ACCESS TO CARE: Physicians, Nurses Disagree Over Expanded Nurse Practitioner Roles, Study Finds

Although a majority of physicians agree that increasing the number of nurse practitioners would improve the timeliness of care, few believe doing so would improve safety and quality of care, according to a study published Wednesday in the New England Journal of Medicine. For the study, researchers surveyed 505 primary care physicians and 467 nurse practitioners. The study found that both groups agreed that nurse practitioners should be able to practice to the full extent of their education and training. While most members of each group agreed that increasing the number of nurse practitioners would increase the timeliness of care, they differed on the quality of care each group provides. Sixty-six percent of physicians said they provide a higher quality of care in exams and consultations compared with nurse practitioners, but 75% of surveyed nurses disagreed. The study also found that nearly 81% of nurses thought expanding their role would improve access to health care, and 77% said it would help reduce health care costs, compared with less than 33% of physicians (Tran, "Capsules," Kaiser Health News, 5/15). Click here for the study (subscription required). Click here for Kaiser Health News' "Capsules" article.

DISEASE PREVENTION: Northern Kentucky Health Department Offers Hepatitis B Vaccines to High-Risk Individuals

The Northern Kentucky Health Department has begun offering low-cost vaccinations to individuals at high risk for hepatitis B. Individuals deemed at high risk for hepatitis B include those who are sexually active with multiple partners and those with other sexually transmitted infections. The vaccination effort comes as the region works to address a rise in diagnoses of the blood disease. Joyce Rice, epidemiology manager for the health department, attributed the rise to an epidemic of intravenous drug use. The vaccines -- which are funded by a grant from the Kentucky Department for Public Health -- are available by appointment at the Northern Kentucky Health Department's centers in Boone, Campbell, Grant and Kenton. Rice said qualifying individuals will receive a series of three vaccines over a six month period (DeMio, Cincinnati Enquirer, 5/15). Click here for the Cincinnati Enquirer article.

HEALTH REFORM: Federal Government To Take Over Ohio's Health Plan for People With Pre-Existing Conditions

Ohio officials on May 21 said the federal government will take over a state program that provides individuals who have pre-existing conditions with health coverage before a 2014 Affordable Care Act provision takes effect next year requiring insurers to cover such individuals. State and federal officials were not able to agree on spending for the stopgap Pre-Existing Condition Insurance Plan. The $5 billion that Congress approved for states to operate the plan is running out because program enrollees' costs were higher than previously expected. Lt. Gov. Mary Taylor (R) wrote in a letter to HHS Secretary Kathleen Sebelius that the state had requested more federal money to run the program, but the request was denied. Taylor also expressed concern that the process of the federal takeover could result in changes or lapses in coverage (Sanner, AP/Columbus Dispatch, 5/22). Click here for the AP/Columbus Dispatch article.

HEALTH REFORM: Kentucky Launches Website With Information on State Health Insurance Exchange

Kentucky Gov. Steve Beshear (D) on May 15 launched a website -- Kynect.ky.gov -- for the state's health insurance exchange. Under the Affordable Care Act, states are required to have online health insurance marketplaces (Ungar, Louisville Courier-Journal, 5/15). Beshear announced the website as being part of a larger campaign to promote and educate residents about the exchange, called Kynect: Kentucky's Healthcare Connection. During open enrollment -- which begins Oct. 1 and runs through March 31, 2014 -- residents will be able to use the website to compare and select health insurance plans, as well as to determine whether they qualify for programs like Medicaid or the Kentucky Children's Health Insurance Program (Brammer, Lexington Herald-Leader, 5/15). Click here for the Louisville Courier-Journal article. Click here for the Lexington Herald-Leader article.

MEDICAID: Undecided States Risk Millions in Federal Funding

As state legislatures wrap up for the year, about a dozen have yet to make a decision on participating in the Medicaid expansion under the Affordable Care Act, potentially risking hundreds of millions of dollars in federal funds. The Obama administration has not imposed a deadline for states to sign up for the Medicaid expansion. However, states that do not decide soon could miss out on funding for the first year of the expansion. Some undecided states -- such as Oklahoma, Pennsylvania and Utah -- have recently suggested it is unlikely they will expand their Medicaid programs until after 2014, if at all. However, some experts say that states could opt into the expansion in 2014 and still be eligible for full funding, provided that they have completed a large portion of the technical work to build health insurance exchanges to support the expansion and developed a plan for implementation (Millman, Politico, 5/23). Click here for the Politico article.

MENTAL HEALTH: Up to 20% of U.S. Children Have Mental Health Conditions, CDC Finds

As many as one in five individuals in the U.S. under age 18 experience a mental health disorder each year and that rate is climbing, according to a CDC report released May 16. The report -- which analyzed data from 2005 to 2011 -- found that such illnesses cost about $247 billion annually in decreased productivity, juvenile justice, special education and treatment. The report cited a pair of studies that found mental health disorders among adolescents are on the rise (Pugh, Washington Post, 5/19). The report found that the most common types of mental health disorders reported were Attention Deficit Hyperactivity Disorder, with 6.8% of adolescents under age 18 diagnosed; behavioral and conduct disorders, with 3.5% diagnosed; and anxiety, with 3% diagnosed (Chumley, Washington Times, 5/17). Ruth Perou, child development studies team leader at CDC, said the increase could stem from greater awareness of the disorders by health care providers and parents, increased poverty or environmental factors (Washington Post, 5/19). Click here for the report. Click here for the Washington Post article. Click here for the Washington Times article.

RX DRUGS: Indiana Gov. Signs Workers Compensation Measure With Regulations on Repackaged Drugs

Indiana Gov. Mike Pence (R) on May 11 signed into law a workers compensation bill (HB 1320) that includes regulations for repackaged drugs. The law prohibits repackaged drugs from being sold for a higher price than the average of the wholesale price that the original manufacturer established. It also enacts a fee schedule for medical services to a maximum rate of 200% of Medicare's rate and limits the price of medical implants for workers compensation plans (Ceniceros, Business Insurance, 5/13). Click here for the Business Insurance article.

RX DRUGS: Report Finds Ohio Medicare Beneficiaries Were Charged $2.6 Billion on Prescription Drugs in 2010

SUBSTANCE USE DISORDERS: Indiana Gov. Pence Bolsters Oversight of Clinics Prescribing Painkillers

Indiana Gov. Mike Pence (R) earlier this month signed into law a bill (SEA 246) that grants the Medical Licensing Board of Indiana authority to regulate who can own and operate clinics distributing prescription painkillers. According to the National Survey on Drug Use and Health, Indiana has one of the highest rates of prescription drug use disorders in the nation, with 5.7% of state residents using prescription painkillers for nonmedical reasons last year. The new law -- which was proposed by state Sen. Ron Grooms (R-Jeffersonville) -- bolsters the state attorney general's power to investigate clinics suspected of overprescribing painkillers. It also calls on the Health Finance Commission to study drug take-back programs and requires the Legislature to investigate opioid use and treatment for prescription misuse (News and Tribune, 5/15). Click here for the News and Tribune article.

SUBSTANCE USE DISORDERS: Kentucky Officials Address Increase in Infants Born Addicted to Prescriptions

Kentucky health care officials and stakeholders on May 20 discussed the growing number of infants born addicted to prescription painkillers that their mothers misused and how to address the issue. When infants experience withdrawal from the substances -- a condition called Neonatal Abstinence Syndrome -- symptoms can include diarrhea, fevers, seizures, tremors, constant crying and vomiting. The number of Kentucky infants with NAS has increased from 29 in 2000 to 730 in 2011, a 2,400% increase. Jeff Jamar, substance abuse branch manager at the Kentucky Division of Behavioral Health, said that the state plans to expand its KIDS NOW Plus program, which assists individuals at risk of giving birth to an infant with NAS. Jamar also said provisions of the Affordable Care Act will expand access to care, including prescription misuse treatment (Ungar, Louisville Courier-Journal, 5/20). Click here for the Louisville Courier-Journal article.