Happy Case Management Week!

Don't forget to join us tomorrow as we toast to our accomplishments! Send us your pictures !

(On Friday, October 19, 2012 at 1 PM ET, 12 Noon CT, 11 AM MT and 10 AM PT, CMSA President Nancy Skinner would like you to join her in toasting the individual and collective accomplishments of the case manager. Choose your beverage, set the alarm on your smart phone and put it on your calendar! )  from www.cmsa.org

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Medicare's 3-Day Stay Rule Doesn't Make Sense

http://seniorhousingnews.com/2012/08/08/medicares-3-day-stay-rule-for-skilled-nursing-coverage-ripe-for-elimination/

I am dissappointed to learn that this bill (H.R. 1543 Improving Access to Medicare Coverage Act of 2011) which will eliminate the 3day Inpatient stay rule before SNF admissions only has 1% chance to pass. We need to keep trying because it does not make sense for some patients who does not fall into the 3 day category to waste healthcare dollars.

New Jersey Death With Dignity Act

http://www.nj.com/politics/index.ssf/2012/09/controversial_bill_would_allow.html#incart_river_default

This is a very controversial bill that if passed, New Jersey could be the third state (next to Oregon and Washington) that will allow patients to self  administer life-ending drugs. This will elicit a lot of discussions, I'm sure. Let us know what you think!

Medicare to Fine Hospitals For Readmissions

http://m.yahoo.com/w/legobpengine/news/medicare-fines-over-hospitals-readmitted-patients-084816882.html?orig_host_hdr=news.yahoo.com&.intl=US&.lang=en-US

It's coming! Medicare will start to penalize hospitals for readmissions. Penalty will be as low as 1% and is expected to go up to 3%. This is part of the Health Care Reform ...transforming Health Care from fragmented care to continuing care. This will make healthcare providers to be more vigilant in ensuring that patients follow up with their doctors after discharge. What do we do with non-compliant ones? It will be a challenge to drag them to their appointments.   I can almost foresee hospitals forming initiatives in attempt to reduce readmissions. This could be a good thing!

Sanofi Reinstated Lovenox Assistance Program

https://patientassistanceprogram.sanofi-aventis.us/index.html

I found out today that Sanofi brought back their Lovenox Assistance Program! Good news right? Not so fast...with the program reinstated, they made some major changes. They no longer give you a confirmation letter prior to discharge.They will only deliver to hospital outpatient pharmacy.  They actually ask you now for dispense log prior to approval. That means, you would have to risk not getting approved while you wait for reimbursement. Do you know of anyone who took advantage of this program? We want to hear how you did it!

Percentage of Uninsured Dropped in Twenty States

http://capsules.kaiserhealthnews.org/index.php/2012/09/insurance-coverage-improves-in-20-states-census-shows/

According to the Census Bureau, the percentage of uninsured dropped in 20 states in 2011. This is great news! Take a look at your favorite state and see where it ranks.

Who Should Lead The Medical Home Model?

http://www.kaiserhealthnews.org/daily-reports/2012/september/19/primary-care.aspx?referrer=search

Let's face it, there are shortage in primary care doctors but do you think it's enough reason to utilize other practitioners to lead the Medical Home Model? The nurse practitioners has evolved because of the same reasons...shortage in doctors. Their role has expanded in some states which now includes diagnosing and prescribing medications, but do you think that's enough?

Prescription Drug Abuse Reform Bill Signed into a Law

http://www.governor.ny.gov/press/08272012prescription-drug-abuse

Finally, someone ackowledged that there is a  problem here. The new law will require the Department of Health to update their Prescription Monitoring program (PMP), healthcare providers and pharmacists can now access the PMP registry before dispensing controlled substance. It will hopefully crack down on those "doctor shoppers". It will also promote e-prescribing which will reduce the theft, forgery, or alteration from paper prescription.It will create safe disposal program for prescription drugs. The article has the detailed explanation of the new law. Way to go New York!

"Partners for Children"- A Beacon of Change for End of Life Care

http://www.reuters.com/article/2012/09/01/us-life-care-idUSBRE88009I20120901

This article showed significant savings on healthcare costs by eliminating the six month time limit on children with life threatening illnesses before they can enter hospice care. It reduced hospital readmissions by 35 percent , a savings of 11percent  per patient. This program "Partners for Children"  was piloted in UCLA. I think it's a good program to adapt. It is however hard for many of us to accept end of life. When do you say enough is enough? My opinion is that it's more of the individual's acceptance of end of life that will decide that...it does not matter if the elimination period is there or not. What do you think?