Medicare May Help Seniors If Advantage Plans Drop Doctors

Next year, seniors with private Medicare Advantage insurance policies whose doctors leave their plan may be able to leave, too, under a new Medicare rule. The Centers for Medicare & Medicaid Services (CMS), which oversee Medicare Advantage programs, will create a special three-month enrollment period in any state where insurers make network changes “considered significant based on the affect or potential to affect, current plan enrollees,” according to an update to Medicare’s Managed Care Manual. The special enrollment period – if granted by CMS – would allow Medicare Advantage members to switch out of their plans and join traditional Medicare or another Medicare Advantage plan whose provider network includes their doctors. The mid-year special enrollment period wasn’t an option in 2013 when more than 32,000 UnitedHealthcare Medicare Advantage members in Connecticut were affected by the company’s decision to drop thousands of doctors from its network of providers. The Fairfield County Medical Association sued the company to stop the terminations but was ultimately unsuccessful.

View “Beyond Pink” Breast Cancer Forum

Thanks to the CT-N Connecticut Network, C-HIT’s women’s health forum —  “Beyond Pink: New Frontiers In Screening, Treating & Preventing Cancer” — is available on demand. C-HIT’s Oct. 21 forum featured a panel discussion by leading breast cancer experts: Dr. Anees Chagpar, the head of the Breast Center – Smilow Cancer Hospital at Yale-New Haven, Dr. Kristen Zarfos, a surgeon at the Hospital of Central Connecticut, and Dr. Regina Hooley, a Yale radiologist. They were joined by U.S. Rep. Rosa DeLauro. To view the video, click here.

C-HIT, Yale Breast Center Team Up For Unique Forum, Oct. 21

US Rep. Rosa DeLauro and leading breast cancer experts from The Breast Center-Smilow Cancer Hospital at Yale-New Haven and the Hospital of Central Connecticut will be the featured panelists at a unique community forum organized by the Connecticut Health I-Team (www.c-hit.org), a non-profit news service that provides in-depth coverage of health care issues. The forum – “Beyond The Pink Ribbon: New Frontiers In Screening, Treating and Preventing Cancer” – will focus on the latest inroads and challenges in breast cancer detection and treatment. The event is open to the public, and early registration (at www.c-hit.org) is encouraged. Proceeds from ticket sales will benefit The Breast Center – Smilow Hospital and C-HIT’s ongoing health journalism. Speakers include: Dr. Anees Chagpar, director of The Breast Center – Smilow Cancer Hospital at Yale-New Haven, who led the effort for Yale to become the first NCI designated Comprehensive Cancer Center in the Northeast to have a nationally accredited breast center; Dr. Regina Hooley, a radiologist and researcher at the Yale Cancer Center who specializes in ultrasound screening, mammography and breast density; and Dr. Kristen Zarfos, a renowned surgeon and women’s health specialist at the Hospital of Central Connecticut who led a successful grassroots campaign to ban “drive-through” mastectomies in Connecticut.

DeLauro Tells USDA: Remove Tainted Poultry From Stores

US Rep. Rosa L. DeLauro today introduced legislation to guarantee that contaminated meat, poultry and egg products are taken off the market. The 3rd District Democrat said that the U. S. Department of Agriculture (USDA) has failed to recall some tainted food because it claims it doesn’t have the authority to do so under current law. “We need federal agencies that will protect public health, not bend to the threats of deep-pocketed food producers seeking to escape regulation,” DeLauro said, in a statement with Rep. Louise M. Slaughter, a New York Democrat, who is the bill’s co-sponsor. They pointed out that the USDA failed to recall chicken produced by California-based Foster Farms, despite a salmonella outbreak over the past year that got more than 600 people sick and resulted in some 240 hospitalizations. This is double the amount of hospitalizations in a typical salmonella outbreak, according to DeLauro, a member of the House Agriculture Appropriations subcommittee.

NIH Move On Gender Disparities Hailed As Breakthrough

A move by the National Institutes of Health (NIH) to eliminate a gender bias in basic research will lead to improvements in medical care for both men and women, says the director of Women’s Health Research at Yale. “The NIH plan to change the longstanding, inadequate representation of females in animal models and laboratory research with cell lines is essential to gaining an understanding of gender differences in human health and disease,” Carolyn M. Mazure, director of Yale’s center on women’s health, said in response to changes announced this week by the NIH. “Gender differences affect risk, onset, prevalence and/or response to treatment in numerous important areas, including cardiovascular disease, autoimmune disorders, substance abuse and a host of other health conditions,” she said. Mazure was reacting to an NIH announcement this week that it is developing policies to require all medical researchers that it funds to use a balance of male and female cells and animals for all future preclinical research. The NIH already has pushed researchers to include adequate numbers of women in clinical trials.

Feds Issue Rules To Protect Seniors Enrolled In Medicare Advantage Plans

UnitedHealthcare’s decision last fall to drop thousands of doctors from its Medicare Advantage plans in Connecticut and across the country has spurred Medicare officials to improve protections for seniors who lose their doctors. The new measures were announced late Monday along with a slight increase in next year’s payment rates to Medicare Advantage insurers who provide policies as an alternative to the traditional government-run Medicare program. Nearly 16 million older Americans have enrolled in a Medicare Advantage plan, including more than 147,000 in Connecticut, which requires members to get treatment only from a network of health care providers. They cannot change plans during the year if their doctor leaves their network. The new rules require insurers to provide at least 90 days advance notice of significant changes in their provider networks and allow members to switch plans under certain circumstances.

CT Breast Density Screening Law May Set National Standard

Nancy Cappello wants all women to receive the same opportunities for breast cancer screening that women in Connecticut have had for years. Cappello, who worked for passage of the state’s 2009 breast density notification law, has taken her cause nationally – advocating for similar legislation in every state and lobbying policymakers in Washington D.C.

Connecticut’s law — the first of its kind in the country — requires radiologists to inform women who undergo mammography if they are diagnosed with dense breast tissue, a condition known to obscure cancer detection. These “inform” reports must reference potential benefits of supplemental screening such as an MRI or ultrasound. So far, 11 states have followed Connecticut’s lead by passing similar laws. According to data collected in Connecticut, ultrasounds have detected breast cancers that mammograms missed.