bill is expected soon. Under the DRA, payments for the technical component of an imaging service are to be set at the hospital outpatient-department rate, if the payment under the Medicare physician fee schedule is higher. The Access to Medical Imaging Coalition said that a new report by the Moran Co. shows that the DRA mandate means physicians face reimbursement that's 18%–19% below that for outpatient departments. “The fact is, the DRA has decimated the imaging payments received by cardiologists, radiologists, and other providers,” said Tim Trysla, executive director of the coalition.

Damage Award in Vioxx Case

Merck & Co. was assessed $47.5 million in compensatory and punitive damages in the latest Vioxx-related court case. A New Jersey jury sided with the plaintiff and determined that Merck had failed to give an adequate warning to physicians about the increased risk of heart attacks from Vioxx prior to September 2001. The plaintiff, Frederick Humeston, alleged that he suffered a heart attack in 2001 as a result of using Vioxx. Merck plans to appeal the verdict. “We believe that the punitive damages assessed today by the jury are uncalled for because Merck acted appropriately in providing information to the medical, scientific, and regulatory communities in a responsible and appropriate manner,” Kenneth C. Frazier, Merck senior vice president and general counsel, said in a statement. Mr. Humeston originally lost his case against Merck; the setting aside of that verdict last year precipitated this latest court battle.

Bill Targets Psoriatic Arthritis

New legislation introduced in the U.S. House aims to expand research into psoriatic arthritis and psoriasis. The legislation (H.R. 1188), “The Psoriasis and Psoriatic Arthritis Research, Cure, and Care Act of 2007,” would widen the scope of research performed by the National Institutes of Health. The bill calls for establishing a national psoriatic arthritis and psoriasis patient registry under CDC direction. If passed, the legislation would also create a federal summit to discuss research opportunities in psoriasis and psoriatic arthritis and direct the Institute of Medicine to issue a report evaluating insurance coverage for psoriasis treatments. “This is the first time psoriasis will be recognized through legislation,” Sheila Rittenberg, director of advocacy for the National Psoriasis Foundation, said in a statement. “Psoriasis research is lagging and treatment options are improving but still often do not meet patients' needs. This bill lays out a plan which will pave the way to a cure.”

FDA to Study DTC Risk Data

Saying that it has become more concerned about how much risk information is disclosed to consumers in print ads, and that the information is not usually in a consumer-friendly format, the Food and Drug Administration announced that it will study how to better present those data. One study will look at whether giving consumers more context—instead of a list of risks, for instance—will aid their understanding of a product's potential downside. Another will look at the usefulness of several different formats for presenting the data. FDA is accepting comments on the proposed testing until mid-April.

ORLANDO — The use of a computer protocol to achieve tight glycemic control lowered insulin administration errors, compared with a paper-based protocol, according to a study of simulated patients in an intensive care unit.

The computer format also improved satisfaction in ICU nurses, Dr. Anthony Y. Lee of Columbus Children's Hospital in Ohio said at the annual congress of the Society of Critical Care Medicine.

Dr. Lee and colleagues at the University of Maryland Medical Center, Baltimore, recruited 51 medical ICU nurses to complete seven simulated patient scenarios using both the standard paper-based insulin protocol and a computer version of the protocol.

The scenarios included a clinical case description, a current insulin dose, and new and previous blood glucose levels. The nurses were given instructions on using the paper and computer versions of the protocol and had to indicate the new insulin dose and time of the next blood glucose check.

The simulated situations produced 357 paper responses and 357 computer responses showing a significant reduction in errors using the computer format. Use of the paper protocol resulted in 82 insulin-dosing errors, compared with 4 errors using the computer system. It seemed that the same study participant committed all four errors using the computer protocol.

Errors in the timing of the next blood glucose check fell from 47 with the paper-based format to 8 with the computer format. The time to completion fell from 9 minutes with the paper-based format to 6 with the computer program.

ORLANDO — The use of a computer protocol to achieve tight glycemic control lowered insulin administration errors, compared with a paper-based protocol, according to a study of simulated patients in an intensive care unit.

The computer format also improved satisfaction in ICU nurses, Dr. Anthony Y. Lee of Columbus Children's Hospital in Ohio said at the annual congress of the Society of Critical Care Medicine.

Dr. Lee and colleagues at the University of Maryland Medical Center, Baltimore, recruited 51 medical ICU nurses to complete seven simulated patient scenarios using both the standard paper-based insulin protocol and a computer version of the protocol.

The scenarios included a clinical case description, a current insulin dose, and new and previous blood glucose levels. The nurses were given instructions on using the paper and computer versions of the protocol and had to indicate the new insulin dose and time of the next blood glucose check.

The simulated situations produced 357 paper responses and 357 computer responses showing a significant reduction in errors using the computer format. Use of the paper protocol resulted in 82 insulin-dosing errors, compared with 4 errors using the computer system. It seemed that the same study participant committed all four errors using the computer protocol.

Errors in the timing of the next blood glucose check fell from 47 with the paper-based format to 8 with the computer format. The time to completion fell from 9 minutes with the paper-based format to 6 with the computer program.

ORLANDO — The use of a computer protocol to achieve tight glycemic control lowered insulin administration errors, compared with a paper-based protocol, according to a study of simulated patients in an intensive care unit.

The computer format also improved satisfaction in ICU nurses, Dr. Anthony Y. Lee of Columbus Children's Hospital in Ohio said at the annual congress of the Society of Critical Care Medicine.

Dr. Lee and colleagues at the University of Maryland Medical Center, Baltimore, recruited 51 medical ICU nurses to complete seven simulated patient scenarios using both the standard paper-based insulin protocol and a computer version of the protocol.

The scenarios included a clinical case description, a current insulin dose, and new and previous blood glucose levels. The nurses were given instructions on using the paper and computer versions of the protocol and had to indicate the new insulin dose and time of the next blood glucose check.

The simulated situations produced 357 paper responses and 357 computer responses showing a significant reduction in errors using the computer format. Use of the paper protocol resulted in 82 insulin-dosing errors, compared with 4 errors using the computer system. It seemed that the same study participant committed all four errors using the computer protocol.

Errors in the timing of the next blood glucose check fell from 47 with the paper-based format to 8 with the computer format. The time to completion fell from 9 minutes with the paper-based format to 6 with the computer program.

BOSTON — Using computer kiosks in the emergency department to provide information on car seat use, smoke alarms, and proper poison storage may help to improve safety and save physicians time, Andrea C. Gielen, D.Sc., said at the annual meeting of the American Public Health Association.

Approximately 12 million preschoolers visit the emergency department each year, and computer technology provides an opportunity to offer a brief intervention, said Dr. Gielen, professor and director of the Center for Injury Research and Policy at Johns Hopkins School of Public Health, Baltimore.

“The potential for a teachable moment may really exist, but it's been largely unexplored,” she said.

In a test of the technology, Dr. Gielen and her colleagues evaluated the feasibility of using a computer kiosk in the pediatric emergency department to improve parents' knowledge about common safety issues.

The researchers randomized 901 families with a child under age 6 who presented in the emergency department into either an intervention or a control group. As part of the intervention, parents used the computer program to complete a 12-minute assessment that collected information on their current knowledge and attitudes about car seats, smoke alarms, and poison storage. The parents then received a four-page report personalized with their child's name that detailed customized safety messages tailored to their responses.

For example, parents without a car seat would receive materials that focused on the need to have a car seat. However, for those parents who already have a car seat, the materials might focus on having the correct seat for the age and weight of the child or on the need to use the seat consistently.

Families in the control group also completed a 12-minute assessment using the computer kiosk and received a personalized report, but the report focused on general child health topics and did not touch on safety issues.

After 2 weeks, 98% of parents in the intervention group remembered the report, 93% read some of the report, 57% read the entire report, and 68% discussed the report with family and friends. About 39% of parents in the intervention group said that they read the entire report and discussed it with others.

When the researchers compared the 39% of the intervention group who had both read and discussed the report with families in the control group, the families who were highly exposed to the intervention materials were significantly more likely to be practicing recommended safety behaviors.

Those families in the intervention group who read the entire report and discussed it with others also were more likely to have higher incomes, highlighting the need to give special attention to the needs of low-income families, Dr. Gielen said.

Overall, the program was well received in the pediatric emergency department and parents liked it, she said.

“We think that this technology does in fact offer a lot of promise for injury prevention in the pediatric emergency department.”

The kiosks have safety information for preschoolers' parents on car seat use, smoke alarms, and proper poison storage, said Dr. Andrea C. Gielen. Vivian E. Lee/Elsevier Global Medical News

BOSTON — Using computer kiosks in the emergency department to provide information on car seat use, smoke alarms, and proper poison storage may help to improve safety and save physicians time, Andrea C. Gielen, D.Sc., said at the annual meeting of the American Public Health Association.

Approximately 12 million preschoolers visit the emergency department each year, and computer technology provides an opportunity to offer a brief intervention, said Dr. Gielen, professor and director of the Center for Injury Research and Policy at Johns Hopkins School of Public Health, Baltimore.

“The potential for a teachable moment may really exist, but it's been largely unexplored,” she said.

In a test of the technology, Dr. Gielen and her colleagues evaluated the feasibility of using a computer kiosk in the pediatric emergency department to improve parents' knowledge about common safety issues.

The researchers randomized 901 families with a child under age 6 who presented in the emergency department into either an intervention or a control group. As part of the intervention, parents used the computer program to complete a 12-minute assessment that collected information on their current knowledge and attitudes about car seats, smoke alarms, and poison storage. The parents then received a four-page report personalized with their child's name that detailed customized safety messages tailored to their responses.

For example, parents without a car seat would receive materials that focused on the need to have a car seat. However, for those parents who already have a car seat, the materials might focus on having the correct seat for the age and weight of the child or on the need to use the seat consistently.

Families in the control group also completed a 12-minute assessment using the computer kiosk and received a personalized report, but the report focused on general child health topics and did not touch on safety issues.

After 2 weeks, 98% of parents in the intervention group remembered the report, 93% read some of the report, 57% read the entire report, and 68% discussed the report with family and friends. About 39% of parents in the intervention group said that they read the entire report and discussed it with others.

When the researchers compared the 39% of the intervention group who had both read and discussed the report with families in the control group, the families who were highly exposed to the intervention materials were significantly more likely to be practicing recommended safety behaviors.

Those families in the intervention group who read the entire report and discussed it with others also were more likely to have higher incomes, highlighting the need to give special attention to the needs of low-income families, Dr. Gielen said.

Overall, the program was well received in the pediatric emergency department and parents liked it, she said.

“We think that this technology does in fact offer a lot of promise for injury prevention in the pediatric emergency department.”

The kiosks have safety information for preschoolers' parents on car seat use, smoke alarms, and proper poison storage, said Dr. Andrea C. Gielen. Vivian E. Lee/Elsevier Global Medical News

BOSTON — Using computer kiosks in the emergency department to provide information on car seat use, smoke alarms, and proper poison storage may help to improve safety and save physicians time, Andrea C. Gielen, D.Sc., said at the annual meeting of the American Public Health Association.

Approximately 12 million preschoolers visit the emergency department each year, and computer technology provides an opportunity to offer a brief intervention, said Dr. Gielen, professor and director of the Center for Injury Research and Policy at Johns Hopkins School of Public Health, Baltimore.

“The potential for a teachable moment may really exist, but it's been largely unexplored,” she said.

In a test of the technology, Dr. Gielen and her colleagues evaluated the feasibility of using a computer kiosk in the pediatric emergency department to improve parents' knowledge about common safety issues.

The researchers randomized 901 families with a child under age 6 who presented in the emergency department into either an intervention or a control group. As part of the intervention, parents used the computer program to complete a 12-minute assessment that collected information on their current knowledge and attitudes about car seats, smoke alarms, and poison storage. The parents then received a four-page report personalized with their child's name that detailed customized safety messages tailored to their responses.

For example, parents without a car seat would receive materials that focused on the need to have a car seat. However, for those parents who already have a car seat, the materials might focus on having the correct seat for the age and weight of the child or on the need to use the seat consistently.

Families in the control group also completed a 12-minute assessment using the computer kiosk and received a personalized report, but the report focused on general child health topics and did not touch on safety issues.

After 2 weeks, 98% of parents in the intervention group remembered the report, 93% read some of the report, 57% read the entire report, and 68% discussed the report with family and friends. About 39% of parents in the intervention group said that they read the entire report and discussed it with others.

When the researchers compared the 39% of the intervention group who had both read and discussed the report with families in the control group, the families who were highly exposed to the intervention materials were significantly more likely to be practicing recommended safety behaviors.

Those families in the intervention group who read the entire report and discussed it with others also were more likely to have higher incomes, highlighting the need to give special attention to the needs of low-income families, Dr. Gielen said.

Overall, the program was well received in the pediatric emergency department and parents liked it, she said.

“We think that this technology does in fact offer a lot of promise for injury prevention in the pediatric emergency department.”

The kiosks have safety information for preschoolers' parents on car seat use, smoke alarms, and proper poison storage, said Dr. Andrea C. Gielen. Vivian E. Lee/Elsevier Global Medical News

Mental Health Parity Legislation

Mental health advocates in Congress recently introduced legislation to bring parity to insurance coverage for the treatment of mental illness. Rep. Patrick Kennedy (D-R.I.) and Rep. Jim Ramstad (R-Minn.) introduced the “Paul Wellstone Mental Health and Addiction Equity Act of 2007” (H.R. 1424) last month, and at press time more than 254 House members had cosponsored the legislation. If passed, the bill would require insurance plans that offer coverage for mental health and addiction disorders to offer the same coverage limits and terms for those services as for other medical care. The requirements would apply to all group health plans with 50 or more employees. However, the bill would not mandate that group health plans provide mental health coverage. A slightly different mental health parity bill (S. 558) was introduced in February by Sen. Pete Dominici (R-N.M.) and has been passed out of the Senate Committee on Health, Education, Labor, and Pensions.

CMS Extends Form Deadline

The Centers for Medicare and Medicaid Services has extended the deadline for filing Medicare claims using its new version of claims form CMS-1500, because of formatting errors on the revised form, CMS announced. The original deadline for switching to the new form–known as CMS-1500 (08/05)–originally was April 2. But CMS said last month that contractors have been directed to continue to accept the old form until the agency notifies them to stop. Additionally, the agency advised physicians who must use the form to use legacy provider numbers, as the form cannot accommodate a National Provider Identifier (NPI) number.

Mental Health Court Cut Costs

Mental health courts, which emphasize treatment rather than jail time, could save taxpayers some money if the experience of one Pennsylvania court is any indication. An analysis by the Rand Corp. found that participants in Allegheny County's mental health court program spent fewer days in jail and received more mental health treatment than they would have if they had been sentenced in a traditional criminal court. They also spent fewer days in jail compared with a past arrest. In the first year of the study, the cost of increased mental health services was mostly offset by the decrease in jail time. However, among a subset of participants analyzed over a second year, the cost savings were more significant. Allegheny County's mental health court was designed to help mentally ill individuals who have committed nonviolent crimes get treatment instead of jail time. Although the study looked at only one court, the researchers noted that it is likely that their findings would be applicable to many of the other approximately 120 mental health courts around the country. The study was funded by the Pennsylvania Department of Public Welfare and the Staunton Farm Foundation.

NIH Launches Addiction Study

In response to the growing problem of prescription drug abuse, officials at the National Institutes of Health are launching the Prescription Opioid Addiction Treatment Study (POATS), a multisite study to be conducted under the direction of the National Institute on Drug Abuse. The researchers will examine the effectiveness of buprenorphine/naloxone (Suboxone) combined with either intensive or brief drug-counseling approaches. Investigators are planning to enroll about 648 participants at 11 sites. “Opioid analgesics were designed to help people in pain and we want to be sure that those who require them for legitimate reasons can continue to effectively manage their pain,” Dr. Nora D. Volkow, director of NIDA, said in a statement. “However, we must also recognize the risk of addiction to pain medications and develop treatments for those who become addicted to them. This trial is an important first step in reaching that goal.”

FDA to Study Ads' Risk Data

Saying that it has become more concerned about how much risk information is disclosed to consumers in print ads, and that the information is not usually in a consumer-friendly format, the Food and Drug Administration announced that it will study how to better present those data. One study will look at whether giving consumers more context–instead of a list of risks, for instance–will aid their understanding of a product's potential downside. Another will look at the usefulness of several different formats for presenting the data. FDA is accepting comments on the proposed testing until mid-April.

Call to Action on Teen Drinking

In its first Call to Action against underage drinking, the U.S. Surgeon General's office appealed to Americans to do more to stop the country's 11 million current underage drinkers from using alcohol, and to prevent other young people from starting to drink. Acting Surgeon General Kenneth P. Moritsugu laid out recommendations for government and school officials, parents, other adults, and young people, saying that although the use of tobacco and illicit drugs has declined significantly, underage drinking has remained consistently high. “Research shows that young people who start drinking before the age of 15 are five times more likely to have alcohol-related problems later in life,” Dr. Moritsugu said in a statement, adding, “new research also indicates that alcohol may harm the developing adolescent brain.”

Mental Health Parity Legislation

Mental health advocates in Congress recently introduced legislation to bring parity to insurance coverage for the treatment of mental illness. Rep. Patrick Kennedy (D-R.I.) and Rep. Jim Ramstad (R-Minn.) introduced the “Paul Wellstone Mental Health and Addiction Equity Act of 2007” (H.R. 1424) last month, and at press time more than 254 House members had cosponsored the legislation. If passed, the bill would require insurance plans that offer coverage for mental health and addiction disorders to offer the same coverage limits and terms for those services as for other medical care. The requirements would apply to all group health plans with 50 or more employees. However, the bill would not mandate that group health plans provide mental health coverage. A slightly different mental health parity bill (S. 558) was introduced in February by Sen. Pete Dominici (R-N.M.) and has been passed out of the Senate Committee on Health, Education, Labor, and Pensions.

CMS Extends Form Deadline

The Centers for Medicare and Medicaid Services has extended the deadline for filing Medicare claims using its new version of claims form CMS-1500, because of formatting errors on the revised form, CMS announced. The original deadline for switching to the new form–known as CMS-1500 (08/05)–originally was April 2. But CMS said last month that contractors have been directed to continue to accept the old form until the agency notifies them to stop. Additionally, the agency advised physicians who must use the form to use legacy provider numbers, as the form cannot accommodate a National Provider Identifier (NPI) number.

Mental Health Court Cut Costs

Mental health courts, which emphasize treatment rather than jail time, could save taxpayers some money if the experience of one Pennsylvania court is any indication. An analysis by the Rand Corp. found that participants in Allegheny County's mental health court program spent fewer days in jail and received more mental health treatment than they would have if they had been sentenced in a traditional criminal court. They also spent fewer days in jail compared with a past arrest. In the first year of the study, the cost of increased mental health services was mostly offset by the decrease in jail time. However, among a subset of participants analyzed over a second year, the cost savings were more significant. Allegheny County's mental health court was designed to help mentally ill individuals who have committed nonviolent crimes get treatment instead of jail time. Although the study looked at only one court, the researchers noted that it is likely that their findings would be applicable to many of the other approximately 120 mental health courts around the country. The study was funded by the Pennsylvania Department of Public Welfare and the Staunton Farm Foundation.

NIH Launches Addiction Study

In response to the growing problem of prescription drug abuse, officials at the National Institutes of Health are launching the Prescription Opioid Addiction Treatment Study (POATS), a multisite study to be conducted under the direction of the National Institute on Drug Abuse. The researchers will examine the effectiveness of buprenorphine/naloxone (Suboxone) combined with either intensive or brief drug-counseling approaches. Investigators are planning to enroll about 648 participants at 11 sites. “Opioid analgesics were designed to help people in pain and we want to be sure that those who require them for legitimate reasons can continue to effectively manage their pain,” Dr. Nora D. Volkow, director of NIDA, said in a statement. “However, we must also recognize the risk of addiction to pain medications and develop treatments for those who become addicted to them. This trial is an important first step in reaching that goal.”

FDA to Study Ads' Risk Data

Saying that it has become more concerned about how much risk information is disclosed to consumers in print ads, and that the information is not usually in a consumer-friendly format, the Food and Drug Administration announced that it will study how to better present those data. One study will look at whether giving consumers more context–instead of a list of risks, for instance–will aid their understanding of a product's potential downside. Another will look at the usefulness of several different formats for presenting the data. FDA is accepting comments on the proposed testing until mid-April.

Call to Action on Teen Drinking

In its first Call to Action against underage drinking, the U.S. Surgeon General's office appealed to Americans to do more to stop the country's 11 million current underage drinkers from using alcohol, and to prevent other young people from starting to drink. Acting Surgeon General Kenneth P. Moritsugu laid out recommendations for government and school officials, parents, other adults, and young people, saying that although the use of tobacco and illicit drugs has declined significantly, underage drinking has remained consistently high. “Research shows that young people who start drinking before the age of 15 are five times more likely to have alcohol-related problems later in life,” Dr. Moritsugu said in a statement, adding, “new research also indicates that alcohol may harm the developing adolescent brain.”

Mental Health Parity Legislation

Mental health advocates in Congress recently introduced legislation to bring parity to insurance coverage for the treatment of mental illness. Rep. Patrick Kennedy (D-R.I.) and Rep. Jim Ramstad (R-Minn.) introduced the “Paul Wellstone Mental Health and Addiction Equity Act of 2007” (H.R. 1424) last month, and at press time more than 254 House members had cosponsored the legislation. If passed, the bill would require insurance plans that offer coverage for mental health and addiction disorders to offer the same coverage limits and terms for those services as for other medical care. The requirements would apply to all group health plans with 50 or more employees. However, the bill would not mandate that group health plans provide mental health coverage. A slightly different mental health parity bill (S. 558) was introduced in February by Sen. Pete Dominici (R-N.M.) and has been passed out of the Senate Committee on Health, Education, Labor, and Pensions.

CMS Extends Form Deadline

The Centers for Medicare and Medicaid Services has extended the deadline for filing Medicare claims using its new version of claims form CMS-1500, because of formatting errors on the revised form, CMS announced. The original deadline for switching to the new form–known as CMS-1500 (08/05)–originally was April 2. But CMS said last month that contractors have been directed to continue to accept the old form until the agency notifies them to stop. Additionally, the agency advised physicians who must use the form to use legacy provider numbers, as the form cannot accommodate a National Provider Identifier (NPI) number.

Mental Health Court Cut Costs

Mental health courts, which emphasize treatment rather than jail time, could save taxpayers some money if the experience of one Pennsylvania court is any indication. An analysis by the Rand Corp. found that participants in Allegheny County's mental health court program spent fewer days in jail and received more mental health treatment than they would have if they had been sentenced in a traditional criminal court. They also spent fewer days in jail compared with a past arrest. In the first year of the study, the cost of increased mental health services was mostly offset by the decrease in jail time. However, among a subset of participants analyzed over a second year, the cost savings were more significant. Allegheny County's mental health court was designed to help mentally ill individuals who have committed nonviolent crimes get treatment instead of jail time. Although the study looked at only one court, the researchers noted that it is likely that their findings would be applicable to many of the other approximately 120 mental health courts around the country. The study was funded by the Pennsylvania Department of Public Welfare and the Staunton Farm Foundation.

NIH Launches Addiction Study

In response to the growing problem of prescription drug abuse, officials at the National Institutes of Health are launching the Prescription Opioid Addiction Treatment Study (POATS), a multisite study to be conducted under the direction of the National Institute on Drug Abuse. The researchers will examine the effectiveness of buprenorphine/naloxone (Suboxone) combined with either intensive or brief drug-counseling approaches. Investigators are planning to enroll about 648 participants at 11 sites. “Opioid analgesics were designed to help people in pain and we want to be sure that those who require them for legitimate reasons can continue to effectively manage their pain,” Dr. Nora D. Volkow, director of NIDA, said in a statement. “However, we must also recognize the risk of addiction to pain medications and develop treatments for those who become addicted to them. This trial is an important first step in reaching that goal.”

FDA to Study Ads' Risk Data

Saying that it has become more concerned about how much risk information is disclosed to consumers in print ads, and that the information is not usually in a consumer-friendly format, the Food and Drug Administration announced that it will study how to better present those data. One study will look at whether giving consumers more context–instead of a list of risks, for instance–will aid their understanding of a product's potential downside. Another will look at the usefulness of several different formats for presenting the data. FDA is accepting comments on the proposed testing until mid-April.

Call to Action on Teen Drinking

In its first Call to Action against underage drinking, the U.S. Surgeon General's office appealed to Americans to do more to stop the country's 11 million current underage drinkers from using alcohol, and to prevent other young people from starting to drink. Acting Surgeon General Kenneth P. Moritsugu laid out recommendations for government and school officials, parents, other adults, and young people, saying that although the use of tobacco and illicit drugs has declined significantly, underage drinking has remained consistently high. “Research shows that young people who start drinking before the age of 15 are five times more likely to have alcohol-related problems later in life,” Dr. Moritsugu said in a statement, adding, “new research also indicates that alcohol may harm the developing adolescent brain.”

NEW ORLEANS — The Drug Enforcement Administration is close to completing a final rule that would let physicians provide up to a 90-day supply of schedule II controlled substances without requiring patients to come into the office each month.

Under this change, physicians would be able to issue three monthly prescriptions at once and specify a future fill date for each one. The DEA statute currently prohibits the refilling of schedule II prescriptions, an agency official said at the annual meeting of the American Academy of Pain Medicine.

The regulation, which is currently being finalized, will be “substantially” similar to a notice of proposed rule making issued by the DEA last September, said Mark W. Caverly, chief of the liaison and policy section of the Office of Diversion Control at the DEA.

“We're going to make some tweaks in the language and try to explain some things a little bit better,” he said.

Mr. Caverly would not offer an estimate on exactly when the final rule would be published.

The public comment period on the proposal ended on Nov. 6 and the DEA received 264 official comments, 87% of which supported the proposal. Opponents of the rule said that it would increase the supply of highly abusable drugs to patients and that it's important to see pain patients every 30 days. Other critics noted that a 90-day supply of medications is inadequate and the limit should be 180 days or there should be no time limits at all.

This pending regulation and other recent communications from the DEA should help to demonstrate to the physician community that the agency is not interested in stopping physicians from writing valid and medically necessary prescriptions, Mr. Caverly said. “DEA and the pain treatment community have strong common interests in the effective and adequate prescribing of controlled substances for the treatment of pain.”

Mr. Caverly also outlined some areas where DEA officials plan to clarify agency policy in the future. For example, agency officials plan to address the issue of whether locum tenens physicians who work in multiple states need to have multiple DEA licenses. They also will look at who should be authorized to call the pharmacy to change medications, how consumers should submit prescription drugs for destruction, and issues related to telemedicine and telepharmacy.

NEW ORLEANS — The Drug Enforcement Administration is close to completing a final rule that would let physicians provide up to a 90-day supply of schedule II controlled substances without requiring patients to come into the office each month.

Under this change, physicians would be able to issue three monthly prescriptions at once and specify a future fill date for each one. The DEA statute currently prohibits the refilling of schedule II prescriptions, an agency official said at the annual meeting of the American Academy of Pain Medicine.

The regulation, which is currently being finalized, will be “substantially” similar to a notice of proposed rule making issued by the DEA last September, said Mark W. Caverly, chief of the liaison and policy section of the Office of Diversion Control at the DEA.

“We're going to make some tweaks in the language and try to explain some things a little bit better,” he said.

Mr. Caverly would not offer an estimate on exactly when the final rule would be published.

The public comment period on the proposal ended on Nov. 6 and the DEA received 264 official comments, 87% of which supported the proposal. Opponents of the rule said that it would increase the supply of highly abusable drugs to patients and that it's important to see pain patients every 30 days. Other critics noted that a 90-day supply of medications is inadequate and the limit should be 180 days or there should be no time limits at all.

This pending regulation and other recent communications from the DEA should help to demonstrate to the physician community that the agency is not interested in stopping physicians from writing valid and medically necessary prescriptions, Mr. Caverly said. “DEA and the pain treatment community have strong common interests in the effective and adequate prescribing of controlled substances for the treatment of pain.”

Mr. Caverly also outlined some areas where DEA officials plan to clarify agency policy in the future. For example, agency officials plan to address the issue of whether locum tenens physicians who work in multiple states need to have multiple DEA licenses. They also will look at who should be authorized to call the pharmacy to change medications, how consumers should submit prescription drugs for destruction, and issues related to telemedicine and telepharmacy.

NEW ORLEANS — The Drug Enforcement Administration is close to completing a final rule that would let physicians provide up to a 90-day supply of schedule II controlled substances without requiring patients to come into the office each month.

Under this change, physicians would be able to issue three monthly prescriptions at once and specify a future fill date for each one. The DEA statute currently prohibits the refilling of schedule II prescriptions, an agency official said at the annual meeting of the American Academy of Pain Medicine.

The regulation, which is currently being finalized, will be “substantially” similar to a notice of proposed rule making issued by the DEA last September, said Mark W. Caverly, chief of the liaison and policy section of the Office of Diversion Control at the DEA.

“We're going to make some tweaks in the language and try to explain some things a little bit better,” he said.

Mr. Caverly would not offer an estimate on exactly when the final rule would be published.

The public comment period on the proposal ended on Nov. 6 and the DEA received 264 official comments, 87% of which supported the proposal. Opponents of the rule said that it would increase the supply of highly abusable drugs to patients and that it's important to see pain patients every 30 days. Other critics noted that a 90-day supply of medications is inadequate and the limit should be 180 days or there should be no time limits at all.

This pending regulation and other recent communications from the DEA should help to demonstrate to the physician community that the agency is not interested in stopping physicians from writing valid and medically necessary prescriptions, Mr. Caverly said. “DEA and the pain treatment community have strong common interests in the effective and adequate prescribing of controlled substances for the treatment of pain.”

Mr. Caverly also outlined some areas where DEA officials plan to clarify agency policy in the future. For example, agency officials plan to address the issue of whether locum tenens physicians who work in multiple states need to have multiple DEA licenses. They also will look at who should be authorized to call the pharmacy to change medications, how consumers should submit prescription drugs for destruction, and issues related to telemedicine and telepharmacy.

BOSTON — In the event of an avian influenza pandemic, old-fashioned containment strategies will need to be the first line of defense to limit exposure, David Heyman, a terrorism expert, said at the annual meeting of the American Public Health Association.

The best countermeasure in the case of a pandemic is vaccine, but vaccine is unlikely to be available for at least 4–6 months after the onset of the outbreak.

Antiviral treatment could help improve outcomes but has been shown to have only a modest effect on transmission and may also be in short supply in the event of an influenza pandemic, said Mr. Heyman, director and senior fellow for the Center for Strategic and International Studies' Homeland Security Program in Washington.

The U.S. strategy for responding to an avian influenza pandemic has so far centered on vaccine production and development, stockpiling of antiviral medications, and state plans for distribution.

Although it is important to focus on vaccines and antivirals, those treatments are unlikely to be ready in time for the first wave of a pandemic, he said.

“There are a number of tools in our toolbox. The strategy needs to be figured out. We don't have a specific strategy right now,” Mr. Hewitt said.

The key to bringing a pandemic under control will be to slow transmission until vaccines and other medicines become available.

Some possible elements of a disease-containment strategy being considered by the U.S. government include closing schools, encouraging social distancing, voluntary household quarantines, and masking and good infection control.

It is important that the least restrictive measures necessary are used, and the public must be engaged as a partner in the response, he said. “They need to be educated, starting today.”

However, implementing such containment strategies would be a challenge because many people are resistant to strategies that involve quarantine because of “the historical use of quarantines that led to deprivation of rights and privacy,” he said.

BOSTON — In the event of an avian influenza pandemic, old-fashioned containment strategies will need to be the first line of defense to limit exposure, David Heyman, a terrorism expert, said at the annual meeting of the American Public Health Association.

The best countermeasure in the case of a pandemic is vaccine, but vaccine is unlikely to be available for at least 4–6 months after the onset of the outbreak.

Antiviral treatment could help improve outcomes but has been shown to have only a modest effect on transmission and may also be in short supply in the event of an influenza pandemic, said Mr. Heyman, director and senior fellow for the Center for Strategic and International Studies' Homeland Security Program in Washington.

The U.S. strategy for responding to an avian influenza pandemic has so far centered on vaccine production and development, stockpiling of antiviral medications, and state plans for distribution.

Although it is important to focus on vaccines and antivirals, those treatments are unlikely to be ready in time for the first wave of a pandemic, he said.

“There are a number of tools in our toolbox. The strategy needs to be figured out. We don't have a specific strategy right now,” Mr. Hewitt said.

The key to bringing a pandemic under control will be to slow transmission until vaccines and other medicines become available.

Some possible elements of a disease-containment strategy being considered by the U.S. government include closing schools, encouraging social distancing, voluntary household quarantines, and masking and good infection control.

It is important that the least restrictive measures necessary are used, and the public must be engaged as a partner in the response, he said. “They need to be educated, starting today.”

However, implementing such containment strategies would be a challenge because many people are resistant to strategies that involve quarantine because of “the historical use of quarantines that led to deprivation of rights and privacy,” he said.

BOSTON — In the event of an avian influenza pandemic, old-fashioned containment strategies will need to be the first line of defense to limit exposure, David Heyman, a terrorism expert, said at the annual meeting of the American Public Health Association.

The best countermeasure in the case of a pandemic is vaccine, but vaccine is unlikely to be available for at least 4–6 months after the onset of the outbreak.

Antiviral treatment could help improve outcomes but has been shown to have only a modest effect on transmission and may also be in short supply in the event of an influenza pandemic, said Mr. Heyman, director and senior fellow for the Center for Strategic and International Studies' Homeland Security Program in Washington.

The U.S. strategy for responding to an avian influenza pandemic has so far centered on vaccine production and development, stockpiling of antiviral medications, and state plans for distribution.

Although it is important to focus on vaccines and antivirals, those treatments are unlikely to be ready in time for the first wave of a pandemic, he said.

“There are a number of tools in our toolbox. The strategy needs to be figured out. We don't have a specific strategy right now,” Mr. Hewitt said.

The key to bringing a pandemic under control will be to slow transmission until vaccines and other medicines become available.

Some possible elements of a disease-containment strategy being considered by the U.S. government include closing schools, encouraging social distancing, voluntary household quarantines, and masking and good infection control.

It is important that the least restrictive measures necessary are used, and the public must be engaged as a partner in the response, he said. “They need to be educated, starting today.”

However, implementing such containment strategies would be a challenge because many people are resistant to strategies that involve quarantine because of “the historical use of quarantines that led to deprivation of rights and privacy,” he said.

Hospitals are reporting consistent quality improvements across five clinical areas as part of a Medicare pay-for-performance demonstration, officials at the Centers for Medicare and Medicaid Services have announced.

In the second year of the demonstration project, the average improvement across the more than 250 participating hospitals was 6.7%, according to the CMS. Agency officials also reported a total gain of 11.8% over the 2-year period. “The results today provide more solid evidence that pay for performance is working to improve the quality of health care at our nation's hospitals,” Herb Kuhn, CMS acting deputy administrator, said during a teleconference to announce the second-year results of the Premier Hospital Quality Improvement Demonstration.

The program was launched in October 2003 by the CMS and the Premier Inc. health care alliance to test whether providing incentives to hospitals would help to speed quality gains. Under the demonstration, the CMS provides financial incentives to the top 20% of high-scoring hospitals in each of five clinical areas—acute myocardial infarction, heart failure, coronary artery bypass graft, pneumonia, and hip and knee replacement. Performance in the five clinical areas is measured by more than 30 nationally recognized quality standards.

Hospitals in the top 10% receive a 2% incentive payment, while hospitals in the next 10% receive a 1% payment. Any hospital that ranks in the top half in each clinical area is recognized on the CMS Web site. In the third year of the program—from October 2006 to September 2007—hospitals that fail to improve over baseline could face penalties.

In the second year, the CMS paid more than $8.6 million to 115 high-performing hospitals. The highest incentive payment went to Hackensack (N.J.) University Medical Center, which received $744,000 as a high-performer in all five clinical areas.

Data from the second year of the demonstration program showed significant improvements in all five clinical areas, according to the CMS. The average composite quality scores for more than 30 quality measures showed that hospitals improved in acute myocardial infarction (87.5% to 94.4%); coronary artery bypass graft (84.8% to 93.8%); heart failure (64.5% to 82.4%); pneumonia (69.3% to 85.8%); and hip and knee replacement (84.6% to 93.4%). The lessons learned thus far in the demonstration will help CMS officials plan for the future. “This demonstration is really helping us to understand what's needed to improve our health care system,” Mr. Kuhn said.

For more information on the demonstration program, visit www.cms.hhs.gov/HospitalQualityInits

Hospitals are reporting consistent quality improvements across five clinical areas as part of a Medicare pay-for-performance demonstration, officials at the Centers for Medicare and Medicaid Services have announced.

In the second year of the demonstration project, the average improvement across the more than 250 participating hospitals was 6.7%, according to the CMS. Agency officials also reported a total gain of 11.8% over the 2-year period. “The results today provide more solid evidence that pay for performance is working to improve the quality of health care at our nation's hospitals,” Herb Kuhn, CMS acting deputy administrator, said during a teleconference to announce the second-year results of the Premier Hospital Quality Improvement Demonstration.

The program was launched in October 2003 by the CMS and the Premier Inc. health care alliance to test whether providing incentives to hospitals would help to speed quality gains. Under the demonstration, the CMS provides financial incentives to the top 20% of high-scoring hospitals in each of five clinical areas—acute myocardial infarction, heart failure, coronary artery bypass graft, pneumonia, and hip and knee replacement. Performance in the five clinical areas is measured by more than 30 nationally recognized quality standards.

Hospitals in the top 10% receive a 2% incentive payment, while hospitals in the next 10% receive a 1% payment. Any hospital that ranks in the top half in each clinical area is recognized on the CMS Web site. In the third year of the program—from October 2006 to September 2007—hospitals that fail to improve over baseline could face penalties.

In the second year, the CMS paid more than $8.6 million to 115 high-performing hospitals. The highest incentive payment went to Hackensack (N.J.) University Medical Center, which received $744,000 as a high-performer in all five clinical areas.

Data from the second year of the demonstration program showed significant improvements in all five clinical areas, according to the CMS. The average composite quality scores for more than 30 quality measures showed that hospitals improved in acute myocardial infarction (87.5% to 94.4%); coronary artery bypass graft (84.8% to 93.8%); heart failure (64.5% to 82.4%); pneumonia (69.3% to 85.8%); and hip and knee replacement (84.6% to 93.4%). The lessons learned thus far in the demonstration will help CMS officials plan for the future. “This demonstration is really helping us to understand what's needed to improve our health care system,” Mr. Kuhn said.

For more information on the demonstration program, visit www.cms.hhs.gov/HospitalQualityInits

Hospitals are reporting consistent quality improvements across five clinical areas as part of a Medicare pay-for-performance demonstration, officials at the Centers for Medicare and Medicaid Services have announced.

In the second year of the demonstration project, the average improvement across the more than 250 participating hospitals was 6.7%, according to the CMS. Agency officials also reported a total gain of 11.8% over the 2-year period. “The results today provide more solid evidence that pay for performance is working to improve the quality of health care at our nation's hospitals,” Herb Kuhn, CMS acting deputy administrator, said during a teleconference to announce the second-year results of the Premier Hospital Quality Improvement Demonstration.

The program was launched in October 2003 by the CMS and the Premier Inc. health care alliance to test whether providing incentives to hospitals would help to speed quality gains. Under the demonstration, the CMS provides financial incentives to the top 20% of high-scoring hospitals in each of five clinical areas—acute myocardial infarction, heart failure, coronary artery bypass graft, pneumonia, and hip and knee replacement. Performance in the five clinical areas is measured by more than 30 nationally recognized quality standards.

Hospitals in the top 10% receive a 2% incentive payment, while hospitals in the next 10% receive a 1% payment. Any hospital that ranks in the top half in each clinical area is recognized on the CMS Web site. In the third year of the program—from October 2006 to September 2007—hospitals that fail to improve over baseline could face penalties.

In the second year, the CMS paid more than $8.6 million to 115 high-performing hospitals. The highest incentive payment went to Hackensack (N.J.) University Medical Center, which received $744,000 as a high-performer in all five clinical areas.

Data from the second year of the demonstration program showed significant improvements in all five clinical areas, according to the CMS. The average composite quality scores for more than 30 quality measures showed that hospitals improved in acute myocardial infarction (87.5% to 94.4%); coronary artery bypass graft (84.8% to 93.8%); heart failure (64.5% to 82.4%); pneumonia (69.3% to 85.8%); and hip and knee replacement (84.6% to 93.4%). The lessons learned thus far in the demonstration will help CMS officials plan for the future. “This demonstration is really helping us to understand what's needed to improve our health care system,” Mr. Kuhn said.

For more information on the demonstration program, visit www.cms.hhs.gov/HospitalQualityInits

Calif. Stem Cell Initiative Advances

Stem cell research efforts took another step forward in California when a state appeals panel ruled that an initiative to provide billions in funding for human embryonic stem cell research is constitutional. In 2004, voters approved Proposition 71, the California Stem Cell Research and Cures Act, which authorized the distribution of $3 billion in funding over 10 years. The initiative was challenged by two taxpayer advocacy groups and the California Family Bioethics Council for not revealing the entire scope of the project and for allowing for the distribution of state funds to groups not under the exclusive control of the state. A challenge to the proposition was defeated last year and the appeals panel rejected an appeal last month. In the meantime, the initiative has been moving forward and recently approved its first round of grants. The 72 grants, which will be funded with $45 million over 2 years, were selected from among more than 200 applications. The grants will fund various projects including the generation of a library of human embryonic stem cell lines that can model a number of human genetic diseases and experiments into how mutations in mitochondria affect the stability of human embryonic stem cells and their ability to develop into nerve cells.

Women's Health at the FDA

Sens. Hillary Rodham Clinton (D-N.Y.), Olympia Snowe (R-Maine), Patty Murray (D-Wash.), and Barbara Mikulski (D-Md.) have written a letter to Food and Drug Administration Commissioner Dr. Andrew von Eschenbach urging him to retain full funding for the agency's Office of Women's Health. “According to news reports, the FDA intends to reallocate $1.2 million in funding from the fiscal year 2007 budget of the Office of Women's Health to other uses. … As Congress moves forward with the budget and appropriations process, we will pursue every course to make certain that this funding is restored,” the senators said in the letter, noting that Congress had allocated $4 million for the office. Phyllis Greenberger, president and CEO of the Society for Women's Health Research, noted that because the proposed cut represents a big chunk of the office's budget, it will probably have to shut down operations for the remainder of the year should the cut be made. “FDA leaders erroneously believe its various centers can fully address women's health needs on their own, something they have not demonstrated,” she said in a statement.

Implementing Routine HIV Testing

Physicians need new tools and resources in order to implement revised recommendations for routine HIV testing of all patients aged 13–64 years from the Centers for Disease Control and Prevention, according to the consensus of various medical professional societies including the American College of Obstetricians and Gynecologists. ACOG was among the groups convened last year by the American Academy of HIV Medicine and the American Medical Association, in cooperation with the CDC, to discuss how best to implement the CDC's “Revised Recommendations for HIV Testing of Adults, Adolescents and Pregnant Women in Health Care Settings.” The American Academy of HIV Medicine released a summary of the discussions in February. For example, physicians will need resources that systematically describe how to provide both positive and negative results to patients.

Assisted Reproductive Data Available

The Society for Assisted Reproductive Technology has released data on the success rates of its member clinics in 2005. The organization collected data from 343 clinics, which reported data on 122,683 treatment cycles in 2005. This is the second year that SART had published this type of outcome data. The information, which is available online at

www.sart.org

HEART for Women Reintroduced

The American Heart Association is throwing its weight behind the Heart Disease Education, Analysis and Research, and Treatment (HEART) for Women Act, which was reintroduced in both the House and Senate last month. Sponsored by Sen. Debbie Stabenow (D-Mich.) and Sen. Lisa Murkowski (R-Alaska), the legislation authorizes the Health and Human Services department to provide education to older women and health care professionals on the diagnosis and treatment of women with heart disease, requires gender-specific reporting of heart disease data to the federal government, and expands WISEWOMAN (Well-Integrated Screening and Evaluation for Women Across the Nation), the free heart disease and stroke screening program, beyond its current 14 states.

Calif. Stem Cell Initiative Advances

Stem cell research efforts took another step forward in California when a state appeals panel ruled that an initiative to provide billions in funding for human embryonic stem cell research is constitutional. In 2004, voters approved Proposition 71, the California Stem Cell Research and Cures Act, which authorized the distribution of $3 billion in funding over 10 years. The initiative was challenged by two taxpayer advocacy groups and the California Family Bioethics Council for not revealing the entire scope of the project and for allowing for the distribution of state funds to groups not under the exclusive control of the state. A challenge to the proposition was defeated last year and the appeals panel rejected an appeal last month. In the meantime, the initiative has been moving forward and recently approved its first round of grants. The 72 grants, which will be funded with $45 million over 2 years, were selected from among more than 200 applications. The grants will fund various projects including the generation of a library of human embryonic stem cell lines that can model a number of human genetic diseases and experiments into how mutations in mitochondria affect the stability of human embryonic stem cells and their ability to develop into nerve cells.

Women's Health at the FDA

Sens. Hillary Rodham Clinton (D-N.Y.), Olympia Snowe (R-Maine), Patty Murray (D-Wash.), and Barbara Mikulski (D-Md.) have written a letter to Food and Drug Administration Commissioner Dr. Andrew von Eschenbach urging him to retain full funding for the agency's Office of Women's Health. “According to news reports, the FDA intends to reallocate $1.2 million in funding from the fiscal year 2007 budget of the Office of Women's Health to other uses. … As Congress moves forward with the budget and appropriations process, we will pursue every course to make certain that this funding is restored,” the senators said in the letter, noting that Congress had allocated $4 million for the office. Phyllis Greenberger, president and CEO of the Society for Women's Health Research, noted that because the proposed cut represents a big chunk of the office's budget, it will probably have to shut down operations for the remainder of the year should the cut be made. “FDA leaders erroneously believe its various centers can fully address women's health needs on their own, something they have not demonstrated,” she said in a statement.

Implementing Routine HIV Testing

Physicians need new tools and resources in order to implement revised recommendations for routine HIV testing of all patients aged 13–64 years from the Centers for Disease Control and Prevention, according to the consensus of various medical professional societies including the American College of Obstetricians and Gynecologists. ACOG was among the groups convened last year by the American Academy of HIV Medicine and the American Medical Association, in cooperation with the CDC, to discuss how best to implement the CDC's “Revised Recommendations for HIV Testing of Adults, Adolescents and Pregnant Women in Health Care Settings.” The American Academy of HIV Medicine released a summary of the discussions in February. For example, physicians will need resources that systematically describe how to provide both positive and negative results to patients.

Assisted Reproductive Data Available

The Society for Assisted Reproductive Technology has released data on the success rates of its member clinics in 2005. The organization collected data from 343 clinics, which reported data on 122,683 treatment cycles in 2005. This is the second year that SART had published this type of outcome data. The information, which is available online at

www.sart.org

HEART for Women Reintroduced

The American Heart Association is throwing its weight behind the Heart Disease Education, Analysis and Research, and Treatment (HEART) for Women Act, which was reintroduced in both the House and Senate last month. Sponsored by Sen. Debbie Stabenow (D-Mich.) and Sen. Lisa Murkowski (R-Alaska), the legislation authorizes the Health and Human Services department to provide education to older women and health care professionals on the diagnosis and treatment of women with heart disease, requires gender-specific reporting of heart disease data to the federal government, and expands WISEWOMAN (Well-Integrated Screening and Evaluation for Women Across the Nation), the free heart disease and stroke screening program, beyond its current 14 states.

Calif. Stem Cell Initiative Advances

Stem cell research efforts took another step forward in California when a state appeals panel ruled that an initiative to provide billions in funding for human embryonic stem cell research is constitutional. In 2004, voters approved Proposition 71, the California Stem Cell Research and Cures Act, which authorized the distribution of $3 billion in funding over 10 years. The initiative was challenged by two taxpayer advocacy groups and the California Family Bioethics Council for not revealing the entire scope of the project and for allowing for the distribution of state funds to groups not under the exclusive control of the state. A challenge to the proposition was defeated last year and the appeals panel rejected an appeal last month. In the meantime, the initiative has been moving forward and recently approved its first round of grants. The 72 grants, which will be funded with $45 million over 2 years, were selected from among more than 200 applications. The grants will fund various projects including the generation of a library of human embryonic stem cell lines that can model a number of human genetic diseases and experiments into how mutations in mitochondria affect the stability of human embryonic stem cells and their ability to develop into nerve cells.

Women's Health at the FDA

Sens. Hillary Rodham Clinton (D-N.Y.), Olympia Snowe (R-Maine), Patty Murray (D-Wash.), and Barbara Mikulski (D-Md.) have written a letter to Food and Drug Administration Commissioner Dr. Andrew von Eschenbach urging him to retain full funding for the agency's Office of Women's Health. “According to news reports, the FDA intends to reallocate $1.2 million in funding from the fiscal year 2007 budget of the Office of Women's Health to other uses. … As Congress moves forward with the budget and appropriations process, we will pursue every course to make certain that this funding is restored,” the senators said in the letter, noting that Congress had allocated $4 million for the office. Phyllis Greenberger, president and CEO of the Society for Women's Health Research, noted that because the proposed cut represents a big chunk of the office's budget, it will probably have to shut down operations for the remainder of the year should the cut be made. “FDA leaders erroneously believe its various centers can fully address women's health needs on their own, something they have not demonstrated,” she said in a statement.

Implementing Routine HIV Testing

Physicians need new tools and resources in order to implement revised recommendations for routine HIV testing of all patients aged 13–64 years from the Centers for Disease Control and Prevention, according to the consensus of various medical professional societies including the American College of Obstetricians and Gynecologists. ACOG was among the groups convened last year by the American Academy of HIV Medicine and the American Medical Association, in cooperation with the CDC, to discuss how best to implement the CDC's “Revised Recommendations for HIV Testing of Adults, Adolescents and Pregnant Women in Health Care Settings.” The American Academy of HIV Medicine released a summary of the discussions in February. For example, physicians will need resources that systematically describe how to provide both positive and negative results to patients.

Assisted Reproductive Data Available

The Society for Assisted Reproductive Technology has released data on the success rates of its member clinics in 2005. The organization collected data from 343 clinics, which reported data on 122,683 treatment cycles in 2005. This is the second year that SART had published this type of outcome data. The information, which is available online at

www.sart.org

HEART for Women Reintroduced

The American Heart Association is throwing its weight behind the Heart Disease Education, Analysis and Research, and Treatment (HEART) for Women Act, which was reintroduced in both the House and Senate last month. Sponsored by Sen. Debbie Stabenow (D-Mich.) and Sen. Lisa Murkowski (R-Alaska), the legislation authorizes the Health and Human Services department to provide education to older women and health care professionals on the diagnosis and treatment of women with heart disease, requires gender-specific reporting of heart disease data to the federal government, and expands WISEWOMAN (Well-Integrated Screening and Evaluation for Women Across the Nation), the free heart disease and stroke screening program, beyond its current 14 states.

Hospitals are reporting consistent quality improvements across five clinical areas as part of a Medicare pay-for-performance demonstration, officials at the Centers for Medicare and Medicaid Services have announced.

In the second year of the demonstration project, the average improvement across the more than 250 participating hospitals was 6.7%, according to the CMS. Agency officials also reported a total gain of 11.8% over the 2-year period.

“The results today provide more solid evidence that pay for performance is working to improve the quality of health care at our nation's hospitals,” Herb Kuhn, CMS acting deputy administrator, said during a teleconference to announce the second-year results of the Premier Hospital Quality Improvement Demonstration.

The program was launched in October 2003 by the CMS and the Premier Inc. health-care alliance to test whether providing incentives to hospitals would help to speed quality gains. Under the demonstration, the CMS provides financial incentives to the top 20% of high-scoring hospitals in each of five clinical areas—acute myocardial infarction, heart failure, coronary artery bypass graft, pneumonia, and hip and knee replacement. Performance in the five clinical areas is measured by more than 30 nationally recognized quality standards.

Hospitals in the top 10% receive a 2% incentive payment, while hospitals in the next 10% receive a 1% payment. Any hospital that ranks in the top half in each clinical area is recognized on the CMS Web site. In the third year of the program—from October 2006 to September 2007—hospitals that fail to improve over baseline could face penalties.

In the second year, the CMS paid more than $8.6 million to 115 high-performing hospitals. The highest incentive payment went to Hackensack (N.J.) University Medical Center, which received $744,000 as a high-performer in all 5 clinical areas.

Data from the second year of the demonstration program showed significant improvements in all five clinical areas, according to the CMS. The average composite quality scores for more than 30 quality measures showed that hospitals improved in acute myocardial infarction (87.5% to 94.4%), coronary artery bypass graft (84.8% to 93.8%), heart failure (64.5% to 82.4%), pneumonia (69.3% to 85.8%), and hip and knee replacement (84.6% to 93.4%).

The lessons learned in the demonstration will help the CMS plan for the future. “This demonstration is really helping us to understand what's needed to improve our health care system,” Mr. Kuhn said.

As part of the Deficit Reduction Act of 2005, the CMS is required to propose a program design for a value-based purchasing system for hospitals for potential implementation in fiscal year 2009. That report to Congress is expected sometime this summer. In the meantime, the CMS is seeking input from health care providers, consumers, and purchasers.

More information about the hospital demonstration program is available online at www.cms.hhs.gov/HospitalQualityInits

Hospitals are reporting consistent quality improvements across five clinical areas as part of a Medicare pay-for-performance demonstration, officials at the Centers for Medicare and Medicaid Services have announced.

In the second year of the demonstration project, the average improvement across the more than 250 participating hospitals was 6.7%, according to the CMS. Agency officials also reported a total gain of 11.8% over the 2-year period.

“The results today provide more solid evidence that pay for performance is working to improve the quality of health care at our nation's hospitals,” Herb Kuhn, CMS acting deputy administrator, said during a teleconference to announce the second-year results of the Premier Hospital Quality Improvement Demonstration.

The program was launched in October 2003 by the CMS and the Premier Inc. health-care alliance to test whether providing incentives to hospitals would help to speed quality gains. Under the demonstration, the CMS provides financial incentives to the top 20% of high-scoring hospitals in each of five clinical areas—acute myocardial infarction, heart failure, coronary artery bypass graft, pneumonia, and hip and knee replacement. Performance in the five clinical areas is measured by more than 30 nationally recognized quality standards.

Hospitals in the top 10% receive a 2% incentive payment, while hospitals in the next 10% receive a 1% payment. Any hospital that ranks in the top half in each clinical area is recognized on the CMS Web site. In the third year of the program—from October 2006 to September 2007—hospitals that fail to improve over baseline could face penalties.

In the second year, the CMS paid more than $8.6 million to 115 high-performing hospitals. The highest incentive payment went to Hackensack (N.J.) University Medical Center, which received $744,000 as a high-performer in all 5 clinical areas.

Data from the second year of the demonstration program showed significant improvements in all five clinical areas, according to the CMS. The average composite quality scores for more than 30 quality measures showed that hospitals improved in acute myocardial infarction (87.5% to 94.4%), coronary artery bypass graft (84.8% to 93.8%), heart failure (64.5% to 82.4%), pneumonia (69.3% to 85.8%), and hip and knee replacement (84.6% to 93.4%).

The lessons learned in the demonstration will help the CMS plan for the future. “This demonstration is really helping us to understand what's needed to improve our health care system,” Mr. Kuhn said.

As part of the Deficit Reduction Act of 2005, the CMS is required to propose a program design for a value-based purchasing system for hospitals for potential implementation in fiscal year 2009. That report to Congress is expected sometime this summer. In the meantime, the CMS is seeking input from health care providers, consumers, and purchasers.

More information about the hospital demonstration program is available online at www.cms.hhs.gov/HospitalQualityInits

Hospitals are reporting consistent quality improvements across five clinical areas as part of a Medicare pay-for-performance demonstration, officials at the Centers for Medicare and Medicaid Services have announced.

In the second year of the demonstration project, the average improvement across the more than 250 participating hospitals was 6.7%, according to the CMS. Agency officials also reported a total gain of 11.8% over the 2-year period.

“The results today provide more solid evidence that pay for performance is working to improve the quality of health care at our nation's hospitals,” Herb Kuhn, CMS acting deputy administrator, said during a teleconference to announce the second-year results of the Premier Hospital Quality Improvement Demonstration.

The program was launched in October 2003 by the CMS and the Premier Inc. health-care alliance to test whether providing incentives to hospitals would help to speed quality gains. Under the demonstration, the CMS provides financial incentives to the top 20% of high-scoring hospitals in each of five clinical areas—acute myocardial infarction, heart failure, coronary artery bypass graft, pneumonia, and hip and knee replacement. Performance in the five clinical areas is measured by more than 30 nationally recognized quality standards.

Hospitals in the top 10% receive a 2% incentive payment, while hospitals in the next 10% receive a 1% payment. Any hospital that ranks in the top half in each clinical area is recognized on the CMS Web site. In the third year of the program—from October 2006 to September 2007—hospitals that fail to improve over baseline could face penalties.

In the second year, the CMS paid more than $8.6 million to 115 high-performing hospitals. The highest incentive payment went to Hackensack (N.J.) University Medical Center, which received $744,000 as a high-performer in all 5 clinical areas.

Data from the second year of the demonstration program showed significant improvements in all five clinical areas, according to the CMS. The average composite quality scores for more than 30 quality measures showed that hospitals improved in acute myocardial infarction (87.5% to 94.4%), coronary artery bypass graft (84.8% to 93.8%), heart failure (64.5% to 82.4%), pneumonia (69.3% to 85.8%), and hip and knee replacement (84.6% to 93.4%).

The lessons learned in the demonstration will help the CMS plan for the future. “This demonstration is really helping us to understand what's needed to improve our health care system,” Mr. Kuhn said.

As part of the Deficit Reduction Act of 2005, the CMS is required to propose a program design for a value-based purchasing system for hospitals for potential implementation in fiscal year 2009. That report to Congress is expected sometime this summer. In the meantime, the CMS is seeking input from health care providers, consumers, and purchasers.

More information about the hospital demonstration program is available online at www.cms.hhs.gov/HospitalQualityInits