Roll Call: Latest News on Capitol Hill, Congress, Politics and Elections
October 31, 2014

October 30, 2014

Cleveland Clinic Queries Staff About Medical Advances Expected in 2015

In July, a massive research project by Thomson Reuters scoured all scientific and patent databases and culled a list of 10 possible medical advances possible by 2025. The list included improved detection and prevention of dementia and Alzheimer’s Disease and genomic engineering to prevent Type 1 Diabetes.

This week, the Cleveland Clinic simply asked its experts on medical innovations expected in 2015. The clinic’s scientists suggested ten advances, including a new speedy and cost-effective blood testing process, single dose radiation therapy for breast cancer and a dengue fever vaccine.


Report: Out-of-Pocket Spending Increases but Hospital Utilization Drops

Earlier this month, the Congressional Budget Office reported that federal health care spending has increased, largely due to new health insurance subsidies and an expanded Medicaid program.

This week, the Health Care Cost Institute released its annual health cost report for persons covered by private sector employer-offered plans. The report indicates that health care spending per enrolled person increased by $183 in 2013 and out-of-pocket spending increased 4 percent to an average of $800 per person. However, while costs have increased, the utilization of brand-name prescription drugs, hospital inpatient admissions and outpatient services declined.  The report noted an increase in utilization rates for physician specialist office visits and generic prescriptions.


October 29, 2014

FDA’s Handling of `Pink Viagra’ Not a Gender Issue, Researchers Say

The Food and Drug Administration has been falsely accused of playing gender politics when it comes to the quest for a so-called “pink Viagra,” or a drug to treat lack of sexual desire in women, when the real issue is a lack of proof that a pharmacological approach would work, researchers say.

At issue is the EventheScore campaign, which has drawn more than 24,000 supporters to sign a petition that states: “Do you believe that women deserve equal treatment when it comes to sex? So do we!” This advocacy campaign cites “gender inequity” as a reason why there are  “26 FDA-approved treatments marketed for male sexual dysfunction,” but none for women. That tally counts several forms of male hormone replacement drug testosterone as different drugs. It also includes Pfizer Inc.’s Viagra and four drugs that use the same approach for treating a problem with blood flow that can prevent men from acting on their sexual desires.

Figuring out what causes a lack of sexual desire in women, though, is much trickier than addressing this physiological issue, said Alan Cassels, a drug policy researcher affiliated with the University of Victoria. “Viagra for men is about treating a plumbing problem,” while the cause of diminished sexual desire in women is often unclear and may relate to other issues in their lives, said Cassels, who also is an author of several books critical of the drug industry and a critic of the EventheScore campaign.

In comments made to the FDA ahead of an Oct. 27-28 workshop on female sexual dysfunction, several researchers argued that the EventheScore campaign is co-opting feminist rhetoric with an aim of getting the agency to lower its standards for drug approval. Sprout Pharmaceuticals Inc,, which provides money for the EventheScore campaign, has been struggling to win FDA approval of flibanserin for hypoactive sexual desire in women. This pill is intended to work in the same way as many approved antidepressants, altering the function of certain messengers in the brain known as neurotransmitters.

A better approach would be “finding a pill that will help couples talk to each other, take care of the children, and reduce the stress of modern busy lives,”  said Carol Tavris, a psychologist and author in a comment on the FDA’s workshop plan.


By Kerry Young Posted at 2:46 p.m.

Bipartisan Duos Identify Ways to Expedite Ebola Research Funding

When Congress returns next month, it really has one primary task – to extend the federal government’s ability to spend money. And lawmakers are already starting to talk about how Ebola might fit into that discussion.

The current short-term federal appropriations measure expires Dec. 11, and an extension will likely address the mechanics of funding for research on Ebola drugs. Bipartisan congressional leaders on Tuesday were calling for funding adjustments to speed Ebola drug development.

In the House, Michigan Republican Mike Rogers and California Democrat Anna G. Eshoo urged appropriators to include additional funding instructions in an HHS bio-defense program to expedite Ebola drug and vaccine research efforts.

In the Senate, the leaders of the Health, Education, Labor and Pensions Committee, Democrat Tom Harkin of Iowa and Republican Lamar Alexander of Tennessee, announced plans to introduce a bill that would allow funding for Ebola drug research through an existing FDA program designed to expedite the development of drugs to combat neglected tropical diseases. The senators note that Ebola is not currently listed as a qualifying drug for the program.

But discretionary spending limits and annual funding priority battles limit the expansion of medical research funding. CQ HealthBeat’s (CQHealthTweet) Kerry Young reports (subscription) that Utah Republican Sen. Orrin G. Hatch and Massachusetts Democratic Sen. Elizabeth Warren are circulating a separate draft bill intended to change that by marking off a permanent allocation of federal funding for biomedical research, separate from the contested pool of discretionary funds.

October 28, 2014

Medifast Teams Up With Fitbit

Weight loss company Medifast is flexing its muscles in the health and fitness community by forming a partnership with Fitbit, the company announced Tuesday.

Wearable devices that track fitness progress – such as the ones sold by Fitbit – have become increasingly popular in the health industry and many weight loss companies have rushed to integrate their products with new fitness technology.

Medifast, which provides a slate of weight-loss programs and products, announced they would be teaming up with Fitbit to create personalized, digital health dashboards for their customers that can synch up with several of Fitbit’s wearable devices. Users will be able to track their exercise, meals, water intake, sleep patterns and weight.

“Studies show that people who use journaling and tracking systems have far greater success with healthy weight management than those who do not,” said Medifast Chairman and Chief Executive Officer Mike MacDonald in a press release. “The combination of Medifast products and programs and wearable health management technology provides our customers with an even more comprehensive solution to wellness.”

Medifast joins a growing list of health companies that have combined forces with fitness trackers, including Weight Watchers and Nutrisystem. Meanwhile, Apple announced in September that it would be launching its own wearable fitness device, Apple Watch, to synch with its health data-sharing app, HealthKit.

Almost 20 percent of adults in the United States own a wearable fitness device, but that number is expected to grow – particularly among millennials – according to a PwC Consumer Intelligence Series report released this month.

Health Insurance Group Chief Comments on Upcoming Exchange Enrollment

CQ HealthBeat’s (CQHealthTweet) John Reichard and Rebecca Adams sat down last week with Karen Ignagni, the president and CEO of America’s Health Insurance Plans. Their report (subscription) noted that the top lobbyist for health insurers expressed optimism that the next open enrollment period under the health law will better than last year but warned that a lobbying battle looms over networks that could lead to higher premiums.

Here are a few brief excerpts from their wide-ranging interview. Questions have been condensed.

Ignagni, speaking about the enrollment experience that consumers will have this year compared to last year, when the federal website did not work initially:

Because of where we started last year, I don’t expect that kind of situation – we had a problem getting people on the website [] entirely last year – so we’re really talking about a very different experience. For consumers that are new to the exchange, they will see a considerably shortened application and they’ll be able to go through the process fairly quickly and be able to get enrolled and that’s a very positive thing. So there’s been a lot of effort to improve the front end…. But we’re in uncharted waters because we’ve never gone through a re- enrollment or renewal process. So we are working very hard to make sure that from a health plan standpoint we’re reaching out to consumers, letting them know that they need to update their information so they can get their latest APTC [advanced payment tax credit] information, their subsidies. That’ll be important for them to know their subsidies as they’re evaluating their choices in the exchange.  That is a very important job that health plans are doing a great deal of outreach [on] to make sure people know about that. We were very pleased to see the administration launching an effort to communicate this message very clearly to consumers – that they need to go back to the exchange and update their information.

Question: One thing consumers ask is “Is my doctor covered?” … Are you thinking of doing anything more to ensure provider directories are accurate?

Plans have on their websites their provider directories and are working very hard to make sure that if a particular clinician decides that he or she doesn’t want to be part of network that we’re updating that when the information comes to us, it gets updated. Sometimes the info doesn’t come from a provider for a month or two to the health plan. So we’re making sure when we get that, we get that on the website. Over time the exchanges, both state as well as federal, will be able to have that information on the exchange websites and we’re very supportive of that … We also are releasing a consumer guide to networks – questions consumers should have at their kitchen table and think about posing.


By Paul Jenks Posted at 2:06 p.m.

States Begin to Follow New CDC Guidance on Quarantines

The Centers for Disease Control and Prevention on Monday issued new guidelines on monitoring for the Ebola virus in travelers arriving from the Ebola infected region in West Africa. The new policy calls for home quarantines at the most restrictive level and ongoing monitoring for a 21-day period. The policy seeks to stem early attempts to enforce stricter state quarantines.

New York and New Jersey this weekend began implementing a hospital-based quarantine policy, which led to the CDC’s new less restrictive guidance on monitoring incoming persons potentially exposed to the virus. On Monday, New Jersey released its first quarantined patient and New York earlier updated its screening plan at JFK airport to include home monitoring. A range of states followed suit on Monday with updated guidelines that focus on home-based quarantines and activity restrictions. A sampling of states issuing updated guidelines include: Illinois, Maryland, Virginia, Georgia (assumes individual compliance), Minnesota and Maine.

October 27, 2014

Ebola Nurses on ’60 Minutes’ Put CDC in Spotlight

The topic of Ebola has dominated Sunday talk shows and appeared in prime time during last night’s episode of “60 Minutes,” once again putting the Centers for Disease Control and Prevention’s capability to contain the outbreak in the national spotlight.

The feature segment examined the first U.S. Ebola case diagnosed at Texas Health Presbyterian Hospital in Dallas and the harrowing tale of the nurses who helped care for the patient, Thomas Eric Duncan.

One nurse said she was frightened, but determined to help — which meant everything from cleaning projectile vomit off the walls to simply comforting the patient since his family could not. “I didn’t allow fear to paralyze me. I got myself together. I’d done what I needed to get myself prepared mentally, emotionally, and physically, and went in there and did what I was supposed to,” she said.

Another nurse, with tears streaming down his own face, described wiping tears away from Duncan’s eyes in the final moments before he died.

The nurses largely defended their care for the patient — whom they described as kind and appreciative — and said they followed all the protocols they were given by the CDC, including wearing protective gear, which was initially suggested that left their necks exposed. Two of the nurses who cared for Duncan have since been diagnosed with, and overcome, Ebola.

The CDC has taken heat for not having sufficient guidelines in place by the time the first Ebola case came to the U.S. and putting health care workers at risk.  CQ Roll Call reporter Melissa Attias explains further:

“The Centers for Disease Control and Prevention, the federal agency expected to restore order during public health crises, is on the defensive amid questions about whether it’s capable of performing its duties as a front-line agency.

Nearly everyone agrees that the Atlanta-based agency erred when it made blanket assurances that U.S. hospitals were capable of treating Ebola cases. But lofty expectations from the public may also be fueling the discontent, as well as misconceptions about the CDC’s role in responding to health threats.

Now officials are scrambling to regain the confidence of the public and health care workers as elevated fears about the often fatal virus play out in a highly partisan pre-election environment.

‘We got hit by something we never had to deal with so far in this way,’ said Scott Burris, professor and co-director of Temple University’s Center for Health Law, Policy and Practice. ‘I think we have had a myth of preparedness to some degree.’

Although officials haven’t pinpointed how the nurses got infected, much of the criticism has focused on whether proper personal protective gear and clear guidelines were in place for health care workers.”

By Melanie Zanona Posted at 6:43 p.m.

Equating Ebola and the Flu on Capitol Hill

ebolasignphoto e1414346947759 240x321 Equating Ebola and the Flu on Capitol Hill

Sign at a deli on Capitol Hill, Sunday, October 26, 2014

CQ Roll Call staff today will be offered an annual flu shot. This year’s inoculation is especially pressing due to concerns about the Ebola virus, which have initial symptoms that are identical with the flu. The similarity of symptoms poses some possible confusion and increased anxiety as flu season begins. Reuters reported last week that hospitals fear a deluge of patients with the flu fearing they have Ebola.

This sign on Sunday greeted people walking by a popular Capitol Hill deli/grocery store. It seems the confusion has already begun.





This Week: Quarantine Wrangling

The focus this week, outside of preparations for next week’s congressional elections, will be on new state quarantine orders on health care workers returning from service in West Africa. On Friday, the governors of New York, New Jersey and Illinois initiated a mandatory quarantine targeting returning medical workers. This weekend Florida instituted a 21-day active monitoring regime for new arrivals. New York on Sunday adjusted the terms of the quarantine order, allowing persons under observation to be quarantined at home.

Separately today, the Centers for Disease Control and Prevention begins a previously announced revised post-arrival monitoring process for persons arriving from West Africa. A White House meeting on Sunday assembled a large group of federal officials ahead of possible new revisions to policies on monitoring incoming travelers.

Meanwhile this week, the Society for Women’s Health Research hosts a panel discussion on Wednesday at Washington, DC’s Union Station on expectations and experiences on breast cancer screening. Also on Wednesday, the Association of American Medical Colleges holds a teleconference on research on medical school application and enrollment data. On Thursday, the Cato Institute examines recent federal court rulings on the IRS’ interpretation of the 2010 health care overhaul law. The group is keen on garnering the court’s consideration of a challenge to the legality of federal insurance subsidies in states that utilize the federally operated insurance exchange.

The next congressional hearing on Ebola concerns and health care spending takes place on Wednesday, Nov. 6, after next week’s election.



October 24, 2014

Cell Phone Data Tracking Rules Hinders Ebola Tracking in West Africa

Amid ongoing controversy over privacy concerns and national security requirements over screening of cell phone data in the U.S., the Ebola crisis in Africa offers a different perspective on the issue. Public health researchers have found that cell phone data is useful in quickly tracking diseases and could be used to monitor the spread of Ebola virus.

This week’s edition of the Economist magazine reports that researchers were able to use cell phone call-data records after previous disease outbreaks to track the spread of the disease. However, real-time access to cell phone data is restricted by government privacy rules and paperwork – plus likely beleaguered West African government agencies. For now, the concept of tracking Ebola through cell phones is on hold but a United Nations telecommunications agency has added emergency access to cell phone data to its agenda for an upcoming meeting next month in South Korea.



Week in Review — Ebola: House Hearing Today; New Case Identified in New York; Airport Screening & Monitoring Revamped

A House committee today examines the coordination of federal agencies in responding to the Ebola crisis. The hearing session includes testimony from federal agency officials but excludes Centers for Disease Control and Prevention Director Thomas Frieden and the newly appointed federal Ebola response czar Ron Klain. The hearing is colored by a newly identified case in New York City. A doctor, who recently returned from an international aid mission in Africa, is now undergoing treatment at a New York hospital.

Testimony at this morning’s hearing will include an update on the U.S. military mission in Liberia and Senegal, where more than 630 U.S. military personnel have been deployed to build medical facilities and help with logistics. Also, the session will likely address Department of Homeland Security enhancements to the airport screening process. The process was adjusted this week to funnel travelers from West Africa to enter the U.S. through the five selected airports offering Ebola screening. An airline trade group noted that the change in itineraries would impact about nine people each day.

Additionally, the CDC is requiring all passengers arriving from Ebola infected countries to submit to post-arrival monitoring for 21 days, the standard period for incubation of the virus. The CDC this week also updated its guidance to hospitals on proper protective procedures for treating an Ebola patient.

Earlier this week, the remaining U.S. Ebola cases and persons under observation as a result of the initial Texas patient were gradually closing. In Africa, the World Health Organization announced the end of Ebola outbreaks in Senegal and Nigeria but a new case emerged this week in Mali. The pandemic continues in Liberia, Sierra Leone and Guinea.



October 23, 2014

State Medicaid Directors Respond to Critique of Varying State Standards

Last month, Healthopolis noted a Department of Health and Human Services Inspector General report that surveyed the wide diversity of state approaches to regulating Medicaid managed care programs.

The Inspector General’s analysis prompted the National Association of Medicaid Directors to craft a response to the report, suggesting that the lack of consistency in state supervision of Medicaid programs is not necessarily a failure but rather illustrates different approaches to managed care programs, which are colored by the unique circumstances of each state in managing very complicated factors influencing the Medicaid program.



Health Programs Factor in Upcoming House Committee Leadership Changes

The focus on upcoming November congressional elections understandably centers on possible election results and which party will control the Senate. However, the election of a new Congress, which convenes in January, also starts the process for reconfiguring the leadership of pivotal House committees. Roll Call’s Emma Dumain and Matt Fuller today examine possible GOP leadership changes in 11 different committees.

Health care program funding authority, particularly for the Medicare program, falls under the jurisdiction of the House Ways and Means Committee. The committee’s current chairman, Michigan Republican Rep. Dave Camp is retiring and Wisconsin Republican Rep. Paul D. Ryan has the inside track — but has some competition — to take over the gavel of the powerful tax committee.

Ryan has led a long-running campaign to overhaul the Medicare program as the chief of the House Budget Committee. His annual budget proposals (view the 2015 budget plan) have suggested ideas on overhauling the Medicare program allowing Medicare beneficiaries to choose between competing private coverage programs with the federal government offering premium support payments. In 2011, a liberal advocacy group attacked an earlier Ryan Medicare proposal with a video featuring a Ryan look-alike actor pushing an elderly woman in a wheelchair off a cliff.  At the helm of the Ways and Means Committee, Ryan would have the opportunity to craft a Medicare overhaul measure instead of offering budgetary suggestions.

If Ryan departs from the budget panel, the heir apparent is the committee’s current Vice Chairman, Rep. Tom Price, a conservative physician from Georgia. Price is a staunch opponent of the 2010 health care overhaul law and has authored his own proposal on overhauling health insurance coverage options. Price’s plan relies on offering tax breaks to give people the means to buy health insurance instead of the current health insurance exchange plan subsidies.

October 22, 2014

EPA Waste Discharge Rule Targets Dentists

The Environmental Protection Agency periodically weighs in on health care provider regulatory matters, usually addressing pollution concerns about medical waste. Today, the environmental regulatory agency published proposed rules on discharges of mercury from dental offices.

Dentists use an amalgam for dental filings and the metal — mostly silver — is bonded together with mercury. The EPA notes that dentists are the main source of mercury discharges into water treatment facilities. The agency claims that mercury waste diffused into the environment is a global pollution problem. The proposed regulations require dentists to use amalgam separators, which separate the mercury for alternative disposal instead of rinsing excess amalgam into the local waste water treatment system.




By Paul Jenks Posted at 3 p.m.

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