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Saturday, November 3, 2012

"Obama Administration Sits on Key Regulations"?

Obama Administration Sits on Key Regulations

Coral Davenport and Margot Sanger-Katz, National Journal
Updated: November 2, 2012 | 4:21 p.m.
November 1, 2012 | 9:28 p.m.

The Obama administration roared into office four years ago with an openly ambitious regulatory agenda, releasing a higher-than-usual number of major regulations in the first two years. In 2012, the number of new regulations has plummeted in a year in which the president's regulatory policies have emerged as a major campaign theme.

Federal agencies are sitting on a pile of major health, environmental, and financial regulations that lobbyists, congressional staffers, and former administration officials say are being held back to avoid providing ammunition to Mitt Romney and other Republican critics...
Well. Oops.

CMS Final Rules, released Thursday Nov 1st, and Friday Nov 2nd (destined for the Federal Register on Monday).

  •  42 CFR Parts 410, 414, 415, 421, 423, 425, 486, and 495 [CMS-1590-FC] RIN 0938-AR11 Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, DME Face-to-Face Encounters, Elimination of the Requirement for Termination of Non-Random Prepayment Complex Medical Review and Other Revisions to Part B for CY 2013 (1,362 pages)
  • 42 CFR Parts 416, 419, 476, 478, 480, and 495 [CMS-1589-FC] [RIN 0938-AR10] Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Electronic Reporting Pilot; Inpatient Rehabilitation Facilities Quality Reporting Program; Revision to Quality Improvement Organization Regulations (1,249 pages)
  • 42 CFR Parts 413 and 417 [CMS-1352-F] [RIN 0938-AR13[ Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Bad Debt Reductions for all Medicare Providers (301 pages)
  • 42 CFR Parts 409, 424, 484, 488, 489, and 498 [CMS-1358-F] [RIN 0938-AR18] Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2013, Hospice Quality Reporting Requirements, and Survey and Enforcement Requirements for Home Health Agencies (298 pages)
  • 42 CFR Part 438, 441, and 447 [CMS-2370-F] [RIN 0938-AQ63] Medicaid Program; Payments for Services Furnished by Certain Primary Care Physicians and Charges for Vaccine Administration under the Vaccines for Children Program (117 pages)
3,327 pages of Ambien replacement. End of the week prior to the Presidential election? In the wake of Superstorm Sandy to boot? Flush. No one's looking.

Still waiting on the HIPAA Omnibus Final Rule.

BTW, these from HHS/CMS were the only ones of interest to me. Most if not all other major federal agencies issued a raft of new regs as well during this dump.


Queens, NY, not far from where my ailing 88 yr old Aunt Edna (my late Mom's sister) lives.
From NPR:
Sandy Leaves Long List Of Health Threats
November 01, 2012

Public health officials are warning that people in areas devastated by Superstorm Sandy face many risks in the aftermath and are urging people to protect themselves from health threats in the water, air and even their refrigerators.

As millions of people try to put their lives back together, the most obvious threat is the floodwaters themselves. In many places, the water could be a toxic stew.

"Floodwaters potentially could contain mixtures of a variety of chemicals such as pesticides, paint, gasoline, you know other things for example that you might store in your garage or your basement that might actually get all flooded out," says Tina Tan, the state epidemiologist for the New Jersey Department of Health.

In several places, sewage-treatment plants have been paralyzed by fires or flooding. In these areas, bacteria and other pathogens might make people sick.

"That kind of shows up as nausea, vomiting, diarrhea and other symptoms related to gastrointestinal illnesses," Tan says.

These infections can be serious for babies, the elderly and people who are already sick.

But in the United States, contaminated floodwater rarely causes the kind of widespread disease outbreaks that can occur in less developed countries.

"In our recent history, we haven't really seen a lot of outbreaks that are associated with floods in general here but that doesn't mean we still shouldn't take caution," Tan says.

So officials are urging people to have as little contact with the water as possible. And if they have no choice, wear protective gear like boots, gloves and goggles.

"If for some reason you come into contact with floodwater — that there's floodwater that touches the skin — wash your hands with soap and clean water very often just to clean yourself of any sort of potential contaminant," Tan says.

In places where drinking water supplies may be contaminated, people have to boil their water for a minute before it's safe to drink...
In the immediate aftermath of the storm I reached out, first to my bi-state REC team, then to all of the ONC listed REC contacts, asking for any thoughts regarding how RECs in the non-affected areas might reach out to help with health IT.

As I put it in my email:
“There have to be significant HIT disaster impacts in NC, VA, WV, MD, DC, DE, NJ, PA, NY, CT, RI, MA (maybe all of New England to a degree). I don’t know that there’s anything we can do except to voice our support for RECs and their clients in the affected areas. 

Individually, yeah, we can donate more generally to the disaster relief organizations of our choice, and at the moment, shelter, clothing, food, potable water, and power are the priorities. But close on the heels of that will be a significant spike in health care needs (at a time of HIT adversity – not to mention ruined paper charts).”

“Open to ideas as to how we might be of assistance. Been a dicey 24 hours for me; I have family across the bull’s eye area from Metro DC to metro NY. I’m sure I’m not the only one at HealthInsight having this anxiety.”
I subsequently reached out to a vendor, one using a "cloud" based subscription model.


Last time I checked on the ONC HITRC prior to the weekend there was no mention of the storm or its health-related import whatsoever.

That sucks pretty significantly.

Maybe my REC will fire me for "exceeding your scope."

More shortly.

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