Many Seniors Erroneously Denied Medicare Coverage

The New York Times (9/13, D5, Span, Subscription Publication) reports that beneficiaries are often told Medicare will no longer cover physical therapy or nursing home stays because they are “stable and chronic,” or have reached “maximum functional capacity,” or they have plateaued.

Seniors “with chronic and progressive diseases – dementia, Parkinson’s, heart failure” – are typically given this incorrect assessment, even though a 2013 settlement of a class-action suit mandated that Medicare “cover skilled care and therapy when they are ‘necessary to maintain the patient’s current condition or prevent or slow further deterioration.’”

In addition, last month, a Federal judge ordered CMS “to do a better job of informing health care” professionals “and Medicare adjudicators that the so-called improvement standard was no longer in effect.” The judge said that while CMS does not have to further update its manuals, it must do a better job of educating the medical community about these changes.

Related Links:

— “Failure to Improve Is Still Being Used, Wrongly, to Deny Medicare Coverage,” Paula Span, New York Times, September 12, 2016.

Over 19,000 Reports Of AD/HD Medication Complications Made To FDA Since 2013

The Milwaukee Journal Sentinel (9/10, Fauber, Wynn, Fiore) reports that “since 2013, there have been more than 19,000 reports of complications from AD/HD” medications “made to the U.S. Food and Drug Administration, according to a Milwaukee Journal Sentinel/MedPage Today analysis.” The article points out that “in the case of adult AD/HD, the definition was relaxed in 2013 by the American Psychiatric Association.”

According to “the new definition, adults need to have five of a possible nine symptoms from either of two categories, down from six of a possible nine, and the symptoms must have been present before age 12, instead of the previous age 7.” However, some “experts question whether adult AD/HD truly is a widespread condition that needs treatment with dangerous” medications.

Related Links:

— “Abuse of ADHD drugs following path of opioids,” John Fauber, Matthew Wynn and Kristina Fiore, Milwaukee Journal Sentinel, September 10, 2016.

9/11 First Responders Experiencing Various Health Problems 15 Years Later

The CBS Evening News (9/9, story 9, 2:25, Pelley) reported on some of the health problems experienced by first responders who survived the 9/11 attacks. CBS News’ Dr. Jon LaPook, MD, said, “In a study of more than 800 first responders, more than 12 percent had cognitive impairment.” He added that “responders…with a diagnosis of PTSD with flashbacks were three times as likely to have impairment.”

Meanwhile, the New York Post (9/9, Fears) reported, “The city Health Department released on Friday new findings from the World Trade Center Health Registry that illustrate the long-term physical and mental effects that 9/11 survivors and recovery workers are suffering.”

Related Links:

— “9/11 survivors continue battling long-term health effects,” Danika Fears, New York Post, September 9, 2016.

Veterinarians Have Third-Highest Risk Of Suicide Compared To Other Occupations

The Minneapolis Star Tribune (9/10, Olson) reported, “Veterinarians have the third-highest risk of suicide as a cause of death when compared to other US occupations,” the Star Tribune found after examining data from the CDC’s National Occupational Mortality Surveillance database. Included in that database are “death records from 24 states in a recent seven-year period.” The suicide rate for veterinarians is surpassed only by that of “podiatrists and dentists.”

Related Links:

— “Veterinarians at high risk for suicide, and job could play a role,” Jeremy Olson, Minneapolis Star Tribune, September 10, 2016.

House Subcommittee Members Push For Insurers To Do More To Ensure Mental Health Parity

The Hill (9/9, Disipio) reported that on Sept. 9, “members of the House Energy and Commerce Subcommittee on Health pushed for insurers to do more to ensure parity so that those with mental health or substance abuse issues don’t face tougher obstacles to receiving care as those with other medical conditions.” According to The Hill, “Since the passage of the Mental Health Parity Act of 1996, Congress has pressed to improve upon making mental health and substance use treatment as accessible as other treatments.” Meanwhile, lawmakers in the Senate “are still struggling to reach a deal” on mental healthcare reform legislation.

Related Links:

— “Lawmakers push insurers on mental health access,” Joe DiSipio, The Hill, September 9, 2016.

“Glaring Differences” In Health Insurance Coverage Persist Despite ACA

The AP (9/8, Murphy) reports on persistent “glaring differences in insurance coverage” for children with autism, amputees, “and others in need of certain expensive treatments even after the Affordable Care Act set new standards as part of its push to expand and improve coverage.” The article says these disparities “stem from random factors like what state someone lives in or who happens to provide their coverage – and often people can do nothing about it,” because the ACA allows states and employers to determine what should be covered. According to the AP, these differences can result in significant debt for patients, or they can push consumers to skip medical care.

Related Links:

— “WHY INSURANCE DENIES YOUR CLAIM, BUT PAYS YOUR NEIGHBOR’S,” TOM MURPHY, Associated Press, September 8, 2016.

Cognitive Impairment Common Among World Trade Center Attack Responders

Healio (9/8, Oldt) reports, “Cognitive impairment was common among individuals who responded to the attacks on the World Trade Center,” researchers found after evaluating “818 responders who reported for annual monitoring visits.” The findings, which were published earlier this year in Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring, suggest an association between post-traumatic stress disorder and cognitive impairment.

Related Links:

— “Analysis of World Trade Center responders shows link between trauma, cognitive impairment,” Healio, September 8, 2016.

Alcohol Ads Affect Underage Drinkers

HealthDay (9/7, Preidt) reports, “The more ads for a brand of alcohol that underage drinkers see, the more likely they are to consume that product,” researchers found after asking some 1,000 13- to 20-year-old participants “who said they’d had alcohol in the past month” a number of questions on drinking and television viewing habits. The findings were published online Sept. 7 in the Journal of Studies on Alcohol and Drugs.

Related Links:

— “TV Booze Ads a Lubricant for Teen Drinking: Study,” Robert Preidt, HealthDay, September 7, 2016.