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Department Of Justice, HHS Boosts Number Of Investigators, Prosecutors Looking At Medicare, Medicaid Fraud
HHS and the Department of Justice on Wednesday launched the Health Care Fraud Prevention and Enforcement Action Team to detect and prevent fraud in Medicare and Medicaid, the Washington Post reports (Johnson, Washington Post, 5/21). DOJ also plans to establish teams to address fraud in the Medicare Part D program and CHIP (Kennedy, AP/Houston Chronicle, 5/20). Wednesday"s announcement also included a recommendation by President Obama"s administration to include $311 million in the fiscal year 2010 budget to address health care fraud, which is a 50% increase from FY 2009. According to Attorney General Eric Holder, efforts to combat health care fraud will contribute to the administration"s health care overhaul plans (Clark/Weaver, McClatchy/Kansas City Star, 5/20). The task force, which will include HHS and DOJ staff members, law enforcement agents and prosecutors, will meet biweekly, CQ HealthBeat reports (Norman, CQ HealthBeat, 5/20). Under the plan, existing enforcement teams in Miami and Los Angeles will be expanded and new teams will be established in Houston and Detroit, where officials say suspicious billing patterns have emerged. In addition, the plan will set up task forces in 10 other major cities, which were not named (AP/Houston Chronicle, 5/20). The enforcement teams will increase site visits to durable medical equipment suppliers upon their enrollment. In addition, officials will expand training to help providers identify and prevent fraud or other mistakes (CQ HealthBeat, 5/20). The task force will use electronic claims data to detect "unusual billing problems," according to the Post (Washington Post, 5/21). HHS Secretary Kathleen Sebelius said the task force also intends to simplify billing systems and assist state officials in conducting Medicaid audits (CQ HealthBeat, 5/20). According to Holder, the joint task force will allow officials to share real-time intelligence data on health care fraud by monitoring claims payments, billing patterns and targeted surveillance (AP/Houston Chronicle, 5/20). Money
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Preserving Patient Access To Primary Care Act Of 2009 Endorsed By American College Of Physicians
The 128,000-member American College of Physicians (ACP) has endorsed the Preserving Patient Access to Primary Care Act of 2009 (H.R. 2350), introduced by Rep. Allyson Schwartz (D-PA). "Primary care is the best medicine for better health and lower costs," ACP noted, "and this is the best medicine for curing the growing crisis in primary care."
News of the day
The 32nd British Transplant Games 30th July - 2nd August 2009
This year the British Transplant Games takes place in Coventry and 900 transplant athletes are preparing to take part. For a handful of these athletes, the Games offers vital training and preparation for other major sporting challenges such as triathlons and marathons. The event organisers, Transplant Sport UK shines the spotlight on these inspiring people, who visibly demonstrate that there is life after transplant, allowing them to train to a high level of fitness against all the odds.
Public Health

Can Inflammatory Arthritis Be 'Worse Than Death'?

Patients with inflammatory arthritis completing a health-related quality of life questionnaire report levels of pain that result in their health being rated as "worse than death" by members of the general population. Researchers at the Arthritis Research Campaign Epidemiology Unit at the University of Manchester sought to identify why the health-related quality of life of a significant number of arthritis patients is rated so poorly, and to further investigate the health status of these patients. Arthritis patients report a range of limitations which impair their quality of life including very high levels of pain; this description of extreme pain was the consistent factor in explaining why certain patient"s quality of life was valued as "worse than death". Pain is the symptom of disease that people perceive to have the greatest detriment on quality of life and fear most as a consequence of disease. Rheumatoid arthritis is the most common form of inflammatory arthritis and affects half a million people in the UK. The disease is more common in women than in men. It is a potentially disabling disease with a considerable economic impact. Within ten years of onset of rheumatoid arthritis, at least 50% of patients are unable to hold down a full-time job. "Our findings highlight the burden of disease experienced by patients with arthritis. However quality of life valuations by the general population based on abstract health state descriptions, may not reflect the fact that treatments are available to relieve the pain of arthritis and alter the long-term outcome. We believe that further research is needed to see if the general public would rate this degree of pain differently if they had more information about the character of arthritis" says Dr Mark Harrison PhD of the University of Manchester. This will be discussed in Value in Health, the official journal of the International Society for Pharmacoeconomics and outcomes Research. Value in Health (ISSN 1098-3015) publishes papers, concepts, and ideas that advance the field of pharmacoeconomics and outcomes research and help health care leaders to make decisions that are solidly evidence-based. The journal is published bi-monthly and has a regular readership of over 4,000 clinicians, decision-makers, and researchers worldwide. ISPOR is a nonprofit, international organization that strives to translate pharmacoeconomics and outcomes research into practice to ensure that society allocates scarce health care res wisely, fairly, and efficiently. ISPOR


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