Calif. Bill Aims To Limit Which Rx Drugs Are Listed in High-Cost Tiers

by:  California Healthline, Thursday, February 19, 2015

California lawmakers are considering a bill (AB 339) that aims to keep prescription drug costs down by limiting which medications insurers can include in the highest-cost drug tier, Capital Public Radio's "KXJZ News" reports.

Details of Bill

AB 339, by Assembly member Richard Gordon (D-Los Altos), would prevent insurers from placing all of the prescription drugs to treat a certain condition in the highest-cost tier of a drug formulary.

According to Gordon, insurers often place high-cost medications into such specialty tiers, which forces patients to pay a larger share of the prescription drug's price. For example, Gordon explained that if "all of the HIV drugs are in a very expensive top-tier category, that would appear to be discriminatory" (Bartolone, "KXJZ News," Capital Public Radio, 2/18).

In addition, the bill would require:

• All health plans offered, renewed or amended after Jan. 1, 2016, that cover outpatient prescription drugs to offer coverage for medically necessary medications that do not have a therapeutic equivalent; and
• The California Department of Managed Health Care and Department of Insurance to define by Jan. 1, 2017, a "specialty prescription drug" category that would be subject to limitations (AB 339, 2/13).

Health Insurer Reaction

Nicole Kasabian Evans with the California Association of Health Plans said the bill could be misleading, noting that patients pay higher shares of specialty drugs because they often are very expensive.

She said, "Bills like this give a false sense that drug costs are going to be reduced, when in reality costs are just shifted from your out-of-pocket costs to premiums."

Health insurers also contend that out-of-pocket costs already are capped under the Affordable Care Act. They say a better way to address high prescription drug costs would be to have drugmakers be more transparent about how prices are set

("KXJZ News," Capital Public Radio, 2/18).

Source: California Healthline, Thursday, February 19, 2015

Keyboard....Get Rid of It

Just as EHRs begin to comply with meaningful use and  ICD-10 codes, think "touch".

Next-generation desktops point to a touch-driven future

Perhaps not as 'sexy' or exciting as the screens Tom Cruise used to manipulate objects in Mission Impossible, the next generation of commercial desktops will follow suit along with their current offspring of mobile apps on tablets and smartphones. In fact the touch screen may allow form factors that are unique, attached to or built into a variety of office furniture (desks, walls, and doors).

HP's Sprout and Dell's conceptual Smart Desk show how touch-driven work surfaces can breathe new life into the desktop form factor.

What is in your future?

Desktop PC shipments have certainly declined in recent years, as sales of portable computers have taken off:

A recent desktop PC evolution, following Apple's lead with the iMac, is the all-in-one (AIO) computer: all the major Windows PC manufacturers (Lenovo, HP, Dell) now offer big-screen AIO systems -- some of them touch-enabled. However, navigating a desktop OS on a big vertically oriented touchscreen is a recipe for 'gorilla arm', which is why the most recent developments, spearheaded by HP, seek to blend the best of the desktop experience with the best of the tablet experience, with some intriguing extras thrown in.

HP Sprout

HP''s Sprout is an 'immersive computing' platform that's the first product to emerge from the company's Blended Reality ecosystem, which will in due course also include MultiJet Fusion 3D printers.

Dell Smart Desk

Dell unveiled its conceptual Smart Desk in November last year. Yet to appear as a finished product, the Smart Desk couples a large (5K) screen PC with a horizontal touch-sensitive work surface that can be driven by fingers, stylus or other 'totems' such as a ruler or a compass-like circular object for use with Google Maps. To exploit the work surface/PC platform, Dell talks of "plug-ins to key ISV applications" (Dell's promotional image clearly shows Adobe Photoshop. 

Take all of this and add Windows 10 ....  

Windows 10: What we know and what we think we know (courtesy of cnet.com)

Windows 10 Video

Built-in or Bolted-on ICD-10: What’s the Difference and Why Does it Matter?

What You Need to Know about the Different Solutions for ICD-10

The bottom line

Diagnostic codes will rise from 13,000 to more than 68,000 – a nearly 425% increase.

The Biggest Challenge DoctorsWill Face

Built-in or Bolted-on ICD-10: What’s the Difference and Why Does it Matter? What You Need to Know about the Different Solutions for ICD-10.

Most doctors, if not their office managers, are aware of the impending chage i medical diagnositc coes that will take effect. Medical pratices will have a massive adjustmet beginning on October 1, 2015 with the introduction of the 10th revision of the Internationnal Statistical Classification of Diseas (ICD 10), a medical classificatin list by the World Health Orgaizati (WHO). Proper knowldedge and use of the codes in billig for services will determine if doctors ge paid.


The problem that most EHR  vendors have is that they don't have the EHR data recorded in a way that that they could create an  algorithm to identify a specific ICD-10 code.

Many of today's current generation of EHRs billing codes generate effortlessly right along with examination notes. Converting from a numeric five digit to a seven digit alpha-numeric code will be a major change for billing accurately.  The new system uses codes for L or R or bilateral diagnoses, instead of modifiers.

Providers should not panic, nor underestimate the nature of the change.  Some experts advise to plan on securing loans to help finance the transition and to cover monetary losses due to the conversion process.  Staff planning and training are essential.

Many EHR vendors say their systems are EHR ready, but this may only be mapping or translation tools rather than an integrated coding system.

Summary:

Just having 68,000 codes in your EMR system to choose from in long lists isn't a time-saving or cost-effective option.  For efficiency, billing codes should generate effortlessly right alog with with your exam notes. Your EMR must be built around ICD-10--it should be it's native tongue', and not have ICD-10 conversion bolted on.

ref:

GE recalls 10,000+ MRI systems after FDA deems them potentially deadly, citing poor training

The FDA just deemed all GE Healthcare ($GE) MRIs with superconducting magnets potentially deadly by classifying the recall of nearly 13,000 of the imaging systems into the most serious Class I category. This means there is a reasonable probability that the device "will cause serious adverse health consequences or death."

The recall covers about 25 different MRIs, including several versions of the Signa brand and three versions of the Discovery brand. The notice posted on the FDA website on Feb. 18 also contains the affected lot and serial numbers, as well as the system ID.

The Discovery MR750 is one of several GE MRI systems being recalled.--Courtesy of GE

FDA RECALL NOTICE:

The notice includes these instructions and test procedures

GE Healthcare sent an "Urgent Medical Device Correction" letter GEHC Ref# 60876 dated January 6, 2015 to affected consignees. The letter was addressed to Hospital Administrators / Risk Managers, Radiology Department Managers, & Radiologists. The letter described the Safety Issue, Safety Instructions, Affected Product Details, Product Correction & Contact Information. Customers were instructed to do the following: As a preventative measure, confirm that MRU is connected to the magnet by performing the following four step test on the MRU. 1. Verify the green CHARGER POWER LED is lit. 2. Depress and hold the TEST BATTERY switch for 15 seconds. The green BATTERY TEST LED should light and remain lit while the TEST BATTERY switch is depressed. 3. Place the TEST HEATER toggle switch in the A position. The green HEATER TEST LED should light. If it does not light, depress TEST HEATER LED switch to verify that the LED is functioning. 4. Place the TEST HEATER toggle switch in the B position. Green HEATER TEST LED should light. If it does not light, depress TEST HEATER LED switch to verify that the LED is functioning. If the MRU test does not perform as described in each of the 4 steps above, GEHC strongly recommends that you stop using the system, and immediately call your GEHC representative. Customers with questions may contact their local service representative. For questions regarding this recall call 262-513-4122.

Digital  Health Space is carrying this announcement as an urgent medical device safety warning.  Further questions should be addressed to your local provider(s)

FDA medical safety alerts can be found