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HealthBiz: Bill mandates sprinkler systems

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WASHINGTON, Aug 24, 2004 (United Press International via COMTEX) -- Two nursing home fires in 2003 -- in Connecticut and Tennessee -- that killed 31 people inspired federal legislation that would require nursing homes to install automatic fire sprinkler systems and have the government pay for them.

Hal Daub, president of the American Health Care Association, the industry group representing more than 10,000 U.S. long-term care facilities, told a telebriefing his group asked the National Fire Protection Association, which publishes safety codes the Centers for Medicare and Medicaid Services uses in regulating nursing homes, to include an amendment in its 2006 code to mandate automatic sprinkler systems.

That has been done and Rep. John Larson, D-Conn., said Tuesday he was sponsoring the Nursing Facility Fire Safety Act of 2004, which would give nursing homes five years to install systems and full financial reimbursement from CMS.

The Government Accountability Office in July issued a report critical of nursing home fire regulations that said, "Cost has been a barrier to CMS requiring sprinklers for all older nursing homes even though sprinklers are considered to be the single most effective fire protection feature."

Larson said he "recognized the responsibility the federal government has" in paying for the systems because 80 percent of nursing home care is paid for by Medicaid and Medicare -- and reimbursement levels, at least from Medicaid, already are $11.55 per patient, per day less than the actual cost of care.

Larson said about 24 percent or "4,080 homes ... have no form of automatic fire sprinkler system" in the United States.


It is part domestic, part international, but the government's Health Resources and Services Administration is targeting the U.S.-Mexican border in its HIV/AIDS treatment efforts.

Elizabeth Duke, administrator of the agency that is part of the Health and Human Services Department, Monday told the second Grantee Conference, part of the Ryan White CARE Act Clinical Conference in Washington, since Congress has given HRSA the authority to work internationally "we have targeted all of HRSA's resources to improvements along the border."

The U.S.-Mexican border is 2,200 miles long and Duke said "if that area were a state of the union, across the board, it would have the worse health statistics in the nation."

In October HRSA will meet with the U.S. Mexican Border Health Commission and officials with Mexico's public health system to develop plans to provide HIV/AIDS services on both sides of the borderline.

More than 2,200 people are at the CARE conference this week, representing hospitals, clinics, public health, academia and others in the HIV/AIDS community. The Ryan White Comprehensive AIDS Resources Emergency Act or CARE Act provides primary care and services to more than 533,000 low-income patients each year -- 90 percent of whom do not have private health insurance.


Hospitals and physicians appear to have had the upper hand in Milwaukee -- negotiating contract terms with insurers that helped make healthcare spending there the 16th highest among 239 metropolitan statistical areas, according to the Government Accountability Office.

The GAO -- formerly the General Accounting Office -- investigated Milwaukee's healthcare prices for 2001 in the Federal Employees Health Benefits Program, at the request of Rep. Paul Ryan, R-Wis. The FEHBP, which contracts with private insurers, covers 8.5 million federal workers and often is touted as a potential future model for expanding coverage in Medicare and to the uninsured.

"Some stakeholders asserted that high spending and prices were caused in part by the leverage exerted by provider networks in Milwaukee, which limited insurers' ability to control the prices they pay," the GAO said in its report. "This assertion was supported by our examination of indicators of the relative strength of providers and payers."

The GAO found health spending in Milwaukee was about 27 percent higher than the average across all of the MSAs in the study. Inpatient prices were 63 percent higher than average hospital inpatient prices and physician prices were 33 percent higher than the average across 319 MSAs in the analysis.

"Stakeholders described highly consolidated provider networks in Milwaukee that included both hospitals and physicians," the GAO reported. "Insurers contended that they had to contract with multiple hospital networks because of consumers' demands for access to their local hospitals and to ensure enrollees had the ability to use hospital services across Milwaukee. Insurers further asserted that because they had to contract with multiple networks, this restricted their ability to direct enrollees to specific networks for care, thereby limiting insurers' leverage to

negotiate lower prices for healthcare services with providers in exchange for a larger share of the insurers' business."

Ryan told a news conference Monday in Milwaukee the report "is a good starting point for an honest dialogue about the best ways to lower costs and strengthen the hand of consumers in our region."


The problem many people have with flexible spending accounts for healthcare is if the money is not spent by the end of the year, they lose it.

"That doesn't make sense," Sen. Chuck Grassley, R-Iowa, chairman of the Senate Finance Committee, said in a statement this week that accompanied a letter to the Treasury Department urging the policy be eliminated.

The letter, to Treasury Secretary John Snow, said the department has the administrative authority to rewrite the use-it-or-lose-it rule.

"I believe that there are strong policy justifications for taking such action. First and foremost, I am aware of no other area of benefits law in which we allow -- let alone mandate -- that employee dollars set aside for benefit expenses revert back to the employer. The current rule unjustly enriches employers at the expense of hard-working employees who participate in FSAs," the letter said.



Copyright 2004 by United Press International.


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