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Department Of Justice, HHS Boosts Number Of Investigators, Prosecutors Looking At Medicare, Medicaid Fraud
HHS and the Department of Justice on Wednesday launched the Health Care Fraud Prevention and Enforcement Action Team to detect and prevent fraud in Medicare and Medicaid, the Washington Post reports (Johnson, Washington Post, 5/21). DOJ also plans to establish teams to address fraud in the Medicare Part D program and CHIP (Kennedy, AP/Houston Chronicle, 5/20). Wednesday"s announcement also included a recommendation by President Obama"s administration to include $311 million in the fiscal year 2010 budget to address health care fraud, which is a 50% increase from FY 2009. According to Attorney General Eric Holder, efforts to combat health care fraud will contribute to the administration"s health care overhaul plans (Clark/Weaver, McClatchy/Kansas City Star, 5/20). The task force, which will include HHS and DOJ staff members, law enforcement agents and prosecutors, will meet biweekly, CQ HealthBeat reports (Norman, CQ HealthBeat, 5/20). Under the plan, existing enforcement teams in Miami and Los Angeles will be expanded and new teams will be established in Houston and Detroit, where officials say suspicious billing patterns have emerged. In addition, the plan will set up task forces in 10 other major cities, which were not named (AP/Houston Chronicle, 5/20). The enforcement teams will increase site visits to durable medical equipment suppliers upon their enrollment. In addition, officials will expand training to help providers identify and prevent fraud or other mistakes (CQ HealthBeat, 5/20). The task force will use electronic claims data to detect "unusual billing problems," according to the Post (Washington Post, 5/21). HHS Secretary Kathleen Sebelius said the task force also intends to simplify billing systems and assist state officials in conducting Medicaid audits (CQ HealthBeat, 5/20). According to Holder, the joint task force will allow officials to share real-time intelligence data on health care fraud by monitoring claims payments, billing patterns and targeted surveillance (AP/Houston Chronicle, 5/20). Money
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New Jersey Senate, Assembly Panels Advance Autism Coverage Bill
Committees in the New Jersey Senate and Assembly on Monday unanimously approved a bill that would provide insurance benefits of up to $36,000 annually for autism treatments, the Philadelphia Inquirer reports. The funding, provided to developmentally disabled individuals younger than age 21, would go toward diagnostic services and early behavioral intervention, as well as occupational, physical and speech therapies. The Assembly could vote on the bill as early as Thursday, while the Senate bill is being considered by the state Senate Budget and Appropriations Committee.Sen. Loretta Weinberg (D), who sponsored the Senate bill, said, "I don"t know of any parent who wouldn"t do everything in their power to give their autistic or developmentally disabled child every chance to excel. However, the enormous cost of behavior intervention ... makes it out of the realm of possibility for many families." Assembly Speaker Joseph Roberts (D), who sponsored the Assembly bill, said, "In this economy, every New Jersey resident is struggling, but families with kids with special needs are struggling even more," adding, "They"re maxing out their credit cards and taking out second mortgages" to cover gaps in health insurance benefits.Citing cost issues, the New Jersey Business and Industry Association and the New Jersey Association of Health Plans were among those opposed to the bill. Christine Stearns, NJBIA vice president for health and legal affairs, said that the bill would make employer-sponsored insurance more costly and cause firms to drop such coverage, adding, "How, who and what is part of a basic health plan is all part of that." Stearns added that the bill is preferable to previous versions because it mandates that covered services be medically necessary and prescribed, places a reasonable cap on prices and ensures that the cost of educational services provided by schools is not shifted to insurers. Roberts said the bill would save money by delivering earlier treatment that could prevent more costly problems in the future (Henry, Philadelphia Inquirer, 5/19).
News of the day
Endocrine Society Issues Position Statement On Endocrine-Disrupting Chemicals
Interest and concern about possible health threats posed by endocrine-disrupting chemicals (EDCs) is on the rise, yet there is currently no comprehensive coordinated approach to regulating EDCs in the United States. To address this emerging public health issue, The Endocrine Society today released a new position statement outlining the public health concerns of exposure to EDCs and proposing a series of recommendations for revising current policy and generating new policy on EDCs.
Endocrinology

New Obesity Data Shows Blacks Have The Highest Rates Of Obesity

Blacks had 51 percent higher prevalence of obesity, and Hispanics had 21 percent higher obesity prevalence compared with whites, according to researchers with the Centers for Disease Control and Prevention. Greater prevalences of obesity for blacks and whites were found in the South and Midwest than in the West and Northeast. Hispanics in the Northeast had lower obesity prevalence than Hispanics in the Midwest, South or West. The study, in CDCò€²s Morbidity and Mortality Weekly Report, examined data from 2006-2008. "This study highlights that in the United States, blacks and Hispanics are disproportionately affected by obesity," said Dr. William H. Dietz, Director of CDCò€²s Division of Nutrition, Physical Activity, and Obesity, "If we have any hope of stemming the rise in obesity, we must intensify our efforts to create an environment for healthy living in these communities." The study uses data from the Behavioral Risk Factor Surveillance System (BRFSS), of the Centers for Disease Control and Prevention. BRFSS is an ongoing, state-based, random-digit - dialed telephone survey of the U.S. civilian, noninstitutionalized population aged 18 years and older. The study found that in 40 states, obesity prevalence among blacks was 30 percent or more. In five of those states, Alabama, Maine, Mississippi, Ohio, and Oregon, obesity prevalence among blacks was 40 percent or greater. For blacks, the prevalence of obesity ranged from 23 percent to 45.1 percent among all states and the District of Columbia; among Hispanics in 50 states and DC, the prevalence of obesity ranged from 21 percent to 36.7 percent, with 11 states having an obesity prevalence of 30 percent or higher. Among whites in 50 states and the District of Columbia, the prevalence of obesity ranged from 9 percent to 30.2 percent, with only West Virginia having a prevalence of 30 percent or more. "We know that racial and ethnic differences in obesity prevalence are likely due to both individual behaviors, as well as differences in the physical and social environment," said Liping Pan, M.D., M.P.H., lead author and epidemiologist. "We need a combination of policy and environmental changes that can create opportunities for healthier living." For this study analysis, CDC analyzed the 2006-2008 BRFSS data. For more information on obesity trends, tables, including an animated map, visit http://www.cdc.gov/obesity/data/trends.html. To learn more about CDCò€²s efforts in the fight against obesity or for more information about nutrition, physical activity, and maintaining a healthy weight, visit http://www.cdc.gov/nccdphp/dnpao. HHS


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