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Senate approves nomination of Mark McClellan for CMS administrator

This stuff doesn’t show up on their website anymore nor the Internet Archive, but it’s still on google cache.

Senate approves nomination of Mark McClellan for CMS administrator


This is G o o g l e’s cache of http://www.njamha.org/nationalupdateapril.htm as retrieved on 23 Jan 2005 07:24:05 GMT.

National Update: March/April 2004

Senate approves nomination of Mark McClellan for CMS administrator

On Friday, March 12, 2004, the U.S. Senate approved the nomination of Mark McClellan, MD, Ph.D., as the new Administrator for the Centers for Medicare and Medicaid Services (CMS). McClellan replaces Thomas Scully who resigned as CMS administrator in December 2003.

CMS is charged with administering health insurance programs for approximately 80 million poor, elderly and disabled Americans. As administrator of CMS, Dr. McClellan would oversee implementation of the new $534 billion Medicare Modernization law.

McClellan’s nomination has not been without some Congressional resistance, due mainly to McClennan’s position on prescription drug importation. As head of the U.S. Food and Drug Administration, McClellan was chiefly responsible for the FDA’s opposition to drug importation. A significant number of lawmakers are seeking the legality of drug purchases from Canada and other developed countries due to the high price tag of drugs in this country. In fact, the House of Representatives has already passed an importation bill.

It has been reported that the Senate nomination of Dr. McClellan resulted from his change in position regarding drug importation. After several senators vowed to hold up his confirmation over the issue, Dr. McClellan pledged that he would work with Congress on bipartisan legislation to ensure the safety of imported drugs.

FDA issues warning on antidepressant therapy

The U.S. Food and Drug Administration (FDA) issued warnings in March as part of a public health advisory about the dangers of prescribing antidepressants to children and adolescents for fear they may become suicidal in the first weeks of therapy or upon change in the dosage. The advisory asked makers of the 10 top-selling antidepressants to add bold-type warnings about the suicide risk that the pills carry. The agency said it is not yet clear whether these drugs actually spur suicide on occasion, but issued the warning anyway after a series of public hearings in which distraught family members of people who committed suicide while on antidepressants testified about the damage the drugs caused to their loved ones.

The warning on the suicide risks of popular antidepressant medications was based in part on the concern that physicians, particularly a growing number of non-psychiatrists, were over-prescribing the medications. A psychiatrist who served on the panel that advised the FDA on the warning said there was great concern that the majority of physicians were under the false belief that these drugs were completely safe.

Congress moving on FY 2005 budget resolutions

Debate over the Fiscal Year 2005 federal budget resolution continues on Capitol Hill. The House of Representatives adopted a bill in late March that would reinstate the Balanced Budget and Emergency Deficit Control Act of 1995, which requires Congress to offset new spending and tax cuts with savings in other areas. Meanwhile, the Senate passed a budget resolution that requires a 60-vote majority to make permanent the President’s 2001 and 2003 tax cuts. This provision was adopted after four Republicans broke ranks and voted with Democrats over the objection of the Senate’s Republican majority.

As reported by The New York Times (March 21, 2004), the House plan would reduce the federal budget deficit more quickly than the President’s proposal. It plans to do this mainly by cutting domestic discretionary programs including housing vouchers for the economically disadvantaged and block grants for child care assistance.

According to the National Mental Health Association, the budget plan adopted by the Senate “…still provides less funding for discretionary programs, including mental health programs, than the President’s budget. While the Senate accepted a Specter-Harkin-Collins amendment adding $1.3 billion for NIH funding, it rejected a Harkin-Feinstein amendment that would have increased public health program funding by $6 billion.”

Congressional leaders were unable to resolve the tax cut issue before Congress adjourned for its spring recess on April 1. A compromise plan being considered would restrict tax cuts but exempt some expected to be enacted this year. Also, any constraints seem likely to last for less than the five years recommended by the Senate. Any compromise along those lines would be seen as a retreat on the issue by both the White House and Republican Congressional leaders. Both have previously stated they would not restrict the tax cuts, which are the central part of the President’s economic strategy.

Federal officials push to control state Medicaid spending

New Medicaid rules that would provide the federal government with the ability to review state decisions on Medicaid spending were published in the January 7, 2004 Federal Register. The focus is on the sources of revenue used by states to cover their share of Medicaid costs. The proposed regulation would require the states to submit prior documentation to support the budget and expenditures information for the Medicaid program report.

In general, the federal government is looking for ways that states are using sources that circumvent the required state share of the federal Medicaid money they receive. Several governors have voiced strong opposition to this proposal stating it generates excessive paperwork and imposes new costs to states.

Secretary of the U.S. Department of Health and Human Services, Tommy Thompson, agreed to consult with states through the National Governors Association and the National Association of State Medicaid Directors. Thompson added that after consultation with these associations, he intends to re-publish the proposal in the Federal Register and allow for 60-day public comment.

Controversy over cost of Medicare prescription benefit

New information on the cost of the Medicare prescription drug benefit is causing an uproar in Congress. The Medicare program’s chief cost analyst, Richard S. Foster, claims he was forced to suppress a higher estimate for the cost of the Medicare prescription drug benefit by Thomas Scully, then administrator of the Centers for Medicare and Medicaid (CMS). Foster claims he estimated the program would cost $538 billion over 10 years, not the $395 billion that Congress was told it would cost by the White House and the Congressional Budget Office.

Questions began to be raised after the President included the $538 billion cost in his proposed FY 2005 budget. The Administration said the higher number reflected a more accurate counting of the number people who would take advantage of the benefit.

Foster claims he wanted to share his estimate with legislators, but was allegedly pressured not to reveal the higher number by Scully. Scully also allegedly threatened to fire Foster if he shared the higher cost estimate with Congress.

What had been expected to be a reelection year achievement for President Bush, has turned into a looming political disadvantage. Tommy Thompson, Secretary of Health and Human Services, has asked the department’s investigative office to look into the accusations.

The debate over the Medicare Modernization Act of 2003, passed late last year and signed into law by President Bush in December, was highly contentious. The final law passed by a single vote in the House of Representatives only after Republican leaders held the vote open longer than expected in order to convince fellow Republicans to support the bill. Those members, mainly ultra-conservatives concerned with the growing red ink in the Bush Administration’s budgets, as well as House and Senate Democrats have called for Congressional hearings on when this information was first known.

28 companies selected to provide Medicare drug discounts

Federal officials have selected 28 companies to provide drug discount cards to Medicare beneficiaries beginning this summer. The discount cards will cut retail prices by 10 percent to 25 percent, offering some relief to seniors who lack a prescription drug benefit through their existing Medicare coverage or private health insurance plan.

Sponsors of the cards, which will carry a federal seal of approval, will negotiate with manufacturers to obtain reduced prices, and will establish networks of pharmacies willing to accept the cards. Seventeen of the sponsors, which include units of Aetna, Medco Health Solutions, and United Healthcare, will market their cards nationwide, while the remainder will only be available in specific states or regions.

The Bush Administration has touted the discount cards as evidence that it is bringing relief to seniors sooner and the Medicare drug benefit as a major achievement of the Bush presidency. However, critics of the law, mainly Democrats, say the cards will provide little actual relief because many large drug manufacturers have recently raised the prices of the drugs most commonly used by seniors. Democrats have railed against Medicare reform since the day it passed Congress, calling a gift to the pharmaceutical and insurance industries.

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