Injured By a Spacecraft? There’s a Diagnostic Code for That

From the Wall Street Journal Health Blog:

So we’ve got this patient here who was injured in this spaceship accident. You know, just a routine, uh, orbital mishap. But how do we account for that? Oh, right, it’s ICD-9 code E845 — “Accident involving spacecraft.”

Medicare Cuts Averted for 18 Months

From the EDPMA:

H.R. 6331 reverses the 10.6 percent Medicare cut that took effect July 1 as well as the projected 5.4 percent cut forecasted for 2009. For 2008, the legislation continues the 0.5 percent increase for the remainder of 2008; in 2009 physicians will receive an additional 1.1 percent increase over 2008. The legislation also extends the Physician Quality Reporting Initiative (PQRI) through 2010, increasing the reporting bonus from 1.5 percent in 2008 to 2 percent in 2009 and 2010.

Congress Overrides Bush’s Veto on Medicare

From the NY Times:

President Bush cast a futile veto on Tuesday, rejecting a bill that would protect doctors from cuts in their Medicare payments. But hours later, the House and Senate voted to override the veto, making the Medicare measure the fourth bill to become legislation over Mr. Bush’s opposition.

The president’s veto message to the House said that he objected to the bill because it was “fiscally irresponsible” and relied on “short-term budget gimmicks” that do not address the long-term fiscal soundness of the Medicare program.

But the House voted, 383 to 41, on Tuesday afternoon to override the veto. Soon afterward, the Senate voted by 70 to 26 to do so. Although the Senate vote was close enough to provide some suspense, it was still over the two-thirds needed, as a number of conservative Republicans who typically side with the president broke with him on this issue.

Bush Veto Likely

From Modern Physician:

President Bush plans to veto a Medicare reform bill Tuesday that would stave off cuts to physician payments through 2009 and make other adjustments to the program, HHS Deputy Secretary Tevi Troy announced.

Should Medicare Stop Medical Imaging Before It Starts?

From the Wall Street Journal Health Blog:

Medicare has been trying to clamp down on burgeoning costs from medical imaging. But a new GAO report suggests the agency might have more success if it were to stop unnecessary CT scans, MRIs and the like before they happen in the first place.

To cut imaging costs, Medicare has been cutting certain physician payments, sifting through its data to spot improper claims, and educating medical practitioners about the issue. But the GAO’s suggestions for Medicare include weighing a front-end tactic that’s common in the private health-insurance market: prior authorization. That’s when, for a patient to get coverage, an insurer has to give permission before something takes place. “We believe that post-payment claims review alone is inadequate to manage one of the fastest growing parts of Medicare,” the GAO said.

ED “Super Users”

From NJ.com

Researchers studying the crisis of America’s overcrowded emergency rooms are beginning to focus on this largely undocumented phenomenon, the super users who turn to hospital emergency rooms dozens, even hundreds, of times.

Researchers say a seemingly intractable problem could be solved, in large part, by focusing on just the top 1 percent of emergency room users, who in Camden alone cost $46 million over five years.

Jaambaaro ambulance concept

From Gizmodo:

There are plenty of places in the world where getting speedy medical attention is difficult. And that’s where the Jaambaaro concept from designer Benoît Angibaud comes in. It’s a two-person pedal-powered ambulance, designed to get the sick and wounded to hospital in areas where motor vehicles are rare. It would have solar panels to help generate some energy, and be made of locally-salvaged materials.

Medicare Cuts Averted

From Politico.com:

Medicare legislation, stalled before the July Fourth recess, broke free in Congress Wednesday after an intense lobbying campaign by doctors and the dramatic return of Sen. Edward M. Kennedy, who gave his party the boost needed to get over the top.

“Aye,” Kennedy said, holding both arms in the air and grinning broadly as he acknowledged the standing ovation he received from members of both parties. It was his first appearance in the Senate since being diagnosed with cancer; his absence before the holiday had left Democrats one short of the 60 needed to invoke cloture and clear the bill for passage.

The bill — which cleared the House last month — seeks to block a scheduled 10.6 percent cut in Medicare reimbursements for physicians. But to help pay for this spending, it trims back future payments to private health plans under Medicare Advantage, a private market alternative to the government run program for the elderly.

For this reason, it has been opposed by the White House. But sensing defeat, as many as eight Republicans switched their votes at the end, and the final 69-30 vote far surpassed the margin needed to cut off debate.

Under prior agreement, the measure will now go directly to President Bush, who now faces a situation where two-thirds of both the House and Senate have now opposed his position—more than enough to override a veto.

Important Medicare Vote in the Senate

From the EDPMA:

Senate Gets Enough YES Votes to Proceed on Medicare Bill

In a near-stunning turn of events, the U.S. Senate just voted by a vote of 69-30 to invoke cloture on H.R. 6331, House-passed legislation that would block Medicare Physician Fee Schedule (MPFS) cuts for 2008 & 2009.  This procedural vote allows the Senate to move forward with debate and vote on the underlying legislative proposal and overcomes a threat of a filibuster as they were able to achieve 60 YES votes.    

What Comes Next?

The Senate needs to consider the actual bill (this vote was a procedural motion to proceed) and would need at least 67 votes to withstand/override the threatened presidential veto.  No word yet on exactly when the Senate will take up the bill, but it is expected to be soon. 

Joint Commission issues alert on unprofessional behavior

From Modern Healthcare (free subscription required)

Rude language and hostile behavior are threats to patient safety and quality of care, according to a sentinel-event alert released today by the Joint Commission.

Healthcare professionals and organizations must take a stand against intimidating behavior by developing a “comprehensive approach” to address issues and establishing codes of conduct, the commission said in a news release. The accrediting body suggested an 11-step plan that includes educating healthcare teams about professional behavior; holding staff accountable; evoking a zero-tolerance policy toward disruptive behavior; determining disciplinary measures; and developing a system to detect and report poor behavior.