Legislative Update

From: Bonnie Athas (BONNIEATHAS@utah.gov)
Date: Fri Apr 18 2003 - 13:12:44 PDT

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    ** 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
    -----------

    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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