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Medicare coverage of evidence-based tobacco-cessation counseling expanded

BY Michael Johnsen

WASHINGTON The Department of Health and Human Services on Wednesday expanded Medicare coverage of evidence-based tobacco-cessation counseling, removing a barrier to treatment for all tobacco users covered by Medicare, the Centers for Medicare and Medicaid Services announced.

 

Before that decision, Medicare had covered tobacco counseling only for individuals diagnosed with a recognized tobacco-related disease or those who showed signs or symptoms of such a disease. Under the new coverage, any smoker covered by Medicare will be able to receive tobacco-cessation counseling from a qualified physician or other Medicare-recognized practitioner who can work with the smoker to help him or her stop using tobacco. All Medicare beneficiaries will continue to have access to smoking-cessation prescription medication through the Medicare Prescription Drug Program.

 

“For too long, many tobacco users with Medicare coverage were denied access to evidence-based tobacco-cessation counseling,” stated HHS secretary Kathleen Sebelius. “Most Medicare beneficiaries want to quit their tobacco use. Now, older adults and other Medicare beneficiaries can get the help they need to successfully overcome tobacco dependence.”

“Today’s decision builds on the existing preventive services that are available to Medicare beneficiaries,” added CMS administrator Don Berwick. “Giving older Americans and persons with disabilities who rely on Medicare the coverage they need for counseling treatments that can aid them in quitting will have a positive impact on their health and quality of life. As a result, all Medicare beneficiaries now have more help to avoid the painful — and often deadly — consequences of tobacco use.”

The new benefit will cover two individual tobacco-cessation counseling attempts per year. Each attempt may include up to four sessions, with a total annual benefit thus covering up to eight sessions per Medicare patient who uses tobacco.

Today’s final coverage decision will apply to services under Parts A and B of Medicare and does not change the existing policies for Part D, or any state-level policies for Medicaid or the Children’s Health Insurance Program. HHS will issue guidance in the coming months about a new benefit for pregnant women to receive Medicaid-covered tobacco-cessation counseling. This new benefit, a provision of the Affordable Care Act, requires states to make coverage available to pregnant Medicaid beneficiaries by Oct. 1.

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Georgia-Pacific Professional launches Spread Wellness campaign

BY Alaric DeArment

ATLANTA As the cold and flu season approaches, a paper company is launching a campaign to combat bad habits that contribute to the illnesses’ spread.

Georgia-Pacific Professional announced Wednesday the launch of its Spread Wellness campaign, designed to teach people proper techniques of washing and drying hands when away from home, especially after coughing and sneezing; according to a 2009 study by the Soap and Detergent Association, 39% of people seldom do so.

The campaign’s website, Spread-Wellness.com, includes links, tips and education materials. People also can sign up to become “Wellness Ambassadors” and receive a kit with a Spread Wellness wristband.

“With the easy transfer of germs and diseases, we all need to be more aware of our surroundings,” Georgia-Pacific Professional president Bill Sleeper stated. “We need to practice good hygiene habits ourselves and share these tips with those we interact with.”

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Medicare bid to simplify Part D program could shift many seniors, study predicts

BY Jim Frederick

WASHINGTON More than 3 million older Americans may have to switch to a different Medicare drug plan next year, a new study from health research and consulting firm Avalere Health revealed.

The study results, reported by the Associated Press, point to a potential snag in the Obama Administration’s plans for a smooth transition to a reformed healthcare system. According to Avalere and the AP, prescription drug plans serving more than 3 million Medicare Part D beneficiaries may be eliminated in 2011 after the Centers for Medicare and Medicaid Services completes a plan to cull redundant, higher-cost or less-efficient Part D plans from the federal drug benefit program for seniors.

That could force those seniors to choose a new plan, the AP reported, despite assurances from the White House during the long campaign to pass health-reform legislation that Americans could keep their current health plans if they chose to.

Avalere cited one instance where the change already is occurring. Medicare officials, according to the AP, already have notified such major prescription benefit management plans as CVS Caremark and the AARP that they must pare the number of drug plan options they offer Part D members. The goal is to simplify the dizzying array of choices available to Medicare beneficiaries in many regions of the country.

On the plus side, administration officials said, the change doesn’t mean seniors will lose coverage. And the elimination of redundant Part D drug plans — which number some 1,600 in total, according to the AP — also will reduce confusion among Medicare recipients and make it easier for newly eligible members to choose among a smaller array of coverage, cost and drug-formulary options.

Medicare also is trying to smooth the way to a more seamless transition for seniors who will be affected by the elimination of some plans, the AP reported, in part by automatically reassigning some beneficiaries to a similar plan offered by their insurer. The agency reportedly will unveil its approved list of Part D drug plans in late September, and the result, the AP indicated could be as much as a 25% reduction in the number of plans.

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