Friday, August 19, 2011

Tuesday, February 1, 2011

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Friday, January 28, 2011

States May Face Showdown With Feds Over Cutting Medicaid Rolls - Kaiser Health News

States May Face Showdown With Feds Over Cutting Medicaid Rolls - Kaiser Health News

Jan 28, 2011

Financially strapped governors, Congress and the Obama administration could be headed for a showdown over the Medicaid health care program that covers 48 million poor, disabled and elderly people nationwide.

Arizona's governor has already asked for permission to drop people from the joint federal-state program, which states say is eating up huge portions of their budgets. But to do so, they need the green light either from Congress or the Obama administration.

If they don't get one? States warn they may need to slash payments to doctors and hospitals and make deep cuts in other programs such as education. They could even thumb their nose at the law and cut eligibility, which would force the Obama administration to decide whether to cut all federal Medicaid funding to those states.

The new health care law requires states to maintain their Medicaid eligibility levels for adults until 2014, when much of the law kicks in. In the meantime, federal funds that helped most states maintain their Medicaid programs – part of the 2009 stimulus package --comes to an end in June, even as enrollment remains at an all-time high while the nation struggles to recover from the recession.

Republicans in the House generally want to allow states more leeway, but their only hope is to get some members of the Democratic-controlled Senate on board.

Sen. Max Baucus, D-Mont., who chairs the Senate Finance Committee, said in an interview he is aware that states are under pressure to cut eligibility and that he will "look at" options. Still, he said, any such effort should "find a way to maintain as much coverage as we can."

He and other Democrats, including Iowa Sen. Tom Harkin, chairman of the Health, Education, Labor and Pensions Committee, and House Minority Leader Nancy Pelosi of California, said they would like to extend the expiring Medicaid aid until 2014.

The odds are against making such a move. Republicans have complained bitterly about the stimulus funding. Now that they control the House, they’re stressing the need to narrow the ballooning federal budget deficit.

Arizona, which says its Medicaid spending has gone from 17 percent of its general fund in 2007 to nearly 30 percent this year, recently asked the administration for permission to drop coverage for 280,000 Medicaid recipients. The state argues it's already more generous than most states – it's one of only 7 states that cover childless adults -- and says Medicaid costs are jeopardizing other priorities.

Other states also are likely to seek waivers. "The states are reaching a crisis point fiscally," said Dan Mendelson, CEO of Avalere Health, a consulting firm. Still, allowing states to drop coverage "runs directly counter to the goals" of the Obama administration, he said, adding that it would lead to "an erosion of coverage before the next (presidential) election."

Earlier this month, the National Governors Association and the Republican Governors Association urged congressional leaders to let them downsize their programs. Matt Salo, director of the Health and Human Services Committee at the NGA, said that some governors’ staff members are warning congressional offices that, unless they get help, they might have to ignore the law and change their eligibility rules anyway.

If that occurred, the federal government would have to decide whether to stop sending Medicaid money to those states. Even without the extra stimulus aid, the federal government, on average pays 57 percent of the cost of the joint program; in some states it is as much as 75 percent.

The health law – and the stimulus program – both require states to maintain eligibility, just as do other agreements between the states and Congress where matching federal funds are involved. Without such rules, there "isn’t a mechanism that the states will use funding the way it is intended by Congress," says Mendelson. "States have taken a lot of federal money over the past couple of years with strings attached and these are the strings."

Under the law, Medicaid will expand sharply in 2014 when 16 million more people are expected to become eligible for the program. The federal government will pick up the full tab for the newcomers for the first three years. By 2020, the federal share ratchets down to 90 percent.

When asked whether he would support loosening the eligibility rules for states, Donald Berwick, the administrator for the federal Centers for Medicare and Medicaid Services, said that he was sensitive to the states’ situation. His solutions, however, were to point states to funding that he said is already available to them, such as subsidies to establish insurance exchanges. Moreover, he added, his agency plans to make recommendations to states on ways to lower costs by improving care. One example is reducing hospital admissions, said Cindy Mann, director of the federal Center for Medicaid and State Operations.

Democrats in Congress have additional ideas, but most have little chance of moving forward because they go against Republican priorities of reducing federal spending and control.

Harkin, for example, said he also plans to look into an idea that has surfaced in the past to turn Medicaid over entirely to the federal government. "Maybe the federal government should take over the whole thing, and in exchange states would do other things," he said.

Mendelson points to another past proposal for the federal government to pick up the nursing home costs for Medicaid enrollees who are also eligible for Medicare, the federal health program for the elderly.

The elderly and disabled account for the majority of Medicaid spending, with a good chunk of that being used for long term care. Medicaid payments represent 40 percent of all nursing home spending, according to the Kaiser Commission on Medicaid and the Uninsured. (KHN and the Kaiser Commission on Medicaid and the Uninsured are both part of the Kaiser Family Foundation.)

While AARP's state policy director JoAnn Lamphere says the idea is "intriguing," it is "a long term policy discussion that not going to save the states right now."

Thursday, January 27, 2011

Alcohol Prep made in the Good Ol USA. Finally. Lets use this one.

Link here to go to an alcohol prep made in the USA. 

Pregenics and Pfizer warning on Alcohol Preps.

NEW YORK — Progenics Pharmaceuticals Inc. and Pfizer Inc. said Tuesday they are warning physicians and patients not to use the alcohol prep pads that come with its Relistor injection kits because the pads have been recalled by their manufacturer.
Relistor is an injectable drug that is used to treat constipation in patients who are on opioid pain medications. The drug is sold in individual vials, as well as in kits that include vials, syringes, and alcohol prep pads that are swiped over the skin to clean the site for injection. The prep pads are made by Triad Group Inc., and earlier this month, Triad recalled all its alcohol prep pads, swabs, and swab sticks because one of its customers was concerned that the products were contaminated with bacillus cereus, a bacterium that can cause food-borne illnesses.
The contamination could cause life-threatening infections, Triad said. So far, it has received one report of a non-life-threatening skin infection.
Progenics and Pfizer said doctors and patients who have the Relistor kits should use a different alcohol pad or a sterile gauze pad with the injection. The kits remain on the market, but shipments of new kits have been suspended until all the pads can be replaced. Triad's pads are not included in Relistor single-vial kits or in any Relistor kits sold outside the U.S.
Triad's recall started Jan. 5. Its alcohol pads were sold in the U.S., Canada, and Europe under Triad's name, and under third-party brands including CVS, Walgreens, Cardinal Health, PSS Select, and others.
Relistor is approved for use in patients with advanced illnesses who are receiving specialized care to reduce the pain of their illness. Progenics sold the drug through a partnership with Wyeth, but Wyeth ended the collaboration as it was being acquired by Pfizer in late 2009. Progenics is trying to get additional market approvals to bolster sales of the drug, which totaled $4.1 million in the third quarter of 2010.
Shares of Progenics, which is based in Tarrytown, N.Y., fell 2 cents to close Tuesday at $6.04. Shares of New York-based Pfizer rose 2 cents to finish at $18.47.

Living with Hemophilia Today: Triad alcohol prep pads with ARIXTRA Starter Kits ...

Living with Hemophilia Today: Triad alcohol prep pads with ARIXTRA Starter Kits ...: "Triad alcohol prep pads with ARIXTRA Starter Kits not to be us If you take Arixtra. Please take note of this."

Triad alcohol prep pads with ARIXTRA Starter Kits not to be used

Triad alcohol prep pads with ARIXTRA Starter Kits not to be us

If you take Arixtra. Please take note of this.

Tuesday, January 18, 2011

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