My View: Hospitals abuse drug program meant to help poor - Opinion - Rockford Register Star - Rockford, IL

 

By David Miller
Posted Dec. 12, 2014 @ 5:00 pm

An obscure federal program designed to help poor Americans afford prescription drugs is being used to boost the profits of the nation’s largest hospitals and pharmacies.

Many of Illinois’ 188 hospitals are taking part in this abuse. And Washington is finally taking notice, pledging to refocus the 340B program so that it serves those it was intended to help.

When Congress created 340B in 1992, lawmakers hoped that by requiring pharmaceutical firms to discount drugs sold to hospitals serving large numbers of poor and uninsured, they’d help those hospitals without tapping taxpayers.

But the law has morphed considerably over the past 22 years. And today, hospitals aren’t required to pass 340B discounts along to patients. Consequently, hospitals participating in the program receive discounted drugs for all their patients — even the ones that are insured or can afford the cost of care.

Here’s an illustration of how this scheme works. Say a drug normally costs $100, but a hospital can purchase it for $60 directly from the drug manufacturer as part of the 340B program. When the hospital treats an insured patient, it bills the insurer the full $100 price for the drug. In addition, the hospital typically collects a co-pay from the patient, say $10.

The end result is that the hospital makes a $50 profit on a drug that cost the hospital only $60. That’s an 83 percent return that has nothing to do with helping the poor and uninsured.

This hypothetical example may actually understate how much money hospitals are making off 340B. Last year, the North Carolina News & Observer reported “large hospitals (with access to 340B discounts) are dramatically inflating prices on chemotherapy drugs at a time when they are cornering more of the market on cancer care. ... Hospitals routinely mark up prices on cancer drugs two to 10 times or more over cost. In some cases, the markup is far higher.”

With this kind of money to be made, it’s no wonder why almost every hospital in the country is vying to be part of the program. In order to be deemed eligible, hospitals have only to meet certain benchmarks for the number of medically underserved patients they treat. But there’s scant evidence that the method used for determining eligibility corresponds with serving high numbers of the poor and uninsured. In fact, the federal Medicare Payment Advisory Commission itself has expressed skepticism of the methodology.

As a result, 1 in 3 U.S. hospitals now participates in the 340B program. The Berkeley Research Group estimates that expenditures under the program will double from $6 billion in 2010 to $12 billion in 2016.

This is not only fiscally irresponsible and unsustainable, it’s wrong. The 340B program is supposed to help poor patients, not hospitals’ profit margins. Federal lawmakers must get 340B back on track.

 

Read more: http://www.rrstar.com/article/20141212/Opinion/141219749#ixzz3LjMPAUcV

Hospitals temporarily restricting visitors to limit spread of flu | The Rock River Times

 

In light of the high number of influenza cases in the Rock River Region, OSF Saint Anthony Medical Center, Rockford Health System and SwedishAmerican Health System are restricting the age of visitors to their facilities per recommendations from Illinois Department of Public Health.

The Illinois Department of Public Health recommends hospitals implement all of the comprehensive influenza prevention and control recommendations from the Centers for Disease Control and Prevention (CDC) during times of increased incidence of influenza-like illness in the community.

Effective immediately, and until further notice, hospital visitors will be limited to those individuals 18 years of age and older. In addition, it is strongly recommended that anyone showing flu-like symptoms refrain from visiting patients in the hospital. All treatment services are still available to all patients.

Read the entire article by clicking on the following:  Hospitals temporarily restricting visitors to limit spread of flu | The Rock River Times

Rockford hospitals restricting patient visits because of flu - Rockford, IL - Rockford Register Star

FLASH FLASH FLASH ---------------------------------------------FLASH FLASH FLASH

All three Rockford hospitals have implemented visitor restrictions because of widespread flu activity in the region.

OSF Saint Anthony Medical Center, Rockford Health System and SwedishAmerican Health System made the announcement today via the Winnebago County Health Department based on recommendations from the Illinois Department of Public Health.

Effective immediately, hospital visitors will be limited to people ages 18 and older. People with flu-like symptoms are also asked to refrain from visiting patients at the hospitals.

All treatment services are still available to patients.

Click on the following for more details:  Rockford hospitals restricting patient visits because of flu - Rockford, IL - Rockford Register Star

Northwest Herald | Board approves Centegra Hospital – Huntley

 

– Centegra Health System officials celebrated with a mix of relief and joy Tuesday after a state panel approved their plans for a $233 million project by a 6-3 vote.

Held at the Bolingbrook Golf Club, the Illinois Health Facilities and Services Review Board hearing reconsidered Centegra's application for a permit to proceed with its 128-bed hospital in Huntley.

Floyd and other officials from surrounding health care providers, including Advocate Good Shepherd in Barrington, expressed disappointment with the board's 6-3 vote in favor of Centegra Hospital - Huntley.

"It is unfortunate that board members chose to reverse their decision from December to deny this project. Nothing has changed related to this application,” said Karen Lambert, president of Advocate Good Shepherd Hospital. “This hospital is not needed. It would duplicate services, and it could reduce the quality of care in the area by pulling patients from other health care providers.”

Read the entire article by clicking on the following:  http://www.nwherald.com/2012/07/24/board-approves-centegra-hospital-huntley/agybb7h/?page=2

Sherman, Elmhurst, Silver Cross hospitals add debt for new buildings

Sherman Hospital in Elgin opened two years ago and its parent system has held talks with several networks, including Oak Brook-based Advocate Health Care. The trend highlights the fight for independence facing Joliet's Silver Cross Hospital, slated to open a $370-million facility in nearby New Lenox next year.

These hospitals combined carry almost $1.3 billion in long-term debt, most of it incurred to finance glitzy new buildings. Even as the boom began, the health care industry was changing: Patients who once filled hospital beds are visiting out-patient clinics or primary care physicians instead. Health insurance companies and Medicare continue to cut reimbursement rates while the costs to adapt to the federal overhaul of health care reform mount.

Read more: http://www.chicagobusiness.com/article/20111203/ISSUE01/312039979/sherman-elmhurst-silver-cross-hospitals-add-debt-for-new-buildings#ixzz1fjAZKYTt

Non-profit hospitals baffled over losing tax-exempt status

The Illinois Department of Revenue denied long-pending requests from three prominent institutions: Prentice Women's at Northwestern Memorial Hospital in Chicago, Edward Hospital in Naperville and Decatur Memorial Hospital in that Downstate city, according to one-page rulings from the department.
Read more: http://www.chicagobusiness.com/article/20110817/NEWS03/110819886/non-profit-hospitals-baffled-over-losing-tax-exempt-status#ixzz1VKp6gwY8
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Man leaves jail for medical treatment

 

Rock County Sheriff Bob Spoden said his jail isn’t equipped to treat Anthony Darwin for testicular cancer and getting him the proper medical care could potentially cost the county hundreds of thousands of dollars

He turned himself in on Jan. 10. District Attorney David O’Leary said Darwin was looking for medical treatment for stage four testicular cancer and had no health insurance

Bates said it was likely taxpayers may still end up with the tab for Darwin’s treatment, since he may end up applying for state health insurance, but the judge still granted Darwin’s release on a signature bond. Darwin is due back in court today.

Click on the following for more details:  Beloit Daily News - your source for news, entertainment, sports, opinion, events, community, shopping and more > News > Local News

NIU proton therapy center runs out of time, needs new state permit | Daily Chronicle

That two-year period will come to an end Friday. And the project remains far from completion,
NIPTRC representatives said.
NIPTRC blamed its failure to complete the project on the problems that have plagued the capital markets, making it virtually impossible to issue the $140 million in bonds

If built, the NIPTRC facility would be the Chicago area’s second proton therapy center, as Central DuPage Hospital and Bloomington, Ind.-based ProCure are completing work on the region’s first such proton center in Warrenville.

Click on the following for more details:  NIU proton therapy center runs out of time, needs new state permit | Daily Chronicle

Crusader Community Health receives $5.3 million in Recovery and Reinvestment Act funds

Crusader Community Health received $5,342,337 in grant funding through the American Recovery and Reinvestment Act to construct a new site in Loves Park and continue renovation of unused space at the existing Crusader Community Health on Broadway-Uram Building.

serves multiple counties in northern Illinois including Boone, Winnebago and Stephenson, and provides care to more than 40,000 individual patients annually in our region.

Click on the following for more of the story:  Crusader Community Health receives $5.3 million in Recovery and Reinvestment Act funds | The Rock River Times

Week 44--H1N1

2009-2010 Influenza Season Week 44 ending November 7, 2009

All data are preliminary and may change as more reports are received.

Synopsis:

During week 44 (November 1-7, 2009), influenza activity decreased slightly in the U.S.

• 3,834 (30.1%) specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories and reported to CDC/Influenza Division were positive for influenza.
• All subtyped influenza A viruses being reported to CDC were 2009 influenza A (H1N1) viruses.
• The proportion of deaths attributed to pneumonia and influenza (P&I) was above the epidemic threshold for the sixth consecutive week.
• Thirty-five influenza-associated pediatric deaths were reported. Twenty-six of these deaths were associated with 2009 influenza A (H1N1) virus infection, eight were associated with an influenza A virus for which the subtype was undetermined, and one was associated with an influenza B virus infection.
• The proportion of outpatient visits for influenza-like illness (ILI) was 6.7% which is above the national baseline of 2.3%. All 10 regions reported ILI above region-specific baseline levels.
• Forty-six states reported geographically widespread influenza activity, Puerto Rico and four states reported regional influenza activity, the District of Columbia reported local influenza activity, Guam reported sporadic influenza activity, and the U.S. Virgin Islands did not report.

National and Regional Summary of Select Surveillance Components

B
19 (0.5%)

During week 44, influenza B viruses co-circulated at low levels with 2009 influenza A (H1N1) viruses. All subtyped influenza A viruses reported to CDC this week were 2009 influenza A (H1N1) viruses.

View WHO-NREVSS Regional Bar Charts| View Chart Data | View Full Screen

Pneumonia and Influenza Hospitalization and Death Tracking:

This new system was implemented on August 30, 2009, and replaces the weekly report of laboratory confirmed 2009 H1N1-related hospitalizations and deaths that began in April 2009. Jurisdictions can now report to CDC counts of hospitalizations and deaths resulting from all types or subtypes of influenza, not just those from 2009 H1N1 influenza virus. To allow jurisdictions to implement the new case definition, counts were reset to zero on August 30, 2009. From August 30 – November 7, 2009, 22,364 laboratory-confirmed influenza associated hospitalizations and 877 laboratory-confirmed influenza associated deaths were reported to CDC. CDC will continue to use its traditional surveillance systems to track the progress of the 2009-10 influenza season.

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Antigenic Characterization:

CDC has antigenically characterized one seasonal influenza A (H1N1), two influenza A (H3N2) and 320 2009 influenza A (H1N1) viruses collected since September 1, 2009.

One seasonal influenza A (H1N1) virus was tested and is related to the influenza A (H1N1) component of the 2009-10 Northern Hemisphere influenza vaccine (A/Brisbane/59/2007).

Both influenza A (H3N2) viruses tested showed reduced titers with antisera produced against A/Brisbane/10/2007, the 2009-2010 Northern Hemisphere influenza A (H3N2) vaccine component, and were antigenically related to A/Perth/16/2009, the WHO recommended influenza A (H3N2) component of the 2010 Southern Hemisphere vaccine formulation.

Three hundred and nineteen (99.7%) of 320 2009 influenza A (H1N1) viruses tested are related to the A/California/07/2009 (H1N1) reference virus selected by WHO as the 2009 H1N1 vaccine virus and one virus (0.3%) tested showed reduced titers with antisera produced against A/California/07/2009.

Annual influenza vaccination is expected to provide the best protection against those virus strains that are related to the vaccine strains, but limited to no protection may be expected when the vaccine and circulating virus strains are so different as to be from different lineages. Antigenic characterization of 2009 influenza A(H1N1) viruses indicates that these viruses are only distantly related antigenically and genetically to seasonal influenza A(H1N1) viruses, suggesting that little to no protection would be expected from vaccination with seasonal influenza vaccine. It is too early in the influenza season to determine if seasonal influenza viruses will circulate widely or how well the vaccine and circulating strains will match.

Antiviral Resistance:

Since September 1, 2009, 315 2009 influenza A (H1N1) virus isolates have been tested for resistance to the neuraminidase inhibitors (oseltamivir and zanamivir), and 761 2009 influenza A (H1N1) original clinical samples were tested for a single known mutation in the virus that confers oseltamivir resistance. In addition, one influenza A (H3N2) and 152 2009 influenza A (H1N1) virus isolates have been tested for resistance to the adamantanes (amantadine and rimantadine). Additional laboratories perform antiviral testing and report their results to CDC. The results of antiviral resistance testing performed on these viruses are summarized in the table below.

Antiviral Resistance Testing Results on Samples Collected (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5832a3.htm).

Pneumonia and Influenza (P&I) Mortality Surveillance

During week 44, 7.7% of all deaths reported through the 122-Cities Mortality Reporting System were due to P&I. This percentage was above the epidemic threshold of 6.8% for week 44. Including week 44, P&I mortality has been above threshold for six consecutive weeks.

View Full Screen

Influenza-Associated Pediatric Mortality

Thirty-five influenza-associated pediatric deaths were reported to CDC during week 44 (Alabama, Arizona, Arkansas [2], California [8], Delaware, Georgia, Illinois, Michigan [2], Missouri, New Jersey, Ohio [2], Oklahoma [3], Tennessee [2], Texas [6], Utah, Virginia, and Washington). Twenty-six of these deaths were associated with 2009 influenza A (H1N1) virus infection, eight were associated with an influenza A virus for which the subtype is undetermined, and one was associated with an influenza B virus infection. These deaths occurred between March 15 and November 7, 2009.

Three deaths reported during week 44, including the death associated with influenza B virus infection, occurred during the 2008-09 season, bringing the total number of reported pediatric deaths occurring during that season to 127.

Since August 30, 2009, CDC has received 117 reports of influenza-associated pediatric deaths that occurred during the current influenza season (18 deaths in children less than 2 years old, 12 deaths in children 2-4 years old, 41 deaths in children 5-11 years old, and 46 deaths in children 12-17 years old). Ninety-eight (84%)of the 117 deaths were due to 2009 influenza A (H1N1) virus infections, and the remaining 19 were associated with influenza A virus for which the subtype is undetermined. A total of 156 deaths in children associated with 2009 influenza A (H1N1) virus infection have been reported to CDC.

Among the 117 deaths in children, 65 children had specimens collected for bacterial culture from normally sterile sites and 18 (27.7%) of the 65 were positive; Staphylococcus aureus was identified in eight (44.4%) of the 18 children. One S. aureus isolate was sensitive to methicillin, six were methicillin resistant, and one did not have sensitivity testing performed. Thirteen (72.2%) of the 18 children with bacterial coinfections were five years of age or older, and five (27.8%) of the 18 children were 12 years of age or older.

 

View Full Screen

Influenza-Associated Hospitalizations

Laboratory-confirmed influenza-associated hospitalizations are monitored using a population-based surveillance network that includes the 10 Emerging Infections Program (EIP) sites (CA, CO, CT, GA, MD, MN, NM, NY, OR and TN) and 6 new sites (IA, ID, MI, ND, OK and SD).

During September 1, 2009 – November 7, 2009, the following preliminary laboratory-confirmed overall influenza associated hospitalization rates were reported by EIP and the new sites (rates include influenza A, influenza B, and 2009 influenza A (H1N1)):

Rates [EIP (new sites)] for children aged 0-4 years and 5-17 years were 4.0 (8.1) and 2.0 (3.1) per 10,000, respectively. Rates [EIP (new sites)] for adults aged 18-49 years, 50-64 years, and ≥ 65 years were 1.5 (1.4), 1.7 (1.4) and 1.4 (1.3) per 10,000, respectively.

.

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Outpatient Illness Surveillance:

Nationwide during week 44, 6.7% of patient visits reported through the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) were due to influenza-like illness (ILI). This percentage is above the national baseline of 2.3%.

View ILINet Regional Charts | View Chart Data | View Full Screen

On a regional level, the percentage of outpatient visits for ILI ranged from 4.2% to 8.8% during week 44, and decreased in nine of the 10 surveillance regions compared to the previous week. All 10 regions reported a proportion of outpatient visits for ILI above their region-specific baseline levels.

Geographic Spread of Influenza as Assessed by State and Territorial Epidemiologists:

The influenza activity reported by state and territorial epidemiologists indicates geographic spread of both seasonal influenza and 2009 influenza A (H1N1) viruses and does not measure the severity of influenza activity.

• During week 44, the following influenza activity was reported:
  • Widespread influenza activity was reported by 46 states (Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming).
  • Regional influenza activity was reported by Puerto Rico and four states (Hawaii, Mississippi, Nebraska, and Texas).
  • Local influenza activity was reported by the District of Columbia.
  • Sporadic influenza activity was reported by Guam.
  • The U.S. Virgin Islands did not report.

Click on the following for more details on these CDC studies:  Flu Activity data in XML Format | View Full Screen

Illegal immigrant population difficult to determine

 

Supreme Court decided in 1982 that illegal immigrants and their children are as entitled to a public school education as American citizens. They’re also entitled to other protections provided in the 14th Amendment, including due process and equal protection provisions, the ruling said.

Emergency care must be provided regardless of a patient’s residency status. In McHenry County, hospitals within the Centegra Health System take the law a step further, said Kim Kubiak, Centegra spokeswoman. Illegal immigrants don’t need to have a medical emergency to receive treatment of any type….but hospital officials do track the dollar amount of “charity care” it provides, Kubiak said. From July 1, 2008, to June 30, the hospital system provided about $3 million in charity care to people who couldn’t pay, she said

The Office of Immigration Statistics estimated that the number of illegal immigrants living in the United States declined from 11.8 million in January 2007 to 11.6 million in January 2008, according to data released in February.

Read the rest of the story by clicking on the following:  Northwest Herald | Illegal immigrant population difficult to determine

Bracing for swine flu :: The Courier News :: Local News

 

less a matter of "if" than a question of "when," says John Cicero, executive director of the Will County Health Department.

Provena Saint Joseph Hospital in Elgin, said the hospital already has taken inventory to make sure it has adequate medications and supplies in case of an outbreak.

the good thing about the swine flu is that doctors can treat it with two antivirals, Tamiflu and Relenza, whereas the regular flu this year was resistant to these antivirals.

Dallas-based El Conejo Bus Line, which also delivers passengers from Mexico to Elgin daily, said that firm has begun to sanitize buses with disinfectant three to four times a day instead of the usual once. The bus line provides masks to passengers in Mexico, and passengers in the United States are able to choose to wear masks. He said that the company probably will refrain from making any route adjustments unless something further happens locally.

Bracing for swine flu :: The Courier News :: Local News

Why Republicans Should Back Universal Health Care - The Atlantic Business Channel

 

There's a massive constituency behind the policy. Buffeted by the recession and the threat of losing their employer-provided health insurance, the American people want universal coverage. Much of the US business community wants it too.

Why Republicans Should Back Universal Health Care - The Atlantic Business Channel

Rockford Memorial on deadline for Medicare fixes - - BusinessRockford.com

This story appears to be in conflict with my earlier posting.  See:  http://boonecountywatchdog.blogspot.com/2009/04/rockford-memorial-hospital-has-resolved.html   It looks like Rockford Memorial is doing some fast talking here.  It would appear that the hospital is out of compliance with federal/state regulation and that is what is causing the threat of suspension of Medicare/Medicaid payments.

 

Click on the following for the rest of the story:  Rockford Memorial on deadline for Medicare fixes - - BusinessRockford.com