Monday, September 29, 2008

PCMA Opposed to Proposed DEA E-Prescribing Rule

The Pharmaceutical Care Management Association (PCMA) released its comments opposing a proposed rule on e-prescribing from the DEA, published on June 28, 2008.

The proposed rule would authorize prescribers to electronically submit prescriptions for controlled substances directly to pharmacies. The DEA believes that e-prescribing will reduce prescription fraud and errors due to illegible handwriting.

PCMA opposes the rule, citing four concerns:
  • E-prescribing standards will prevent pharmacies from being able to substitute generic drugs
  • Real-time DEA registration verification of prescribers is not possible because the DEA database is only updated weekly, not in real-time
  • Prescribers should be allowed to verify their identity and license in-person at a DEA registered facility where they hold privileges, a state or professional license board, or with state or local law enforcement
  • If the e-prescribing system remains idle for 2 minutes, prescribers must re-authenticate their request, which would create a work burden

The proposed rule can be found here:

PCMA's Comments can be found here:

Source: Business Wire 2008

2008 Presidential Candidate Health Plans

Both Sen. Barack Obama (D-IL) and Sen. John McCain (R-AZ) share an interest in making healthcare accessible and affordable for all Americans under their possible administrations. In some ways, their plans are similar. Both candidates are pushing for lower drug costs, innovations in health information technology, cost and quality transparency from insurance providers, and portability of coverage.

However, the candidates diverge when it comes to whether healthcare based on a public plan or the private market will provide the most benefits to Americans, with Obama pushing for the development of a new public plan and McCain emphasizing affordable coverage through private companies.

The candidates are expected to discuss their respective health plans and other domestic policy issues during a town hall meeting debate on October 7 at Belmont University in Nashville, TN.

Below are highlights of each candidate’s plan:

  • Market competition among insurance providers will lead to lower costs and higher quality
  • Provide a tax credit of $2500 per individual and $5000 per family towards the purchase of coverage through the provider of their choice
  • Expand the benefits of Health Savings Accounts (HSAs) to reward Americans for saving towards additional medical expenses
  • Create Guaranteed Access Plans (GAP) - A non-profit organization would be established to contract low-cost plans with state and private insurers
    - Those who were previously denied coverage would be able to form into large pools eligible to purchase plans through GAP under a group rate
    - Available to all Americans regardless of pre-existing condition or other inability to qualify - Intended to help low-income Americans and those who lack employer benefits
  • Create a national program to assist seniors with managing their healthcare
    - Modeled after state programs, seniors would receive a monthly stipend towards home care and would also have access to counselors who can help them manage their medical finances


  • Expand Medicare and SCHIP and establish a new public program to increase access to health coverage
    - The plan would be modeled after the Federal Employee Health Benefits Program (FEHB) currently used by members of Congress and federal employees
    - Available to small businesses, the self-employed, those without employer benefits, as well as those who do not qualify for Medicaid or SCHIP
  • Mandate health coverage for every child either under the national plan or a parent’s plan - Children would be eligible for coverage under a parent’s plan until the age of 25
  • Require all employers, except small businesses, to contribute either to their employees’ individual health plans or directly to the national plan
  • Provide a tax credit to small businesses of up to 50 percent of all premiums paid on behalf of their employees
  • Establish the National Health Insurance Exchange (NHIE) to monitor state and private insurance providers
    - Hold state and private providers accountable to the same price and quality standards as the national plan
    - Ensure consumer fairness by requiring providers to be transparent with price and quality data and to justify above-average premium increases
    - Ensure that private companies direct premiums towards patient care, not administrative costs and profit

Outside Talent Is Only as Good as Its Portability

Hiring outside talent only benefits an organization if the new employee's performance can be maintained at their new workplace. For some professionals, such as surgeons, whose performance is aided by the help of a strong surgical team, performance portability becomes more difficult.

Source: The Wall Street Journal

Survey Finds Patient Care May Be Harmed by Physician Handoff Errors

A survey showed that interruptions and distractions that occur during patient handoffs between residents may contribute to errors in patient care.

In 2006, 161 residents at Massachusetts General Hospital admitted that handoffs often did not take place in a quiet setting and were often interrupted, leading to misinformation or the incomplete communication of information.

An article in The Joint Commission Journal on Quality and Patient Safety urges physicians to compile complete information before meeting a colleague for a handoff in a quiet location with minimal distractions.

Source: The Boston Globe

Joint Commission Sentinel Alert: Blood Thinner Deaths and Overdoses

The Joint Commission has released a new Sentinel Alert that recommends 15 steps for preventing deaths due to errors in the administration of anticoagulants.

The recommendations include establishing best practices such as clearer medication packaging, better staff communication, and the use of bar code labeling and computerized physician orders.

The alert can be found here:

Tuesday, September 16, 2008

Senate Approves Bill to Require Background Checks on Long-Term Care Employees

On September 10, the Senate Finance Committee approved S. 1577, the Patient Safety and Abuse Prevention Act. The bill would require criminal background checks for all employees with direct patient access in nursing homes and long-term care facilities. The bill does not include hospitals or managed care facilities.

In addition to conducting an NPDB-HIPDB query, participating states must screen job applicants in both the state police database and the FBI’s national criminal history database. The goal of the legislation is to increase patient safety by preventing the hire of employees with prior history of abuse or violence.

Senate Special Committee on Aging Chairman Herb Kohl (D-WI) is calling for the bill to be passed by the end of September. Senate Finance Committee Chairman Max Baucus (D-MT) believes the bill can be passed by unanimous consent.

A full version of S. 1577 is available here: