On May 12, 2014 DPH submitted a grant proposal to CDC for funding to implement the Tobacco Use Prevention - Public Health Approaches for Ensuring Quitline Capacity under ACA §4002.

 

These funds are available to all state and territorial health departments to sustain and expand the capacity of a national smoking cessation helpline, known as the Quitline, so that all callers to the Quitline during a federal media campaign are offered at least one smoking cessation coaching call, either immediately upon calling or by being re-contacted within two to three days. The secondary purpose is to build the capacity of state tobacco control programs to implement evidence-based smoking cessation interventions in all 50 states.

 

Created through the CDC's first national tobacco education campaign (Tips From Smokers), the Quitline is a free telephone helpline (1-800-QUIT-NOW) which routes callers to their state quitlines, offering assistance and treatment for tobacco-related addiction and behavior issues. You can learn more about this program by visiting: http://www.cdc.gov/tobacco/campaign/tips/about/campaign-overview.html

 

Read the project abstract at: Mass.gov

  

For information about ACA grants awarded to and grant proposals submitted by the Commonwealth, visit the Grants page of the Massachusetts National Health Care Reform website at: Mass.Gov

  

5/12/14 OIG/HHS published a proposed rule "Medicare and State Health Care Programs: Fraud and Abuse; Revisions to the Office of Inspector General's Civil Monetary Penalty Rules".

 

This proposed rule would amend the civil monetary penalty (CMP or penalty) rules of the Office of Inspector General (OIG) to incorporate new CMP authorities, including those under ACA sections 6402 and 6408, clarify existing authorities, and reorganize regulations on civil money penalties, assessments and exclusions to improve readability and clarity.

 

Comments are due on July 11, 2014.

 

Read the rule at:  http://www.gpo.gov/fdsys/pkg/FR-2014-05-12/pdf/2014-10394.pdf

News

  

5/14/2014 The U.S. Preventive Services Task Force (USPSTF) issued a draft recommendation statement on Behavioral Counseling to Promote a Healthy Diet and Physical Activity for Cardiovascular Disease Prevention in Adults with Known Risk Factors. The USPSTF recommends that overweight and obese adults who have additional cardiovascular disease (CVD) risk factors participate in intensive behavioral counseling interventions to promote a healthy diet and physical activity for CVD prevention. The USPSTF assigned a "B" rating to the recommendation, indicating that the Task Force recommends the service.

 

According to the USPSTF, CVD, primarily in the form of heart disease and stroke, is a leading cause of death in the United States. Adults who adhere to a healthy diet and physical activity have lower chances of cardiovascular death than those who do not. Furthermore, all individuals who follow healthy eating behaviors and increased physical activity will see benefits in their health.

 

The USPSTF's evidence review found that overweight or obese adults have an increased risk of CVD. Those adults who participate in intensive behavioral counseling had a moderate benefit on risk for CVD, including improvements in body mass index (BMI), blood pressure, lipids, fasting glucose, and levels of physical activity. The USPSTF found inadequate evidence that intensive behavioral counseling interventions lead to improvements in mortality or CVD rates.

 

However, none of the dietary intervention studies explicitly reported adverse events. Studies of physical activity interventions reported mostly minor adverse events, and intense physical activity was very rarely associated with cardiovascular events. The USPSTF found adequate evidence that the harms of behavioral counseling interventions are small to none.

 

The USPSTF is an independent panel of non-federal government experts that conduct reviews of scientific evidence of preventive health care services. The USPSTF then develops and publishes recommendations for primary care clinicians and health systems in the form of recommendation statements. As part of their recommendations process, the USPSTF will assign definitions to the services they review based on the certainty that a patient will receive a substantial benefit from receiving the benefit. Services that are graded "A" and "B" are highly recommended and the USPSTF believes there is a high certainty that patient will receive a substantial or moderate benefit.

 

Under ACA §1001, all of the recommended services receiving grades of "A" or "B" must be provided without cost-sharing when delivered by an in-network health insurance provider in the plan years (or, in the individual market, policy years) that begin on or after September 23, 2010. If the recommendations are finalized with "B" ratings, then behavioral counseling to promote a healthy diet and physical activity for cardiovascular disease prevention in adults with known risk factors will be required to be covered without cost-sharing under the ACA.

 

Comments on the draft are due June 9, 2014 and can be submitted at:

http://www.uspreventiveservicestaskforce.org/draftrec.htm

 

Learn more about preventive services covered under the ACA at: HHS.Gov 

Learn more about the USPSTF at: http://www.uspreventiveservicestaskforce.org/

 

5/12/2014 Commonwealth Fund Report: ACA MLR Provision Has Yielded More Than $3 Billion in Total Consumer Benefits. The ACA has required health insurers to pay out a minimum percentage of premiums in the form of medical claims or quality improvement expenses-known as a medical loss ratio (MLR). If an insurer uses 80 cents of every premium dollar to pay its customers' medical claims and carry out activities to improve the quality of care, it has a medical loss ratio of 80 percent. Insurers with MLRs below the minimum percentage must rebate the difference to consumers.

 

According to this report, in 2012 insurers paid consumers $513 million in rebates, down nearly a half from the $1 billion paid to consumers in 2011. These findings show that insurers are in better compliance with the MLR requirements set forth by the law. The report also finds that insurers reduced spending on brokers' fees, marketing and other administrative fees by $1.4 billion in 2012 and that spending on improving the quality of care for patients did not change.

 

To find out more about the Commonwealth Fund and to read this report, please visit: Commonwealthfund.org 

 

Upcoming Events  

  

Integrating Medicare and Medicaid for Dual Eligible Individuals (also known as One Care) Implementation Council Meetings

 

Friday, June 27, 2014

1:00 PM -3:00 PM

1 Ashburton Place, 21st Floor

Boston, MA

 

Friday, July 25, 2014

1:00 PM -3:00 PM

1 Ashburton Place, 21st Floor

Boston, MA

 

A meeting agenda and any meeting material will be distributed prior to the meetings.