** High Priority **
ADA POLICY INITIATIVES AND ADVOCACY REPORT
ON THE PULSE - edited by Bonnie Athas and sent to GN Members per
permission of the Legislative Office of ADA.
Editor's Note: The Policy Initiatives and Advocacy group issues this
email
each week to inform members of the American Dietetic Association of
developments affecting food, nutrition and health. Topics reflect
ADA's
legislative and regulatory priorities in Washington and the states,
reimbursement issues, related matters and larger developments that
affect
the environment in which these topics are considered.
Information contained in On the Pulse includes sensitive material and
should
not be shared outside the American Dietetic Association. For
additional
information or to seek permission for reprinting, please contact ADA
Policy
Initiatives and Advocacy at 800/877-0877. Please send comments to
pulse@eatright.org.
Friday, April 18, 2003
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Report shows Medicare Rx drug provision could save states billions
The Commonwealth Fund released a study emphasizing how making
Medicare,
rather than Medicaid, the delivery program for prescription drugs to
seniors
could save states up to $6.8 billion annually and improve care to
low-income
beneficiaries. This would help keep states from having to make cuts to
Medicaid. (The Commonwealth Fund is a private foundation that
supports
independent research on health and social issues.)
The report's findings support the approach incorporated last year in a
bill
that passed the House of Representatives, H.R. 4954, the Medicare
Modernization and Prescription Drug Act of 2002. According to the
report,
Rep. Bill Thomas (R-CA), Chair of the Ways and Means Committee, said,
"Treating Medicare beneficiaries as seniors first and low-income second
is
the right thing to do. This approach ensures all seniors across the
country
have access to affordable prescription drugs, while alleviating much of
the
burden states now confront."
The House of Representatives is expected to debate a new prescription
drug
bill prior to the end of May. $400 billion (over ten years) was
included in
the recently passed budget resolution for Medicare reform, including
the
addition of a prescription drug benefit. The Senate is also expected
to
consider a prescription drug benefit in the near future.
It is estimated that almost six million Medicare recipients (both
senior
citizens and people with disabilities) are also eligible for Medicaid
because of their low income levels. The report, State Medicaid
Prescription
Drug Expenditures for Medicare-Medicaid Dual Eligibles, concludes that
a
properly designed Medicare prescription drug plan would provide more
uniform
coverage for Medicare eligible low-income beneficiaries.
The study identifies three major advantages a Medicare program would
provide:
1. Greater Uniformity. State Medicaid programs vary widely
in
their basic eligibility rules, including the kinds of restrictions
they
impose on prescription drug use (prior authorization requirements,
limits on
the number of prescriptions and refills, formulary limits, generic
substitution requirements), the amount of beneficiary cost sharing
required
and methods for reimbursing pharmacists. All of these factors can
affect
dual eligibles' prescription drug coverage.
2. Improved Access. Low-income beneficiaries could have
improved access to prescription drugs in states where full Medicaid
coverage
is now below 74 percent of poverty or where there are cost-sharing
requirements or other limits on coverage. In addition, low-income
Medicare
beneficiaries may be more likely to obtain prescription drug coverage
if
they can do so through Medicare rather than Medicaid. Many believe
Medicaid
enrollment is burdensome or believe the program carries a stigma.
3. Improved Coordination. Including prescription drugs in
a
Medicare benefit package for dual eligibles could improve coordination
of
prescription drug use with other aspects of care, including physician,
inpatient home health and skilled nursing facilities.
HHS announces action plan for prevention and treatment of heart disease
and
stroke
HHS Secretary Tommy G. Thompson has introduced a strategy for
developing a
national health care system that addresses the prevention and treatment
of
heart disease and stroke. The strategy, "A Public Health Action Plan
to
Prevent Heart Disease and Stroke," provides health practitioners and
policymakers a framework to prevent and treat heart disease and stroke,
the
nation's first and third leading causes of death.
"These leading causes of death for men and women are largely
preventable,
yet we as a nation are not taking the steps necessary for us to lead
healthier, longer lives," said Secretary Thompson. "Our nation is
facing
one of its most challenging health crises where the cost of failure is
too
high. We must start emphasizing prevention of this epidemic."
The action plan, which was unveiled at HHS' "Steps to a HealthierUS:
Putting
Prevention First" conference in Baltimore, estimates that heart disease
and
stroke will have an economic cost of more than $351 billion in 2003.
In
addition, certain racial and ethnic populations are at increased risk
of
heart disease and stroke, as are people with lower income and
educational
levels. Throughout the conference, Secretary Thompson underscored his
priorities and programs for "Steps to a HealthierUS," the department's
initiative to advance the President's HealthierUS Initiative. The
plan's
five main recommendations are:
* Taking action to prevent and treat heart disease and
stroke
by using the latest scientific
findings;
* Ensuring a clear focus at public health agencies;
* Evaluating the impact of policy and program
interventions;
* Advancing prevention policies; and
* Collaborating with regional and global partners to
share
knowledge and practices.
For more information visit www.cdc.gov/cvh <http://www.cdc.gov/cvh>.
Food firms form coalition to craft qualified claim recommendations
The Grocery Manufacturers of America (GMA) is leading a food industry
coalition on qualified health claims for conventional foods. The
coalition
plans to draft recommendations on how the Food and Drug Administration
(FDA)
could set up a clear and transparent system for allowing qualified
conventional food health claims. In January the agency announced that
it
had established an internal task force to develop guidance documents
answering key questions about how the agency will implement a plan to
allow
conventional foods for the first time to carry qualified health
claims.
The effort to coordinate food industry views stems from a January
meeting of
GMA's nutrition and labeling work group. Christine Taylor, FDA food
center's director of nutritional products, attended the GMA work group
meeting and suggested pulling together one industry voice on the
subject.
Taylor is also a member of the task group charged with implementing
the
agency's new health claim initiative.
The first industry coalition meeting took place at the end of March,
according to GMA. Industry participants plan to meet regularly to
pull
together the food industry's views and relay them to FDA. Several key
food
trade associations attended the March meeting, including: the National
Food
Processors Association (NFPA), the Food Marketing Institute (FMI), the
International Dairy Foods Association and the American Frozen Food
Institute.
Lo-carb diet studies lack middle aged subjects and long term
information
A recent study published in the Journal of the American Medical
Association
points to the lack of both long-term data on low carbohydrate diets and
the
effects these diets have on middle aged individuals.
"Low-carbohydrate
diets have been extremely popular as of late, and the lay press has
suggested they're a safe and effective means of weight loss. While
these
diets are effective in the short term, weight loss results from
reduced
calories, not carbohydrate restriction," said lead study author Dr.
Dena
Bravata of Stanford University's Center for Primary Care and Outcomes
Research. Bravata and colleagues collected literature on 107
low-carbohydrate diet studies conducted from 1966 to the present, and
they
found studies to be small and greatly varied. Furthermore, none of
the
studies had participants over age 53 or lasted longer than 90 days.
"Information on older adults and long-term results are scarce at best,
and
this should be kept in mind when looking at our findings," said
Bravata.
The data analysis showed people on diets of 60 grams of carbohydrates
or
less per day did lose weight, however, the weight loss was more the
result
of lower calorie intake, not lower carbohydrate intake. Furthermore,
the
greatest weight loss occurred among study participants who had the
highest
baseline weight and lowest caloric content. The overall conclusion
drawn by
the study authors was that insufficient evidence currently exists to
argue
for or against a low carbohydrate diet regimen. Future studies should
focus
on the role of exercise, long-term effects and the effectiveness and
safety
of low carbohydrate diets for people over age 53.
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