News in Brief: Week of March 24-28

March 26, 2014 04:00 pm News Staff

This roundup includes the following news briefs:

AAFP Recommends Hepatitis C Screening for Baby Boomers

The AAFP has agreed with the U.S. Preventive Services Task Force (USPSTF) recommendation(www.uspreventiveservicestaskforce.org) that screening for hepatitis C virus (HCV) infection should occur in people at high risk for infection. In addition, says the AAFP, a one-time screening should be performed for all adults born between 1945 and 1965. The AAFP delayed its response to the original USPSTF June recommendation so that this "birth-cohort approach" could be reviewed.

"We (the USPSTF) got a lot of public comments (on the draft recommendation), and many of them suggested that risk-based screening would essentially be a greater burden (to those doing the screening) than a birth-cohort approach, at least for that age group," said USPSTF Co-vice Chair and family physician Michael LeFevre, M.D., M.S.P.H., of Columbia, Mo., in a past AAFP News story. "Even though the birth cohort doesn't have as high an incidence of people identified as those identified as high-risk, the downsides seem to be outweighed more significantly by the benefits in the context of an improved link between treatment and outcomes."

Clinical considerations related to the HCV screening update(www.uspreventiveservicestaskforce.org) can be found on the USPSTF website.

Individuals Granted Extension to Complete Insurance Enrollment

The Obama administration announced this week that it will allow more time for individuals to enroll in a health insurance plan if they began the application process via a federally run marketplace but were unable to finish by the March 31 deadline. Initially, government officials had said there would be no extensions to the March deadline outlined by the Patient Protection and Affordable Care Act.

The grace period is a way to provide flexibility to people who may not have been able to finish the process because of technical problems with the Healthcare.gov website or communication gaps between the insurance marketplaces and insurance companies. Officials at HHS were concerned that a surge of last-minute applications could destabilize the site.

No specific cutoff date for the extension was given, but CMS is expected to announce guidelines explaining what circumstances will be permitted before an extension is formally granted.

Several states that are operating their own insurance exchanges already have extended the enrollment deadline. It's worth noting that the upcoming deadline applies to the 2014 open enrollment period. After the deadline passes, most individuals will not be able to sign up for insurance until November.

Evidence Is Insufficient to Recommend Screening for Dementia in Older Adults

The AAFP concurs with the U.S. Preventive Services Task Force (USPSTF) on its March 24 recommendation(www.uspreventiveservicestaskforce.org) that there is insufficient evidence to determine the effectiveness of screening older adults for cognitive impairment.

Dementia in the United States affects 5 percent of people ages 71-79, increasing to 24 percent in those 80-89 and to 37 percent in those 90 or older, according to the USPSTF recommendation statement.

Physicians should continue to observe for early signs or symptoms of cognitive impairment (e.g., memory or language problems), especially in response to concerns expressed by a caregiver, and evaluate as appropriate.

In addition to its clinical recommendation regarding screening for dementia, the AAFP offers a dementia Q&A document(familydoctor.org) at FamilyDoctor.org. The National Institute on Aging offers a database resource of tools(www.nia.nih.gov) to detect cognitive impairment, as well.

Telemedicine Organization Urges HHS, CMS to Waive Restrictions

The American Telemedicine Association (ATA) recently urged the federal government to waive restrictions on telemedicine that prevent Medicare-participating health care professionals who are paid through alternative payment models, such as accountable care organizations (ACOs), from using telehealth technology.

In a March 5 news release(www.americantelemed.org), the ATA pointed out that language in the Patient Protection and Affordable Care Act specifically created several value-based payment models, including ACOs, bundled payments and medical homes, to improve care coordination and reduce health care costs.

In separate letters to HHS Secretary Kathleen Sebelius and CMS Administrator Marilyn Tavenner, the ATA argued that without the telemedicine waivers, physicians would lack all the necessary tools needed to provide their patients with high-quality and low-cost comprehensive care.

ONC Issues Correction to Proposed EHR Rule

HHS' Office of the National Coordinator (ONC) for Health IT has corrected portions of a proposed rule covering the 2015 edition of electronic health record (EHR) certification criteria originally published in the Feb. 26 Federal Register(www.federalregister.gov).

In a correction notice published on March 19(www.gpo.gov), the ONC corrected the preamble text and gap certification table for four certification criteria that were omitted from the list of certification criteria eligible for gap certification for the 2015 Edition EHR certification criteria. The correction also provided information on inactive Web links that appeared in the original proposed rule.

Comments about the proposed rule will be accepted until April 28; the final rule is due in the third quarter of 2014.


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