Headlines: April 26, 2010
by Meg Larkin
In the wake of the new health care law, con men are taking advantage of the public’s confusion. In multiple states, consumers have reported telemarketers offering health insurance with names like Obamacare or “government health care reform.” The scammers usually ask for bank account information after offering health care at very low premiums. Although the scams are often no more sophisticated than spam e-mail, they have drawn the attention of State governments and Health and Human Services Secretary Kathleen Sebelius. Government officials are warning consumers to avoid plans that have names like “Obamacare” or that offer to expedite Medicare Part D drug benefits. The elderly and the poor have been the largest victims of the fraud so far.
In Massachusetts, insurers bent on reining in costs are offering plans that exclude elite hospitals. Insurers in the state typically offer wide open networks, which allow a patient to choose between community hospitals and more expensive academic medical centers. However, given the rising costs of health insurance in Massachusetts, some insurers are offering plans that require pre-approval for treatment at an elite hospital or that offer incentives for consumers to chose to go to less costly providers for routine services. These “limited network plans” are typically less expensive for both insurers and consumers. However, in concentrated markets, hospitals with clout often have terms in their contracts with insurers that allow the hospital to stop working with the insurer if the insurer attempts to steer patients to other providers. These clauses would prevent insurers from offering limited network plans in many cases. Governor Deval Patrick and Senate President Therese Murray both support limited network plans as a technique for controlling health care costs.
In regulatory news, the FDA is increasing oversight of infusion pumps. Health care providers use the pumps to dispense medication intravenously both in hospitals and at home. Formerly, many of the pumps were allowed to go to market without additional testing because they were similar to devices already on the market, but the FDA has grown concerned about the number of patient deaths connected to the devices. According to the New York Times, “Over the last five years, the agency says it has received reports of 710 patient deaths linked to problems with the devices, though F.D.A. officials say they think the number may be significantly higher. Some of those deaths involved patients who suffered drug overdoses accidentally, either because a hospital worker entered incorrect dosage data into a pump or because the device’s software malfunctioned.” Under the proposed requirements, which could be promulgated within a year, pump manufacturers would be required to do clinical trials of the devices and support their approval applications with more data on the safety and efficacy of the devices.
Finally, months after the end of the H1N1 flu pandemic, federal health officials are investigating possible complications from the swine flu vaccine. According to the Washington Post, “The latest analysis of data has detected what could be a somewhat elevated rate of Guillain-Barré syndrome, which can cause paralysis and death; Bell's palsy, a temporary facial paralysis; and thrombocytopenia, which is a low level of blood platelets.” However, officials have emphasized that it is far to early to know if any of these complications are actually present. Additionally, if they are, the incidence is very low, and the risk of encountering complications from the vaccine is still far lower than the risks of contracting influenza according to the CDC.
Meg Larkin is a second year law student at Boston University. Please feel free to email her with any questions, comments, suggestions, or concerns.